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JOURNAL OF
EXPERIMENTAL
MEDICINE
SELECTED ARTICLES APRIL 2015 www.jem.org
INNATE IMMUNITY
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Welcome
I n n a t e I m mu n i t y
The Journal of Experimental Medicine now prints topic-specific mini collections to showcase a handful
of our recent publications. In this installment, we highlight papers focusing on two innate cell subsets,
dendritic cells and macrophages in health and disease.
Immunotherapy has proven successful in many types of cancer treatment, but has also been
associated with dangerous inflammatory responses in some patients. Our collection begins with
an insight by Merghoub and Wolchok discussing the findings of Mirsoian et al. who show that
lethal inflammation in response to anti-CD40 and IL-2 immunotherapy is triggered by increased
inflammatory macrophages in the accumulated visceral fat of aged mice. Similarly, young obese
mice succumbed to treatment while older mice on diets were protected.The study highlights factors
to be considered with use of immunotherapeutics.
In the gut, the immune system must balance recognition of infectious pathogens with minimal responses to commensal
bacteria. An Insight by Giorgio Trinchieri describes these immune challenges and the findings from Longman et al. showing that
in both mice following Citrobacter rodentium infection and in patients with colitis, CX3CR1+ mononuclear phagocytes (MNPs)
are potent producers of IL-23 and IL-1b. The production of these cytokines by MNPs efficiently induces IL-22 production by
group 3 innate lymphoid cells to promote barrier integrity and mucosal protection.
Lambrecht and Guilliams examine genetic fate mapping of myeloid cells that distinguishes macrophages derived from
embryonic precursors vs. circulating monocytes. They highlight the contribution to macrophage biology from Molowi et al.
reporting that cardiac macrophages are initially of embryonic origin, but are progressively replaced by monocyte-derived cells as
mice age. They speculate about how manipulation of different macrophage populations could be used in therapeutics.
Myelin destruction in multiple sclerosis (MS) is mediated by inflammatory macrophages, but the origin of these cells has been
unclear. An Insight from Michael Heneka discusses findings from Yamasaki et al., who use a mouse model of MS to distinguish
tissue-resident microglial cells from infiltrating monocytes. Using double chemokine reporter mice, the authors find that
monocyte-derived macrophages initiate myelin destruction, mainly in the nodes of Ranvier, while microglia-derived macrophages are
involved with clearing debris.
Two papers from the Liu and Nussenzweig groups track the differentiation of human progenitor cells into dendritic cells
(DCs). They show that a granulocyte/monocyte/DC progenitor gives rise to a monocyte-DC progenitor that in turn generates
both monocytes and a common DC progenitor. The common DC progenitor produces the three major subsets of human DCs,
such as CD1c+ cDCs, CD141+ cDCs and pDCs. They go on to identify the immediate precursor of CD1c+ and CD141+ DCs
in the circulation of healthy donors. These precursor cells (hpre-cDC) were detectable in cord blood, bone marrow, blood, and
peripheral lymphoid organs. An Insight by Frederic Geissmann describes the novel in vitro culture system used in the studies to
parse out the development of human DCs as well as a discussion of the developmental similarities between mouse and human DCs.
Together these studies characterize the many roles and functions of innate immune cells. We hope you enjoy this
complimentary copy of our Innate Immunity collection. We invite you to explore additional collections at www.jem.org
and to follow JEM on Facebook, Google+, and Twitter.
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Print ISSN 0022-1007 Online ISSN 1540-9538
INSIGHTS
Immunotherapy and the belly of the beast
Immunotherapy has emerged as an effective means to restore immune recognition of cancer.
Numerous forms of immunotherapy are currently being explored clinically. The most common are
vaccines (dendritic cell, viral, and whole tumor cell based), adoptive T cell therapy and immune
checkpoint blockade. The recent successes in melanoma, renal cancer, and lung cancer have generated renewed optimism for treatment of multiple cancer types that were believed not amenable to
immune-based therapies. However, immune-related events such as colitis, dermatitis, and, less
frequently, endocrinopathy and pneumonitis have been reported and can be a challenge in the
clinical use of these approaches. Cytokine release syndrome has been reported in the case of CAR Insight from Taha Merghoub (left)
(chimeric antigen receptor) T cell therapy and treatment with agonist antibodies. In this issue,
and Jedd Wolchok (right)
Mirsoian et al. provide evidence that adiposity in aged mice induces a lethal cytokine storm following systemic administration of stimulatory immunotherapy consisting of anti-CD40 agonist antibody with IL-2.
This is an elegant follow up to a previous study by the same authors in which they showed that systemic immunotherapy administration in aged mice resulted in the induction of a rapid and lethal cytokine storm. In the current paper, they find that it is the fat that
accumulates during aging, and mainly the visceral fat, that is associated with toxicity. This results in increased levels of proinflammatory
M1 macrophages within the peritoneal cavity and visceral adipose tissues, leading to heightened production of TNF. In order to confirm that it is indeed the fat that is associated with
lethal effects, the authors repeated their studies in young mice
with genetic (ob/ob) or diet-induced obesity (DIO). While
young obese mice also displayed severe toxicity to the therapy,
it was much more severe in older mice suggesting that age is
also a significant factor. Reciprocally, calorie-restricted aged
mice had lower visceral body fat content and reduced cytokine
levels, with increased survival following immunotherapy.
Obese mice were also protected by macrophage depletion or
TNF blockade. These data demonstrate the need to consider
age and body fat content as variables in preclinical assessment
of therapeutics and when modeling diseases such as cancer.
Since many cancer patients fall into the elderly category,
this study brings up a critical point that aged mice respond differently to immunotherapy than younger mice. This also
highlights an important issue when considering potential toxicities associated with any therapy, as most animal studies are
performed in young, healthy mice. Another interesting point
is the potential impact of body mass index and adipose accumulation in predicting side effects when investigating and utilizing immunotherapies. This is a very important and impactful
The Murphy group previously showed that immunotherapy with anti-CD40
finding for the field, and further investigations in tumor bearand IL-2 leads to a productive immune response in young mice (A) but
ing mice with commonly used therapies are warranted. If the
lethal cytokine storm in older mice (B). They now find that the visceral fat
findings are confirmed in other therapeutic settings, the incluthat accumulates in aged mice (or young obese mice) is the primary trigger
sion of supportive measures, such as TNF blockade, should
of inflammation after immunotherapy, resulting in increased inflammatory
continue to be considered for early management of immuneM1 macrophages and toxic cytokine storm (B). Immunotherapy-induced
related toxicities to improve clinical outcomes.
lethality was prevented by blocking TNF or depleting macrophages
(B). Whether the success of immunotherapy in the treatment of tumorbearing mice will also be impaired by obesity remains to be determined.
Taha Merghoub and Jedd D. Wolchok, Memorial Sloan Kettering Cancer Center: merghout@mskcc.org and wolchokj@mskcc.org
2
Article
Aging is a contributing factor in cancer occurrence. We recently demonstrated that systemic immunotherapy (IT) administration in aged, but not young, mice resulted in induction
of rapid and lethal cytokine storm. We found that aging was accompanied by increases in
visceral fat similar to that seen in young obese (ob/ob or diet-induced obese [DIO]) mice.
Yet, the effects of aging and obesity on inflammatory responses to immunotherapeutics are
not well defined. We determine the effects of adiposity on systemic IT tolerance in aged
compared with young obese mice. Both young ob/ob- and DIO-generated proinflammatory
cytokine levels and organ pathologies are comparable to those in aged ad libitum mice
after IT, culminating in lethality. Young obese mice exhibited greater ratios of M1/M2
macrophages within the peritoneal and visceral adipose tissues and higher percentages of
TNF+ macrophages in response to CD40/IL-2 as compared with young lean mice. Macrophage depletion or TNF blockade in conjunction with CD40/IL-2 prevented cytokine
storms in young obese mice and protected from lethality. Calorie-restricted aged mice
contain less visceral fat and displayed reduced cytokine levels, protection from organ
pathology, and protection from lethality upon CD40/IL-2 administration. Our data demonstrate that adiposity is a critical factor in the age-associated pathological responses to
systemic anti-cancer IT.
CORRESPONDENCE
William J. Murphy:
wmjmurphy@ucdavis.edu
Abbreviations used: AL, ad
libitum; ALT, alanine amino
transferase; CR, calorie restricted;
DIO, diet-induced obese; HD,
high dose; IT, immunotherapy;
LD, low dose; MRI, magnetic
resonance imaging.
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Ar ticle
mice (Fig. 1, G and I).These results indicate that aged mice are
not only heavier and larger in size but that these size differences
are attributed to increases in adipose tissue accumulation.
Adipose tissue is widely published to be a highly active
metabolic organ with immune modulatory capabilities. To
address whether in our aged AL-fed mice, who were allowed
to freely access food, the increased adiposity noted was con
tributory toward the development of IT-induced toxicities in
the aged, we aimed to determine the effects of IT administra
tion into an aged calorie-restricted (CR) cohort. CR mice are
placed on a food restriction diet beginning at 14 wk of age
and maintained throughout life. To ensure that age-matched
CR aged mice contained a decreased accumulation of body
fat in comparison with aged AL mice, we quantified total body
weight and visceral fat through MRI (Fig. 1, H and I). CR
mice weighed significantly less than AL aged mice and exhib
ited a decreased presence of visceral adiposity to levels that
JEM Vol. 211, No. 12
Figure 2. Calorie restriction in the aged confers protection by decreasing cytokine levels and IT-associated organ pathology, thereby
allowing increased survival during IT. (AC) Aged AL and age-matched aged CR mice (18 mo) were treated with HD CD40/IL-2 or rIgG/PBS; at day 2
of IT, mice were sacrificed for histological analysis of livers (A) and intestines (C). Serum was collected on day 2 and assessed for ALT (B) levels, n = 3 mice/
group. Representative H&E images of liver and intestines (gut) for aged AL and aged CR groups. Bars, 200 m. Asterisks represent steatosis and arrows
denote areas of severe immune infiltration and/or necrosis. (DF) Serum was analyzed day 2 after treatment for TNF (D), IL-6 (E), and IFN- (F). (G) Aged
(18 mo) C57BL/6 mice on AL or CR diet were treated with either LD or HD of CD40/IL-2 and survival was monitored. Control groups received rIgG/PBS.
All data panels are representative of one of four independent experiments with similar results for all panels. Survival analysis was plotted according to
the Kaplan-Meier method and statistical differences were determined by using the log-rank test. Bar graph (mean value SEM) statistics were performed
using one-way ANOVA with Bonferroni post-hoc test. ****, P < 0.0001; ***, P < 0.001; **, P < 0.01.
Ar ticle
that young ob/ob mice have higher total body fat content that
is similar in accumulation to the aged mice, being deposited
largely in the intra-abdominal cavity, in comparison with young
AL mice (Fig. 3 B).
To determine if adiposity could solely induce toxic con
sequences in aged AL, young ob/ob and age-matched young
AL mice were treated with HD IT and at day 2 of treatment
analyzed for the presence of immune-mediated organ patholog
ical changes within the liver and intestines (Fig. 3, C and D).
IT resulted in mild inflammatory infiltrates in young AL mice
but resulted in moderate to severe inflammation in the ob/ob
mice, which was comparable to the aged within the intestines
(Fig. 3 D).Yet, analysis of IT-induced liver pathology was hin
dered by the presence of extensive steatosis in ob/ob mice, re
sulting in a paradoxical interference in determining the intensity
of immune-mediated inflammatory liver damage (Fig. 3 C).
IT resulted in both the intestines and liver displaying the most
immune-mediated inflammatory damage within the ob/ob that
JEM Vol. 211, No. 12
Figure 4. IT toxicity is TNF-dependent through M1 macrophage accumulation. (AD) Young (2 mo) WT and young (2 mo) ob/ob mice were
treated with either control rIgG/PBS or LD CD40/IL-2. Visceral adipose tissue and peritoneal lavages were collected on day 2 and assessed for the presence of macrophages identified as CD45+CD19F4/80+CD11b+. Ratio of M1/M2 macrophages (A), and total numbers (B) and percentages (C) of TNFproducing macrophages. Macrophages identified as M1 macrophages were characterized as CD206; M2 macrophages were gated as CD206+. (EH)
Young AL (2 mo) and young ob/ob (2 mo) were treated with either control or macrophage depleting clodronate liposomes before and during LD CD40/IL-2
and survival was monitored; n = 5 mice/group. (F and G) On day 2, visceral adipose tissues and peritoneal lavages were collected and assessed for the
percentages TNF+ macrophages (F and G) as characterized in experiments in AD and serum TNF levels (H), n = 4 mice/group. (IL) Young AL (2 mo) and
young ob/ob (2 mo) mice were treated with either control hIgG/PBS or subcutaneous injection of 1.5 mg/0.1 ml etanercept before and during LD CD40/
IL-2 and survival was monitored (I), n = 5 mice/group. (J and K) On day 2, visceral adipose tissue and peritoneal lavages were collected and assessed by
flow cytometry for the percentages of TNF+ macrophages (J and K) and serum TNF levels (L); n = 4 mice/group. Data in all panels are representative of one
of at least three experiments with similar results. Survival data were plotted using the Kaplan-Meier method and statistical differences were determined
with the log-rank test. Bar graph (mean value SEM) statistics performed using one-way ANOVA with Bonferroni post-hoc tests. **, P < 0.01; *, P < 0.05.
Ar ticle
purified diet that was 10% fat and served as lean controls. In
creases in body mass were validated in DIO mice before IT
administration (Fig. 5, AC). DIO mice displayed increases in
overall body weight and size (Fig. 5, A and B). MRI analysis
of body fat content showed increased total body fat accumu
lation, largely as increased visceral fat, in young DIO mice that
was similar to the aged AL mice (Fig. 5 C).
Confirming our previous findings, DIO mice treated with
HD CD40/IL-2 displayed increased serum TNF, IL-6, and
IFN- levels compared with age-matched young mice on a
10% fat diet after IT administration (Fig. 5, DF).The increases
in proinflammatory cytokines in DIO mice were lower, yet not
significantly so, than aged mice after IT (Fig. 4, CE). Young
DIO mice started succumbing to IT lethality at day 3 of treat
ment (>60%), and <40% were still alive by day 4 (Fig. 5 G).
Together, these results suggest that adipose tissue is a criti
cal component to the development of systemic cytokine storm
and lethality after IT.Yet, due to the observation that treatment
of DIO mice did not result in 100% of mice succumbing to
lethality, aging itself may also likely contribute to the overall
heightened inflammatory responses incurred by IT.
DISCUSSION
After initiation of strong immune stimulation with IT, we
show that both young obese and aged AL mice demonstrate
increased levels of adiposity, which led to aberrant increases in
both TNF and IL-6 levels that ultimately resulted in multiorgan damage. Similar to aging, obesity has been shown to be
immunomodulatory, where the cross talk between adipocytes
and macrophages is thought to lead toward the development
and perpetuation of a meta-inflammatory state through con
tinual NF-B activation, which is currently hypothesized to
be responsible for the induction of metabolic diseases. A study
conducted by Spaulding et al. (1997) examined the effects of
age and calorie restriction on the production of TNF and IL-6
in resting mice and demonstrated that serum levels of both
cytokines were significantly higher in aged mice in compari
son to young, and yet aged mice subjected to long-term calo
rie restriction resulted in TNF and IL-6 serum levels that
were comparable to the young mice.These findings lend sup
port to the protective effects seen within our studies in the
aged CR cohort administered IT.
Importantly, the data presented here demonstrate the need
for using age and body fat content as variables in preclinical
assessment of therapeutics and modeling diseases, such as can
cer. However, the vast majority of inbred mouse studies are
housed in specific pathogen-free colonies where normal aging
may result in higher body fat content and yet less immune
challenge from pathogens making them more susceptible to
proinflammatory responses and toxicities after immune thera
pies. It will therefore be important that future studies ascer
tain responses in mice that have been exposed to pathogens
and immune challenges as they age.
Furthermore, our data demonstrate that an obese phenotype
resulted in lethal consequences that were ameliorated through
calorie restriction in the aged. Also, differences in lethality
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Ar ticle
Criteria
No portal inflammation
Portal inflammatory infiltrate is in a minority of the portal triads, which is minimal
Inflammatory infiltrate in 50% of the triads, which is generally mild, and confined within the portal spaces
Inflammatory infiltrate, expanding most or all of the triads, and associated with mild interface and lobular activity
As above for moderate, with spillover into periportal areas and moderate to severe perivenular inflammation that
extends into the hepatic parenchyma and is associated with perivenular hepatocyte necrosis
Criteria
No inflammation
Scattered infrequent inflammatory infiltrate in a minority of crypts, which is minimal
Inflammatory infiltrate in 50% of the crypts, which is generally mild, and confined within the mucosa epithelium with
mild architectural distortion
Inflammatory infiltrate involving most of the crypts, and associated with architectural distortion (villous blunting and
focal mucosal atrophy/erosion) and luminal inflammatory exudate
Extensive inflammatory infiltrate (large lymphoid aggregates) with expanding into the lamina/muscular propria, and
associated with prominent mucosal ulceration/denuding, muscular wall necrosis, and/or perforation
in each sample was then directly determined from the change in absorbance
within 5 min time. Dilutions of the Pyruvate Control, included in the kit,
were used to construct a standard curve to calibrate the assay. Every serum
sample was assayed in triplicate.
Histopathology and grading/scoring. Liver and whole intestines were
collected on day 2 of IT, flushed, and fixed in 10% paraformaldehyde, embed
ded in paraffin, cut into 5-m sections, and stained with hematoxylin and
eosin (H&E). All tissues were prepared and stained at Histology Consultation
Services, Inc. (Everson, WA). Images were captured with a microscope (BX4;
Olympus) equipped with a Q-color3 camera and 10 numerical aperture
objective lens. Magnification for each captured image is specified in the figure
legends. Grading of histopathological inflammation was performed using a
scale from 0 to 4 in a blind fashion by a board-certified pathologist (M. Chen)
at the UC Davis Medical Centers Department of Pathology and Laboratory
Medicine. Specifically, the grading score for liver and gastrointestinal tract
followed our previously published grading method (Bouchlaka et al., 2013),
summarized in Tables 1 and 2.
MRI. To quantify abdominal fat, MR images were acquired in collaboration
with the National Institute on Aging. Images were acquired using a Biospec 7
Tesla 30-cm MRI scanner (Bruker Biospin) with a 72-mm diameter transmitreceive birdcage coil. In each experiment, two mice were inserted into the
scanner, side by side, in feet-first prone orientation immediately after sacrifice.
During scanning, the mice were cooled with a stream of cold air from a vortex
tube (Exair, Inc.) to minimize decomposition. Two different pulse sequences
were used: a heavily T1-weighted fast spin echo (RARE) sequence yielding
bright-fat (water-suppressed [WS]) images and a fat-suppressed proton density
weighted fast gradient echo (FLASH) sequence yielding fat-suppressed (FS)
images. 3D datasets were acquired in axial orientation with a field of view of
72 36 80 mm (left-right anterior-posterior head-foot) and matrix size
256 128 128.The voxel size (spatial resolution) was 281 281 625 m.
The spectral bandwidth in both sequences was 100 kHz (391 Hz/pixel) and
two averages were acquired for improved signal-to-noise ratio. For the RARE
sequence, the RARE factor (i.e., number of spin echoes per shot or number
of k-space lines per segment) was 8, the repetition time (TR) was 125 ms, the
actual echo time (TE) was 11.4 ms, and the effective echo time (TEeff) was
46.3 ms. Each RARE scan took 8 min and 32 s to acquire. For the FLASH
sequence, the repetition time was 25 ms and the echo time was 3.2 ms. The
excitation pulse had a flip angle of 30. Each FLASH scan took 13 min 39 s to
acquire. Image processing was performed in ImageJ 1.45 (NIH). The statisti
cal analyses were performed using one-way ANOVA and the Newman-Keuls
post-hoc test. P < 0.05 was considered to be significant.
To visualize fat distribution and content imaging of young ob/ob, DIO,
and lean age-matched controls were conducted in collaboration with the
Center for Molecular and Genomic Imaging (CMGI) Facility at the Univer
sity of California, Davis. Mice were anesthetized before imaging using 2%
isoflurane in an induction chamber and then maintained on 12% isoflurane
throughout imaging via a nose cone fitted for anesthetic inhalation. Mice
were imaged using a BioSpec 70/30 7T (Bruker Biospin) horizontal bore
system designed specifically for small animal imaging. Animals were kept at
2382
normal body temperature using warm air. Mice were inserted into the scan
ner in a head-first prone orientation. Spin-echo T1-weighted images were
obtained through the mouse body (neck-to-base of the tail) using a 72-mm
linear volume coil. Scan sequence parameters were the following: TR 1,000 ms,
TE 15 ms, and 2 averages. The field of view was 7.7 3.85 2.0 cm, with a
matrix size of 256 128 40. The corresponding voxel size was 0.3 0.3
0.5 mm. Images were acquired using ParaVision 5.0 software. After acquisi
tion, images were transferred into Invenon Research Workplace 4.0 software
(Siemens Preclinical) allowing fat to be displayed with high intensity (white).
Statistical analysis. Statistical analyses were performed using Prism soft
ware (GraphPad Software Inc.). Data were expressed as mean SEM. For
analysis of three or more groups, a nonparametric ANOVA test was per
formed with a Bonferroni post-hoc test. Analysis of differences between two
normally distributed test groups was performed using the Students t test.
Non-parametric groups were analyzed with the Mann-Whitney test.Welchs
correction was applied to datasets with significant differences in variance be
fore Students t test.
We thank Monja Metcalf and Weihong Ma for technical help.
This work has been supported by NIH grants CA0905572 and AG034874 and
by the Intramural Research Program of the National Institute on Aging, NIH.
The authors declare no competing financial interests.
Author contributions: A. Mirsoian, M.N. Bouchlaka, D.D. Taub, and W.J. Murphy
designed the research; A. Mirsoian, M.N. Bouchlaka, G.D. Sckisel, M. Chen, C.C.S. Pai,
A.M. Monjazeb, and D.D. Taub performed the research; A. Mirsoian, M.N. Bouchlaka,
D.D. Taub, and W.J. Murphy analyzed the data; M. Chen analyzed and scored all
histology data; E. Maverakis provided etanercept (Enbrel) for TNF blockade studies;
R.G. Spencer, K.W. Fishbein, and S. Siddiqui performed and analyzed MRI studies;
B. Martin, C. Hesdorffer, L. Ferrucci, and S. Maudsley provided aged mice and assisted
with data interpretation; A. Mirsoian, M.N. Bouchlaka, D.D. Taub, and W.J. Murphy
wrote the paper; and G.D. Sckisel, D.L. Longo, B.R. Blazar, and R.H. Wiltrout helped with
the editing of the paper. All authors read and approved the manuscript.
Submitted: 18 January 2014
Accepted: 6 October 2014
REFERENCES
Ar ticle
2383
INSIGHTS
Cr itical role for CX 3 CR1 + mononuclear phagocytes in
intestinal homeostasis
A key challenge at the intestinal barrier is to minimize responses to commensal bacteria, which can lead to
inflammatory bowel disease (IBD) in genetically predisposed individuals, but retain the ability to recognize
and control the growth of infectious pathogens. Group 3 innate lymphoid cells (ILC3) help maintain intestinal homeostasis by producing the cytokine IL-22, which promotes mucosal healing and maintains barrier
integrity. Microbial signals trigger production of IL-23 and IL-1b, which stimulate ILC3s to produce IL-22,
leading to the induction of antibacterial peptides and epithelial cell regeneration.
But the identity of the cell type producing IL-23 in response to microbial signals is unclear and has
Insight from
been the subject of much debate; resident mononuclear phagocytes, inflammatory monocytes, and
Giorgio Trinchieri
conventional dendritic cells have all been implicated. In this issue, Longman et al. provide compelling
evidence, both in mouse following Clostridium rodentium infection and in patients with colitis, that
CX3CR1+ mononuclear phagocytes (MNPs) are the most potent producers of IL-23 and IL-1b and are very efficient in
inducing IL-22 production by ILC3.
The authors demonstrated the importance of microbial stimulation in IL-22 induction
in patients with surgical diversion of the fecal streamIL-22 production by ILC3 was lower in
the sites unexposed to the gut microbiota compared with exposed sites. Microbial TLR4 and
TLR9 agonists were particularly efficient at inducing IL-23 and IL-1b production by CX3CR1+
MNPs. The authors also discovered that a gene significantly associated with both ulcerative
colitis and Crohns disease in GWAS, TNF-like ligand 1A (TL1A or TNFSF15), is overexpressed
in mouse CX3CR1+ MNPs and synergizes with IL-23 and IL-1b to induce IL-22 production
in both human and mouse ILC3.
The study does not completely exclude the role of other cell types in the production of IL-23 and
induction of IL-22 production but in the conditions studied (mouse infection with C. rodentium and
human colitis), CX3CR1+ MNPs were crucial in mediating this mucosal protective loop. In basal
conditions or in other types of inflammatory or preneoplastic conditions, and under stimulation by
different microbial TLR agonists (e.g., flagellin), it is quite possible that other cell types, including
conventional dendritic cells, may play an important role, as suggested by published studies. However,
Confocal immunofluorescence
the study by Longman et al. greatly contributes to our understanding of the mechanisms of human
image of mouse colon shows
IBD and reassures us that when mouse data are carefully combined with experimental human studies
juxtaposition (white arrows)
and GWAS, they are powerful in providing mechanistic evidence that explains human pathology.
of CX3CR1+ MNPs (green) and
Longman, R.S., et al. 2014. J. Exp. Med. http://dx.doi.org/10.1084/jem.20140678.
2
Article
Kimmel Center for Biology and Medicine of the Skirball Institute and 2Howard Hughes Medical Institute, New York
University School of Medicine, New York, NY 10016
3The Jill Roberts Center for IBD, Department of Medicine, Weill-Cornell Medical College, New York, NY 10021
4Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, NY 10032
5Center for Genomics and Systems Biology, Department of Biology; and 6Courant Institute of Mathematical Sciences,
Computer Science Department, New York University, New York, NY10003
Interleukin (IL)-22producing group 3 innate lymphoid cells (ILC3) promote mucosal healing and maintain barrier integrity, but how microbial signals are integrated to regulate
mucosal protection offered by these cells remains unclear. Here, we show that in vivo
depletion of CX3CR1+ mononuclear phagocytes (MNPs) resulted in more severe colitis and
death after infection with Citrobacter rodentium. This phenotype was rescued by exogenous
IL-22, which was endogenously produced by ILC3 in close spatial proximity to CX3CR1+
MNPs that were dependent on MyD88 signaling. CX3CR1+ MNPs from both mouse and
human tissue produced more IL-23 and IL-1 than conventional CD103+ dendritic cells
(cDCs) and were more efficient than cDCs in supporting IL-22 production in ILC3 in vitro
and in vivo. Further, colonic ILC3 from patients with mild to moderate ulcerative colitis or
Crohns disease had increased IL-22 production. IBD-associated SNP gene set analysis
revealed enrichment for genes selectively expressed in human intestinal MNPs. The product
of one of these, TL1A, potently enhanced IL-23 and IL-1-induced production of IL-22
and GM-CSF by ILC3. Collectively, these results reveal a critical role for CX3CR1+ mononuclear phagocytes in integrating microbial signals to regulate colonic ILC3 function in IBD.
CORRESPONDENCE
Randy S. Longman:
ral2006@med.cornell.edu
OR
Dan R. Littman:
dan.littman@med.nyu.edu
Abbreviations used: CD,
Crohns disease; DT, diphtheria
toxin; DTR, DT receptor; IBD,
inflammatory bowel disease;
ILC3, group 3 innate lymphoid
cell; MAMP, microbe-associated
molecular pattern; MNP,
mononuclear phagocyte;
PAMP, pathogen-associated
molecular pattern; UC, ulcerative colitis.
Inflammatory bowel disease (IBD) has been defined as a dysregulated cellular immune response
to environmental triggers in genetically predisposed individuals. Although the initial discovery
linking single-nucleotide polymorphisms in the
IL23R locus with susceptibility to IBD (Duerr
et al., 2006) was consistent with a role for IL-23
responsive T cells, more recent evidence supports
the importance of IL-23responsive innate lymphoid cells (ILC) in maintaining epithelial homeostasis (Sonnenberg and Artis, 2012). These
RORt-dependent ILCs (now named group 3
ILCs, or ILC3 (Spits et al., 2013)) were initially
2014 Longman et al. This article is distributed under the terms of an Attribution
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Mononuclear phagocytes (MNPs) are sentinels of the intestinal lamina propria, capable of responding to microbial products, and play a crucial role in orchestrating intestinal lymphocyte
homeostasis. MNPs can be subdivided based on their expression
of CD103 or CX3CR1, and each group has been ascribed critical functions in maintaining intestinal homeostasis (Bogunovic
et al., 2009; Merad et al., 2013). CD103+ cells, which can be
further subdivided based on the expression of CD11b, differentiate from a common DC precursor and are thought to be
the conventional, migratory myeloid DCs (Varol et al., 2010).
CD103+ CD11b DCs require Irf8, Id2, and Batf3 for their development and are thought to play a critical role in cross-priming
virus- and tumor-specific CTLs (Hildner et al., 2008; Merad
et al., 2013). Loss of these cells, however, does not alter intestinal
T cell homeostasis or lead to spontaneous inflammation (Edelson
et al., 2010). CD103+CD11b+ DCs, in contrast, require Notch2
signaling, produce IL-23 in response to flagellin-induced TLR5
activation, resulting in IL-22 production by ILC3, and have additionally been proposed to support Th17 polarization (Lewis
et al., 2011; Kinnebrew et al., 2012). These cells can produce
retinoic acid, which promotes the expression of the gut-homing
receptor CCR9 and synergizes with TGF to induce regulatory
T cells (Sun et al., 2007). One recent study suggests that Notch2dependent CD103+ CD11b+ DCs regulate protection from
C. rodentiuminduced colitis (Satpathy et al., 2013). However,
specific depletion of CD103+ CD11b+ intestinal DCs revealed
that these cells are not the MNP subset required for protection
against C. rodentium or IL-22 production (Welty et al., 2013).
In contrast to CD103+ cDCs, CX3CR1+ MNPs differentiate from monocyte precursors (Varol et al., 2010). Although
these cells were previously thought to be tissue-resident and to
promote local Treg differentiation (Hadis et al., 2011), recent data
from our group showed that they can up-regulate CCR7 and
migrate to secondary lymphoid organs, suggesting a broader role
in orchestrating immunity (Diehl et al., 2013). Notably, we observed that interaction with microbiota limits the migration of
these cells to mesenteric LNs (MLNs; Diehl et al., 2013), and an
increase in CX3CR1+ cells has been described in the lamina
propria during mouse (Zigmond et al., 2012) and human colitis
(Kamada et al., 2008). A recent study reported that fractalkine
receptor (CX3CR1) expression supports innate celldependent
clearance of C. rodentium infection (Manta et al., 2013), but a
functional role for CX3CR1+ MNPs in regulating colitisassociated ILC3 remains unclear.To evaluate this question, we
employed novel mouse models to enable selective depletion of
CX3CR1+ MNPs in vivo. Our results reveal a critical role for
CX3CR1+ MNPs from both mouse and human tissue in supporting IL-22 induction in ILC3 in vitro and in vivo. Moreover,
we identify the ability of TL1A produced by MNPs to potently
enhance IL-23 and IL-1induced production of IL-22 and
GM-CSF by ILC3.
RESULTS
CX3CR1+ cells protect against C. rodentiuminduced colitis
To investigate the role of the expanded population of CX3CR1+
cells in the intestinal lamina propria during colitis, we generated
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a mouse with the diphtheria toxin receptor (DTR) cDNA inserted into the Cx3cr1 locus (Diehl et al., 2013). Analysis of
colonic lamina propria mononuclear cells (LPMCs) after infection of DT-treated mice revealed a reduction in the percentage
of CD11c+ MHCII+ LPMCs (Fig. 1 A), which reflected a pref
erential loss of the CX3CR1+ CD11b+ CD14+ fraction of MNPs
(Fig. 1 B; Tamoutounour et al., 2012), as well as CX3CR1+
monocytes in Cx3cr1DTR/+ mice compared with control mice.
CD103+ CD11b+ cDCs were not depleted (Fig. 1 C).To induce
colitis, mice were infected with C. rodentium, a mouse model
for infectious colitis (Zheng et al., 2008; Sonnenberg et al., 2011;
Qiu et al., 2012). DT-treated infected Cx3cr1DTR/+ mice, but
not uninfected or control infected mice, lost more weight
(Fig. 1 D), displayed more severe intestinal pathology (Fig. 1 E),
and ultimately succumbed to infection (Fig. 1 F). Infected
Cx3cr1DTR/+ mice also had increased bacterial burden in the
spleen, consistent with the loss of barrier integrity (Fig. 1 G).
To examine potential involvement of signaling pathways
for receptors of pathogen- or microbe-associated molecular
patterns (PAMPs or MAMPs) in mediating this phenotype, mice
with a conditional deletion of MyD88 in CD11c-expressing
MNPs (CD11c-Cre/Myd88fl/fl) were infected with C. rodentium. Infection of CD11c-Cre/Myd88fl/fl mice, but not littermate controls, was lethal by 15 d after infection (Fig. 2 A),
implicating PAMP/MAMP signaling as having a critical role
in barrier protection mediated by CD11c-expressing MNPs.
The C. rodentium colitis model depends on IL-22 for protection (Zheng et al., 2008). Thus, to test if exogenous IL-22
could rescue the susceptibility phenotype described above,
CD11c-Cre/Myd88fl/fl (Fig. 2 A) and DT-treated CX3CR1DTR (Fig. 2 B) mice were hydrodynamically injected with a
plasmid encoding IL-22 (Qiu et al., 2012). The exogenous
IL-22 rescued both lines of mice from colitis-induced death.
Colonic CX3CR1+ MNPs regulate ILC3 production of IL-22
High-dose infection with C. rodentium is controlled by ILC3,
which represents the large majority of LPMCs producing IL-22
(Sonnenberg et al., 2011). At day 7 after infection, both the
percentage and absolute number of IL-22+ colonic, lineage,
CD90hi, and RORt+ ILCs (Fig. S1 shows gating strategy)
from mice depleted for CX3CR1+ cells were reduced in comparison to ILCs from mice with intact CX3CR1+ cells (Fig. 2,
CE). Depletion of CX3CR1+ cells did not affect the absolute number of ILC3 (Fig. 2 F). Although T cells can also contribute to IL-22 production in low-dose C. rodentium infection
(Basu et al., 2012), no statistically significant difference in the
total IL-22+ (or IL-17+) T cells was noted in mice depleted
for CX3CR1+ cells (Fig. 2 G). To assess the ability of colonic
CX3CR1+ MNPs to interact with ILC3 within the colonic tissue, Cx3cr1GFP/+ mice were used to visualize CX3CR1+ MNPs
in situ ( Jung et al., 2000). Consistent with the ability of these
cells to regulate ILC3 function, confocal microscopy revealed
the spatial proximity of RORt+ ILC3 cells with CX3CR1+
MNPs in the colonic lamina propria (Fig. 2 H).
To evaluate the ability of intestinal CX3CR1+ cells and
cDCs to support ILC3 activation, CX3CR1+ (GFP+) cells and
CX3CR1+ MNPs regulate ILC3 | Longman et al.
Ar ticle
Figure 2. CX3CR1+ cells support colonic ILC3 production of IL-22. (A) Survival curves of C. rodentium
infected Myd88f/f littermate controls (n = 10, open circle)
as compared with CD11c-cre/Myd88f/f mice without
(n = 13, filled circle) or with (n = 5, open triangle) exogenous hydrodynamic delivery of an IL-22producing
plasmid. Results are a composite of two independent
experiments. (B) Survival curves of DT-treated Cx3cr1DTR/+
mice infected with C. rodentium after hydrodynamic
delivery of a plasmid expressing IL-22 (n = 8) or control
vector (n = 9). DT was administered at days 2, 1, and 0
and every other day after infection. Results are a composite of three independent experiments. (CE) Percentage (C and D) and total number (E) of colonic Lin
CD90.2+ ILCs producing IL-22 from DT-treated Cx3cr1DTR/+ (n = 10) and littermate control mice (n = 9) 7 d
after C. rodentium infection and from uninfected mice
(NT; n = 3). Results are a composite of two independent
experiments. DT was administered at days 2, 1, and 0
and every other day after infection. Intracellular IL-22 was
assayed by flow cytometry after 4-h culture. A representative flow cytometry plot from each group is shown
in C. **, P 0.01. One way ANOVA with Bonferronis
correction. Error bars represent the SEM. (F) Total
number of ILC3 per colon in Cx3cr1DTR/+ (n = 9) or control
(n = 8) mice administered DT. Error bars represent the
SEM. Results are one of three representative experiments.
(G) Total number of IL-17+ or IL-22+ colonic CD4+ T cells
from DT-treated Cx3cr1DTR/+ (n = 10) and littermate control mice (n = 9) 7 d after C. rodentium infection and
from uninfected mice (n = 3). Intracellular IL-22 and IL-17
was assayed by flow cytometry after 4-h culture.
*, P 0.05. One way ANOVA with Bonferronis correction.
Error bars represent the SEM. Results are a composite of
two independent experiments. (H) Confocal immunofluorescence of colonic samples from Cx3Cr1GFP/+ mice
stained for CD3 and RORt. Bar, 10 m. White arrows
indicate sites of MNP and ILC3 juxtaposition.
DCs in vitro (Fig. 4, C and D). To evaluate the role of MNPderived IL-23 and IL-1, co-cultures were performed with intestinal CD11c+ cells derived from WT or Il23p19/ mice and
ILCs from WT or Il1r/ mice. IL-23deficient MNPs and
IL1R-deficient ILCs yielded significantly reduced production
of IL-22 (Fig. 4 E), consistent with the importance of MNPderived IL-1 and IL-23 in supporting IL-22 production.
These data reveal a mechanistic role for IL-23 and IL-1 produced by colonic MNPs in supporting colitis-associated ILC3
secretion of IL-22.
Human intestinal ILC3 production of IL-22
is regulated by microbial stimulation of MNPs
To evaluate the regulation of intestinal ILC3 in humans with
IBD, we prepared LPMCs from descending colon biopsies of
patients with endoscopically mild to moderate Crohns disease
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Ar ticle
Figure 4. CX3CR1+ MNP-derived IL-23 and IL-1 activate ILC3 to produce IL-22. (A) Phenotype analysis of colonic LPMCs from Cx3cr1STOP-DTR/GFP
mice with or without CD11c-cre after DT injection for 2 d. (top) Selective depletion of CX3CR1hi MNPs. (bottom) Expression of Ly6C and MHCII on
CX3CR1hi and CX3CR1int populations. (B) Expression of IL-22 in Lin CD90.2+ colonic ILCs from Cx3cr1STOP-DTR/+ (Stop-DTR) or CD11c-Cre x Cx3cr1STOP-DTR/+
(Cre-DTR) mice at 7 d after C. rodentium infection. DT was administered at days 2, 1, and 0 and every other day postinfection. One representative
intracellular cytokine flow cytometry plot is shown on the left and a composite graph (n = 6/group) on the right. *, P 0.05, two-tailed Students t test.
Error bars represent the SEM. Results are a composite of two independent experiments. (C) Supernatants from APC-ILC co-cultures (Fig. 3, B and C) were
harvested after 18 h and assayed for IL-23 by ELISA. Results are averages of three independent experiments and the SEM is shown. (D) CX3CR1+ MNPs or
CD103+ CD11b+ DCs were sorted and incubated with media or CpG for 18 h and supernatants were assayed for IL-1 by ELISA. Results are the mean of
two independent experiments performed in duplicate and the SEM is shown. *, P 0.05; **, P 0.01. (E) Lin CD90.2hi ILCs from WT or Il1r/ mice were
co-cultured with sorted intestinal MNPs from WT or Il23p19/ mice, with or without CpG, as indicated. IL-22 production by the ILCs was assessed after
18 h by ELISA. Data are combined from three independent experiments performed in duplicate. *, P 0.05; ***, P 0.001. One-way ANOVA with Bonferroni
correction. Error bars represent the SEM.
Ar ticle
Figure 5. Increased ILC3 production of IL-22 in mild to moderate IBD correlates with presence of fecal stream. (A) LPMCs isolated from descending colon biopsies from patients with endoscopically mild to moderate Crohns disease (n = 8, gray) or ulcerative colitis (n = 6, black; Table S1),
as well as age-matched non-IBD control patients undergoing routine screening colonoscopy (n = 8, white), were stimulated ex vivo with PMA/ionomycin
and evaluated by intracellular cytokine staining for expression of IL-17 and IL-22. The percentage of CD3+ or CD3 fraction expressing IL-17 or IL-22 is
indicated. *, P 0.05, two-tailed Students t test. Black bars represent the geometric mean. (B) Expression of c-Kit and CD56 in electronically gated CD3
IL-22+ (black lines) and CD3 IL-22 (gray) LPMCs. (C) Expression of RORt by c-Kit+CD56+ LPMCs. Lin cells (CD14/CD19/CD3/CD11b/CD11c/TCR;
Fig. S3 A) were stained with antibodies to surface markers c-Kit and CD56 and to intracellular RORt. Lin CD56+ c-Kit+ ILC3 (black line) were compared
with Lin CD56+ c-Kit NK cells (gray) for RORt expression. (D) Surface staining of Lin c-Kit+ ILCs for the indicated markers (black line) compared with
isotype control (gray) and all live LPMCs (dotted line) (E) LPMCs stained for intracellular IL-22 after stimulation with IL-23 for 3 h (solid line) or with control media (dotted line). Cells shown were gated on Lin CD56+ c-Kit+. The isotype control is in gray. (F) CD11c+ MHCII+ human colonic APCs were electronically gated for expression of CD103 and CD14. One of three donors is shown. (G) Lamina propria cells from biopsy samples of tissue exposed
(prediversion) or not exposed to the fecal stream (post-diversion) were cultured for 3 h and ILC3 production of IL-22 was assessed by flow cytometry.
(left) Result from one representative donor. (right) Percentage of IL-22+ ILCs in afferent (Pre) and efferent (Post) limbs of three diverted patients.
**, P 0.01, two-tailed Students t test. Black bars represent the geometric mean.
Figure 6. Human ILC3 production of IL-22 is supported by IL-23 and IL-1 produced by TLR-stimulated CD14+ and CX3CR1+ MNPs.
(AC) HLA-DR+ CD11c+ cells from intestinal resection tissue were sorted into CD103+ DCs and CD14+ MNPs subpopulations and transcriptional profiles
were assessed by RNA-seq. (A) Sorting strategy. (B) Each subset was examined for expression of the indicated cell surface markers. Isotype controls are
shown in gray. One of three donors is shown. (C) Heatmap of relative expression of relevant MNP-related genes. Values represent the mean of two independent donors, and an asterisk denotes individual genes differentially expressed at an FDR = 0.01. (D and E) Induction of IL-22 in human ILCs in coculture with CD14+ MNPs or CD103+ DCs in the presence of media alone, LPS, or flagellin, as indicated. c-Kit+ cells were examined for intracellular IL-22
production after 18-h culture. Data are representative of five independent experiments. (F) CD14+ MNPs or CD103+ DCs sorted from human intestine (as
in A) were stimulated with the indicated TLR ligands for 18 h and qPCR or cytometric bead array analysis were used to quantitate IL-23p19 and IL-1,
respectively. Results are averaged from three independent donors, and technical replicates were performed in duplicate or triplicate, respectively. *, P 0.05.
N.D., not detected. Two-tailed Students t test. Error bars represent the SEM. (G) Sorted human intestinal CD14+ MNPs and ILCs were left unstimulated or
were co-cultured in the presence of LPS with or without neutralizing antibodies against IL-1 and IL-23. IL-22 ELISA was performed after 18h. Results
are averaged from two independent donors performed in duplicate. *, P 0.05. Two-tailed Students t test. Error bars represent the SEM.
of multiple myeloid subsets in the immune response to C. rodentium (Schreiber et al., 2013), and our data do not exclude a
contribution of other myeloid subsets. Alternatively, Notch2
may affect cellular subpopulations in addition to CD103+
CD11b+ cDCs. This latter hypothesis is supported by the report that an alternate selective depletion strategy for CD103+
CD11b+ cDCs, by expression of DT under the human Langerin promoter (Welty et al., 2013), did not result in increased
susceptibility to C. rodentium. Some of the conflicting data
may additionally reflect differential roles of inflammatory monocytes and MNPs in colitis. Inflammatory monocytes may exacerbate pathology, as antibody-mediated depletion of Ly6Chi
monocytes during DSS treatment improved pathology in DSS
CX3CR1+ MNPs regulate ILC3 | Longman et al.
Ar ticle
Figure 7. CX3CR1+ MNP-derived TL1A synergizes with IL-23 and IL-1 to induce IL-22 in intestinal ILC3. (A) Gene-set enrichment analysis
was used to determine whether the indicated disease-related SNP were differentially expressed between CD14+ MNPs and CD103+ DCs. Significance was
estimated using the hypergeometric cumulative distribution, with a raw p-value cutoff of 0.05 for differential expression. Data were averaged from two
independent donors. (B) B cells (CD3 CD19+), CX3CR1+ MNPs, CD103+ DCs, and Ly6C+ monocytes were sorted from the intestinal lamina propria of
Cx3cr1GFP/+ and quantitative PCR for TL1A was performed. Relative quantitation was performed by Ct normalized to GAPDH expression. Data are from
two biological replicates performed with two technical replicates. *, P 0.05. Two-tailed Students t test. (CE) Sorted intestinal ILCs from mice (C and E)
or cultured human intestinal ILCs (D) were stimulated with media alone, IL-1, or IL-23 with or without TL1A as indicated for 18 h. Brefeldin was added
to the cultures 4 h before intracellular cytokine staining for IL-22 (C and D) or GM-CSF (E). Data are representative of six independent experiments.
(FH) Sorted intestinal ILCs were transfected with siRNA targeting Tnfrsf25 or a scramble control. (F) Knockdown efficiency was assessed after 24 h by
flow cytometry comparing scramble control (solid line) with Tnfrsf25 siRNA. One of two representative experiments is shown. ILCs were then cultured
with media alone (-) or IL-23 and TL1A or co-cultured with CX3CR1+ MNPs with or without LPS as indicated for an additional 18 h. (G) IL-22 production
was measured by intracellular flow cytometry. Brefeldin was added to the cultures 4 h before intracellular cytokine staining. Data are representative
of two independent experiments. (H) IL-22 secretion by samples from G were assessed by ELISA, performed in duplicate, before addition of Brefeldin.
*, P 0.05; **, P 0.01. Two-tailed Students t test. Error bars represent SEM.
of IL-23 and IL-1. At steady state, commensal-dependent signaling may negatively regulate ILC production of IL-22 via intestinal epithelial cell production of IL-25 (Sawa et al., 2011),
but we and others (Satoh-Takayama et al., 2008) find that
microbes support colitis-associated ILC production of IL-22,
which promotes mucosal healing. Although intravenous delivery of flagellin can induce CD103+ CD11b+ cDCs to produce
IL-23 that regulates ILC3 in the small intestine (Kinnebrew
et al., 2012), we and others (Kamada et al., 2008) found that
in vivo colonic inflammation and other bacterial-derived signals
induced more robust production of IL-23 and IL-1 by MNPs,
suggesting that the type of stimulation and/or colonic inflammation may confer specificity. Similar to our results in mice,
we found marked reductions in IL-22 production by intestinal
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Ar ticle
and produce the Cx3cr1DTR/+ mice. All mice were kept in specific pathogen
free (SPF) conditions at the animal facility of the Skirball Institute. Mouse
experiments were performed with at least three mice per group and multiple
experiments were combined to assess statistically significant differences as
noted. Littermates of the same genotype were randomly assigned to experimental groups. Animals were used between 8 and 16 wk of age. Males and
females were used in approximately equal ratios. All animal experiments were
performed in accordance with approved protocols for the NYU Institutional
Animal Care and Usage Committee.
Preparation of LPMCs. Endoscopic biopsies were obtained under IRBapproved protocols at Weill Cornell Medical College (1103011578 and Columbia University Medical Center (AAAE5448) including patients >18 yr of
age and able to give informed consent. IBD sample was defined based on endoscopic inflammation with history of ulcerative colitis or Crohns disease.
Endoscopic score (mild, moderate, or severe) was based on Mayo Endoscopic
subscore or SES-CD (1, 2, 3, respectively) at the site of biopsy (Pineton de
Chambrun et al., 2010). All endoscopic biopsies were taken from the sigmoid
or descending colon to reduce sampling variation. Study sample sizes for
human biopsies were based on preliminary data and powered to achieve statistically significant differences in the production of IL-22 or IL-17. Surgical
resections were obtained under an IRB-approved protocol at New York University Langone Medical Center. Mouse and human intestines were washed
in PBS and 1 mM DTT twice with 30 mM EDTA, and then digested in collagenase 8 (Sigma-Aldrich) and DNase-containing media with 10% fetal bovine serum. Digested material was passed through a cell strainer and separated
on a discontinuous 40%/80% Percoll gradient. LPMCs were cultured ex vivo
in the presence of GolgiPlug (BD) for 4 h or stimulated with phorbol myristate acetate (PMA; 20 ng/ml) and ionomycin (1 g/ml) or IL-23 (40 ng/ml;
eBioscience) in the presence of GolgiPlug (BD) for 4 h before staining.
Intestinal ILC cultures. Surgical resections were obtained from the NYU
Biorepository (Rachel Brody). Lin c-Kit+ CD45int ILCs were sorted and
cultured in tissue culture media (RPMI 1640; Invitrogen) supplemented with
10% (vol/vol) heat-inactivated FBS (HyClone), 50 U penicillin-streptomycin
(Invitrogen), 2 mM glutamine, and 50 M -mercaptoethanol), supplemented
with IL-7 (50 ng/ml; PeproTech) and IL-2 (1,000 U/ml; PeproTech) for 810 d
before stimulation. Lin, CD90.2+, RORt-GFP mouse ILC3 were sorted
from LPMCs and resuspended in RPMI-based tissue culture media for stimulation directly ex vivo. Human and mouse ILCs were stimulated with human
or mouse IL-23 (eBioscience; 40 ng/ml), IL-1 (eBioscience; 10 ng/ml), or
TL1A (R&D Systems; 200 ng/ml) as indicated, respectively. After 18 h, supernatants were harvested for IL-22 ELISA (eBioscience) and Golgi Plug (BD)
was added to cells for 4 h for subsequent intracellular cytokine staining.
Co-culture assay. ILCs and APC populations were sorted on a FACSAria
and co-cultured with 5 103 and 2.5 103 cells, respectively, in 96-well
round-bottom plates in tissue culture media.TLR stimulation was performed
with 1 g/ml LPS (Escherichia coli; Sigma-Aldrich), 1 M CpG 1668 (mouse),
1 M CpG 2216 (human), or 1 g/ml flagellin (Salmonella Typhi; InvivoGen).
Cultures were incubated for 18 h. Supernatants were harvested for ELISA
and remaining cells were incubated with Golgi Plug (BD) for 4 h and sub
sequently analyzed by flow cytometry.
siRNA transfection. Sorted intestinal ILCs were cultured overnight in IL-7
(20 ng/ml) and SCF (20 ng/ml). After 24 h, 4 105 ILCs were transfected
using AMAXA T cell nucleofection protocol. 300 pmol of Tnfrsf25 siRNA
pool or scramble control (Thermo Fisher Scientific) was used per transfection. Cells were rested overnight and harvested at 24 h for experimental use.
Knockdown efficiency was assessed at 24 h by DR3 surface staining.
Colitis models. C. rodentium DBS100 (ATCC 51459; American Type Culture
Collection) was harvested at log phase growth and 1010 CFU were delivered by
gavage in PBS. 200 ng of DT was administered i.p. as indicated for depletion.
Plasmid DNA expressing IL-22 or control plasmid (Qiu et al., 2012) were
JEM Vol. 211, No. 8
delivered i.v. at 5 g DNA/mouse diluted in TransIT-EE Hydrodynamic Delivery Solution (Mirus) at 0.1 ml/g body weight. Immune cell functional analysis
and histology were performed at day 7 after exposure. Spleens were harvested on
day 21, homogenized, and plated at serial dilutions to determine CFU/spleen.
RNA-seq processing and gene set enrichment analysis. Sequence reads
were mapped to the human genome (version hg19) by Tophat (version 2.0.6),
using Bowtie2 (version 2.0.2) and Samtools (version 0.1.18). Reads are deposited at Bioproject PRJNA219394. Reads mapped per transcript served as input
to DESeq (version 1.12.0), an R package that calculates differential gene expression. To improve detection of APC lineage-dependent gene-expression
changes and overcome donor-dependent variability, we used the following
strategy: independently for each donor, differential gene expression, comparing
CD103+ to CD14+ human myeloid cells, was estimated using the negative binomial distribution (nbinomTest), and then results from biological replicates
were combined using Fishers method. Several gene set enrichment techniques
(e.g., hypergeometric test and area under precision-recall curve) were used to
test whether specific gene sets (Table S2) were significantly differentially regulated between the two lineages.The GWAS gene sets are derived from diseaseassociated SNPs from the NHGRI GWAS Catalog. False-discovery rates
(FDRs) were calculated using the Benjamini-Hochberg procedure. The enrichment analyses were implemented in Matlab R2013a (8.1.0.604).
qPCR. RNA from primary intestinal APCs stimulated as indicated was prepared with TRIzol (Invitrogen). RNA was reverse transcribed into cDNA
(SuperScript III; Invitrogen) and QPCR was performed with a Roche LightCycler with SYBR Green Supermix (Bio-Rad Laboratories), 20 pmol forward
and reverse primers, and 0.1 g of cDNA from 5-TGTTCCCCATATCCAGTGTGG-3 and 5-CTGGAGGCTGCGAAGGATTT-3 for human
IL23p19, 5-ATGCTTCGGGCCATAACAGA-3 and 5-TGAAGGCCATCCCTAGGTCA-3 for mouse TL1A; 5-ACCACAGTCCATG
CCATCAC-3 and 5-TCCACCACCCTGTTGCTGTA-3 for human
GAPDH; and 5-AATGTGTCCGTCGTGGATCT-3 and 5-CATCGA
AGGTGGAAGAGTGG-3 for mouse GAPDH. The thermocycling program was 40 cycles at 95C for 15 s, 60C for 30 s, and 72C for 30 s, with
an initial cycle of 95C for 2 min. Relative levels of target gene were determined by using the delta Ct value compared with delta Ct (GAPDH).
Immunofluorescence. Intestinal tissue was Swiss-rolled before fixing for 4 h
in 4% paraformaldehyde. Tissue was incubated overnight in 30% sucrose before freezing in OCT. Tissue was cut into 5-M sections. Tissue was blocked
in PBS-XG (0.1% Triton X-100, 10% goat serum) before incubating overnight in primary antibody in PBS-XG. Tissue was washed and then incubated with secondary antibody for 1 h before DAPI staining. The following
primary antibodies are from eBioscience: antihuman/mouse RORt (clone
AFKJS-9) and antimouse CD3e (clone 145-2C11). Secondary antibodies
are from Jackson ImmunoResearch Laboratories (Cy3-AffiniPure goat antirat
IgG and goat antiArmenian hamster). Tissue was imaged using an LSM 710
confocal (Carl Zeiss) and images were processed using ImageJ.
Online supplemental material. Fig. S1 shows the gating strategy for colonic ILC3. Fig. S2 shows increased production of IL-22 in ILCs from patients with IBD. Fig. S3 shows Lin gating and surface phenotype for human
intestinal ILC3. Fig. S4 shows that TL1A enhances IL-23 and IL-1 induction of IL-22 by intestinal ILC3s. Online supplemental material is available at
http://www.jem.org/cgi/content/full/jem.20140678/DC1.
We thank Rachel Brody (NYU Biorepository), Fatiha Chabouni, Priyanka Patel, Ryan
Warren and members of The Roberts Center for IBD for help with sample collection
as well as the patients that participated in this study. We would like to thank
Michael Cammer for assistance with microscopy.
This work was supported by the American Gastroenterological Association
Research Foundation (R.S. Longman), National Institutes of Health K08 DK099381
(R.S. Longman), American Cancer Society (G.E. Diehl), NIH T32 CA009161 (G.E. Diehl),
K99DK091508 (J.R. Huh), and the Howard Hughes Medical Institute (D.R. Littman).
The authors declare no competing financial interests.
1581
Author contributions: R.S. Longman and G.E. Diehl designed and performed the
experiments. R.S. Longman, G.E. Diehl and D.R. Littman planned experiments and
wrote the manuscript with input from the co-authors. J.R. Huh, C. Galan, and
D.A. Victorio helped plan and perform experiments. E.R. Miraldi and R. Bonneau
performed data analysis. A. Swaminath and E.J. Scherl helped with sample collection
and experimental design.
Submitted: 9 April 2014
Accepted: 18 June 2014
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CX3CR1+ MNPs regulate ILC3 | Longman et al.
Ar ticle
1583
INSIGHTS
Monocytes and macrophages belong to the mononuclear phagocyte system (MPS). The concept of the MPS is based on the idea that circulating monocytes represent the immediate
precursors of tissue macrophages. Recent genetic fate mapping of myeloid cells caused a conceptual frameshift, as it was found that many macrophages are derived from embryonic precursors that seed the tissues before birth and then self-maintain without any significant
contribution from circulating monocytes. In this new view, monocytes merely represent an
emergency squad that can be rapidly recruited to sites of inflammation to provide a transient
Insight from Bart Lambrecht (left)
supplement of inflammatory macrophages to the local tissue-resident macrophage pool of
and Martin Guilliams (right)
embryonic origin.
In this issue, Molawi et al. challenge this new concept by reporting that cardiac macrophages are initially of embryonic
origin but are progressively replaced by monocyte-derived cells. These newcomer macrophages lack the capacity to self-renew
and are slowly but constantly replaced by circulating monocytes. In this regard, the heart resembles the skin and intestine.
There, macrophages are also mainly derived from circulating monocytes. Because the skin and the intestine are barrier sites with
an important influence of the microbiome, a continuous low-grade inflammation could explain continuous recruitment of
circulating monocytes. Molawi et al. report that cardiac macrophages of embryonic origin gradually lose the capacity to selfrenew with age and hypothesize that this allows circulating monocytes to occupy the heart niche and join the cardiac macrophage
pool. Why embryonic macrophages would lose their self-renewal capacity in the heart but not in the liver, the lung, or the
spleen remains to be determined. Another unexplored hypothesis is that continuous microtrauma induced by cardiac contraction
is the driver of monocyte influx to the sterile heart.
Tissue-resident macrophages are astonishingly diverse in terms of gene expression and are adapted to perform specific functions
in their tissue of residence. The unique functions of cardiac macrophages remain largely unknown. Molawi et al. describe
four subsets of cardiac macrophages based on the expression of CX3CR1 and MHC class II (see figure). Embryonic macrophages
preferentially give rise to MHC class IIlow cells, while most monocyte-derived macrophages express high levels of MHC class II.
This implies a different capacity to
interact with lymphocytes and distinct
functional adaptations for embryonic
macrophages. Macrophages play an important role in wound healing, and many
cardiovascular diseases are associated with
poor or exaggerated tissue repair. It will
therefore be interesting to investigate
whether embryonic macrophages are
better at tissue repair compared with
monocyte-derived macrophages, and
whether the presence of the embryonic
pool explains the superior regeneration
capacity of the heart at a young age.
Manipulation of macrophage self-renewal
might yield important therapeutic appliCardiac macrophages derived from embryonic progenitors gradually lose their capacity to
cations to increase macrophage populaself-renew and are continually replaced in adulthood by macrophages derived from circulating
tions involved in tissue homeostasis and
monocytes, even in the absence of inflammation.
repair, while avoiding the recruitment of
macrophages that fuel inflammation.
With these exciting prospects and new concepts, macrophage biology is going through a revival period, and this study
certainly contributes to that. Given the breadth of tissue-specific macrophage heterogeneity, both in terms of functional specialization
and cellular origin, we have many years ahead until we fully understand the cell that initiated immunology research more than
a century ago.
Molawi, K., et al. 2014. J. Exp. Med. http://dx.doi.org/10.1084/jem.20140639.
Bart Lambrecht and Martin Guilliams, VIB Inflammation Research Center, UGent: bart.lambrecht@irc.vib-Ugent.be and martin.guilliams@irc.ugent.be
Cardiac macrophages (cM) are critical for early postnatal heart regeneration and fibrotic
repair in the adult heart, but their origins and cellular dynamics during postnatal development have not been well characterized. Tissue macrophages can be derived from embryonic
progenitors or from monocytes during inflammation. We report that within the first weeks
after birth, the embryo-derived population of resident CX3CR1+ cM diversifies into
MHCII+ and MHCII cells. Genetic fate mapping demonstrated that cM derived from
CX3CR1+ embryonic progenitors persisted into adulthood but the initially high contribution
to resident cM declined after birth. Consistent with this, the early significant proliferation rate of resident cM decreased with age upon diversification into subpopulations.
Bone marrow (BM) reconstitution experiments showed monocyte-dependent quantitative
replacement of all cM populations. Furthermore, parabiotic mice and BM chimeras of
nonirradiated recipient mice revealed a slow but significant donor contribution to cM.
Together, our observations indicate that in the heart, embryo-derived cM show declining
self-renewal with age and are progressively substituted by monocyte-derived macrophages,
even in the absence of inflammation.
CORRESPONDENCE
Michael H. Sieweke:
sieweke@ciml.univ-mrs.fr
Abbreviations used: cM,
cardiac macrophages; HSC,
hematopoietic stem cell;
YS, yolk sac.
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Figure 1. cM develop into 4 subpopulations after birth. (A and B) Cytometry analysis of cM from adult CX3CR1GFP/+ mice. (A) FACS profiles of
cM populations, pregated on living single CD11b+ cells with low CD11c and Ly6C expression. (B) Mean of total and subpopulations of cM in absolute
numbers (left) or as percentage of total (right) as determined by bead-normalized flow cytometry. Error bars represent SEM (n = 4). (C and D) Cytometry
analysis (C) and mean percentage (D) of cM subpopulations from CX3CR1GFP/+ mice of indicated age. Error bars represent SEM (n = 34). (E) MHCII and
MHCII+ cM from adult CX3CR1cre:R26-yfp mice (black line) were analyzed for YFP expression and compared with Cre littermate controls (gray area;
n = 34). Data in all panels are representative of at least two independent experiments.
Here, we examined the origin and turnover of tissueresident cM during postnatal development. Using genetic
lineage tracing, parabiotic mice, and unconditioned BM chimeras, we demonstrate that embryo-derived cM are gradually replaced by monocyte-derived macrophages with age and
in the absence of inflammation or injury. This replacement is
mirrored by dynamic changes in the resident cM population
composition and decreasing cM self-renewal over time.
RESULTS AND DISCUSSION
We focused on the resident cM population and applied a
rigorous flow cytometry gating strategy to exclude potential
infiltrating leukocytes (Fig. S1, AC). Tissue-resident macrophages were identified as positive for the core macrophage
signature markers CD14, CD64, and MerTK (Gautier et al.,
2012; Tamoutounour et al., 2013) and the classical macrophage marker F4/80 (Fig. 1 A). The chemokine receptor
CX3CR1 is widely expressed in the mononuclear phagocyte
system (Jung et al., 2000) and cM have been reported to be
CX3CR1-positive (Pinto et al., 2012). Therefore, we refined
our analysis of the global cM population by testing CX3CR1
expression in CX3CR1GFP/+ knock-in mice (Jung et al.,
2000). Additionally, we included MHCII in our analysis,
which can be differentially expressed on tissue macrophages
JEM Vol. 211, No. 11
Figure 3. Decreased proliferation rate of embryo-derived cM with age. (A) cM subpopulations of adult CX3CR1GFP/+ mice were analyzed for
BrdU incorporation and expression of Ki67 by flow cytometry four hours after BrdU injection (i.p.). Bars show median (n = 1213). *, P 0.05; **, P 0.01;
***, P 0.005; Wilcoxon test. (B and C) Total (B) or CX3CR1+MHCII (C) cM of CX3CR1GFP/+ mice of indicated age were analyzed for BrdU incorporation
and Ki67 expression by flow cytometry 4 h after BrdU injection (i.p.). Bars show median (n = 415). ***, P 0.005, Mann-Whitney test. Data in all panels
were pooled from 23 independent experiments.
and diversification of embryo-derived cM as suggested elsewhere (Epelman et al., 2014), or replacement of embryoderived cM by adult monocyte-derived macrophages.
To address these alternatives, we first analyzed the persistence of embryo-derived cM by genetic lineage tracing using
CX3CR1-driven tamoxifen (TAM)-inducible Cre recombinase (CreERT2) and R26-yfp reporter mice (CX3CR1creER:
R26-yfp; Fig. 2 A; Yona et al., 2013). Tamoxifen-induced
pulse labeling at E9 permits us to identify cells derived from
yolk sac (YS) CX3CR1+ macrophages before the onset of
definitive hematopoiesis. Labeling at E13 cannot distinguish
YS- and hematopoietic stem cell (HSC)derived macrophages, but should increase cM labeling because the heart
is colonized by CX3CR1+ macrophages at this time (Epelman
et al., 2014). cM labeling was normalized to YFP+ microglia, which are YS-derived, remain CX3CR1+ throughout
development, self-maintain without contribution of HSCderived cells (Ginhoux et al., 2010; Kierdorf et al., 2013),
and therefore represent an internal control for maximal
CX3CR1 labeling efficiency. E13 labeling revealed that relative cM labeling declined from 35% in newborn mice
to 18% in 6-wk-old mice (Fig. 2 B), indicating a loss of
embryo-derived cM with age. E9 labeling showed that
embryo-derived cM were at least partially of YS origin and
similarly declined from 14% in neonates to 4% in 6-wkold mice (Fig. 2 C). Interestingly, all embryo-derived YFP+
cM were MHCII at birth but had partially differentiated
into MHCII+ cM after 6 wk (Fig. 2 D). Although this
demonstrated that both populations can develop from cells of
embryonic origin, the relative contribution of embryo-derived
YFP+ cM to MHCII+ cM was significantly lower than to
MHCII cM, (Fig. 2 E).
2154
Figure 4. Monocytes contribute to four cM subpopulations in adult mice. (A) WT mice were lethally irradiated and reconstituted with BM from
Ubow:CX3CR1GFP/+ mice. cM were analyzed for contribution of dTomato+ cells at indicated time points after reconstitution and graft-derived cells were
analyzed for CX3CR1 and MHCII expression. Data are presented as mean percentage SEM (n = 37) and derived from two independent experiments.
(B) Mixed BM chimeras were generated by reconstituting lethally irradiated WT mice (CD45.1/CD45.2) with BM from CCR2/:CX3CR1GFP/+ (CD45.2) and
WT CX3CR1GFP/+ (CD45.1) mice. cM, circulating CD11b+CD115+ monocytes (Ly6C+ and Ly6C) and B220+ B cells were analyzed for WT (CD45.1) and
CCR2/ (CD45.2) contribution. Host- and graft-derived cM were analyzed for the ratio of MHCII+/MHCII cM. Bars show median (n = 4). *, P 0.05,
Mann-Whitney test. (C) Parabiosis was established between adult CCR2/ (CD45.2) and WT (CD45.1) mice. After 10 wk, CCR2/ mice were analyzed for
contribution of CD45.1+ non-host cells to cM (total, MHCII+, and MHCII), circulating monocytes (Ly6C+ and Ly6C), and B cells. For CD45.1 host and
CD45.1+ non-host cM, the ratio of MHCII+/MHCII cM was calculated and compared. Bars show median (n = 4). **, P 0.01, Mann-Whitney test.
(D) BM chimeras were generated by transfer of LT-HSC isolated from panYFP mice into nonirradiated Rag2/c/KitW/Wv mice. cM (total, MHCII+, and
MHCII) and neutrophils (Gr1hi and SSChi) were analyzed for contribution of grafted YFP+ cells 8 wk after transplantation. Bars show median (n = 6).
**, P 0.01, Mann-Whitney test. Data in all panels are representative of two independent experiments.
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2157
2158
INSIGHTS
M acrophages der ived from infiltrating monocytes mediate
autoimmune myelin destruction
<doi>10.84/jem2nsight1<do>ajem.218insght</ad>uMicelT.Hnka</>AF1UiverstyofBn</AF1>crmihael.nk@ub-ode</cr>haInsigt</doce> piNws</doct>
Macrophages mediate myelin destruction in multiple sclerosis (MS), but the origin of these cells (whether derived from tissue-resident microglial cells or infiltrating monocytes) has been widely debated. Now, Yamasaki
and colleagues distinguish these cells in a mouse model of MS and show that monocyte-derived macrophages
(MDMs) mediate myelin destruction, whereas microglia-derived macrophages (MiDMs) clear up the debris.
Previous attempts to decipher the nature and role of cells involved in autoimmune demyelination have
proven challenging. Although ontogenetically distinct, it has not been possible to distinguish macrophages
derived from tissue-resident or -infiltrating cells based on morphological features (by light microscopy) or
surface phenotype. Previous attempts to address this problem include parabiosis and bone marrow transInsight from
plantation after irradiation, both strategies with substantial technical problems and limitations.
Michael Heneka
Yamasaki et al. studied double chemokine receptor (CCR2-RFP+;
CX3CR1-GFP+) mice in the experimental autoimmune encephalomyelitis (EAE) mouse model of MS. Inflammatory lesions were filled with both MDMs and
MiDMs. Confocal immunohistochemistry, serial block-face scanning electron microscopy
(SBF-SEM), and subsequent 3D reconstruction revealed that myelin destruction was initiated
by MDMs, often at the nodes of Ranvier, whereas MiDMs were not detected at this site.
Disruption of MDM infiltration by CCR2 deficiency completely abolished the presence of
macrophages at the nodes of Ranvier. Gene expression profiling of both cell types at disease
onset revealed substantial differences, which correlated well with the observations obtained
by SBF-SEM. MDMs expressed genes attributable to effector functions, including those
involved in phagocytosis and cell clearance. In contrast, MiMD gene expression patterns at
disease onset were characteristic of a repressed metabolic state.
This paper sets a new standard for further studies in the field. For the first time,
MDMs and MiDMs have been clearly differentiated and their morphological relationship to axoglial structures has been analyzed. The finding that MDMs rather than
MiDMs initiate myelin destruction at disease onset should enable this cell population to
be targeted more effectively in future. The next stage is to verify these findings in human
tissue. Future research should also assess further time points over the entire disease
Nodes of Ranvier represent a prime
course, in particular to exclude that MiDMs do not join MDMs at the node of Ranvier
site of attack for MDMs at the onset
at later stages of disease. A precise distinction between local and infiltrating cell populaof EAE. This 3D reconstruction of SBFtions may also contribute to a better understanding of pathogenesis in other CNS disorSEM images shows a monocyte-derived
ders such as stroke and brain trauma and will hopefully lead to the development of new
macrophage encircling the node of
therapeutic strategies.
Ranvier, as shown by the two primary
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Article
In the human disorder multiple sclerosis (MS) and in the model experimental autoimmune
encephalomyelitis (EAE), macrophages predominate in demyelinated areas and their numbers correlate to tissue damage. Macrophages may be derived from infiltrating monocytes
or resident microglia, yet are indistinguishable by light microscopy and surface phenotype.
It is axiomatic that T cellmediated macrophage activation is critical for inflammatory
demyelination in EAE, yet the precise details by which tissue injury takes place remain
poorly understood. In the present study, we addressed the cellular basis of autoimmune
demyelination by discriminating microglial versus monocyte origins of effector macrophages. Using serial block-face scanning electron microscopy (SBF-SEM), we show that
monocyte-derived macrophages associate with nodes of Ranvier and initiate demyelination,
whereas microglia appear to clear debris. Gene expression profiles confirm that monocytederived macrophages are highly phagocytic and inflammatory, whereas those arising from
microglia demonstrate an unexpected signature of globally suppressed cellular metabolism
at disease onset. Distinguishing tissue-resident macrophages from infiltrating monocytes
will point toward new strategies to treat disease and promote repair in diverse inflammatory pathologies in varied organs.
CORRESPONDENCE
Richard M. Ransohoff:
ransohr@ccf.org
Abbreviations used: CNS,
central nervous system; EAE,
experimental autoimmune
encephalomyelitis; MDM,
monocyte-derived macrophage;
MiDM, microglia-derived macrophage; MS, multiple sclerosis;
SBF-SEM, serial block-face
scanning electron microscopy.
1533
(HSCs), which require the transcription factor Myb. Microglial precursors are Myb independent, and microglia self-renew
independently of bone marrow HSCs (Gomez Perdiguero
et al., 2013). Distinct developmental origin and renewal mechanisms imply that monocyte-derived macrophages (MDMs)
and microglia-derived macrophages (MiDMs) might exert different functions in pathological processes. Microglia represent
one instance of tissue-resident macrophages, which reside in all
organs. Studying the CNS as compared with other organs
may carry advantages for distinguishing tissue-resident myeloid cells from infiltrating monocytes during disease, as there
is virtually no background trafficking of monocytes in the
CNS parenchyma of healthy animals.
In EAE, which models inflammatory aspects of MS
(Williams et al., 1994; Ransohoff, 2012), macrophages dominate
the inflammatory infiltrates and their numbers correlate to
EAE severity (Huitinga et al., 1990, 1993; Ajami et al., 2011).
However the cellular mechanisms by which macrophages
promote disease progression are uncertain. Whether MiDMs
or MDMs are functionally distinct and whether the two cell
types differentially initiate demyelination or promote repair
(Steinman et al., 2002) also remains elusive (Bauer et al., 1995).
In MS autopsy tissues, prominent macrophage accumulation
correlates with active demyelination (Ferguson et al., 1997;
Trapp et al., 1998). Based on kinetics of cell accumulation and
differential marker expression, its estimated that 3050% of
activated macrophages in active MS lesions derive from microglia (Brck et al., 1995; Trebst et al., 2001). Therefore, differential functions of MDMs and MiDMs are relevant for
human demyelinating disease.
To date, no research techniques have permitted distinction
between monocytes and microglia in CNS tissue without irradiation chimerism or parabiosis, techniques that confound
interpretation or impose practical limitations (Ajami et al.,
2007, 2011; Ransohoff, 2007). When F4/80+ macrophages
Purpose
Finding
(RFP+)
from
MDMs and MiDMs can be distinguished by cell volume and primary
Confocal analysis of 0.2 mm optical
To distinguish MDMs
MiDMs (GFP+).
processes.
sections (n = 104 cells).
SBF-SEM inspection in 0.2 mm sections To detect MDMs and MiDMs in SBF- Using criteria detected in the previous step, it is possible to distinguish
MDMs and MiDMs in SBF-SEM images.
from 14 lesions, 7 mice at EAE onset. SEM using cell volume and process
criteria.
SBF-SEM inspection of ultrastructure To detect ultrastructural characteristics MDMs and MiDMs show characteristic ultrastructural differences
of MDMs and MiDMs.
of MDMs and MiDMs.
regarding their mitochondria, nuclei, osmiophilic granules and
microvilli.
To determine relationship of MDMs Most (55/75; 73%) axoglial units are contacted in limited fashion by
Quantification of relation of MDMs
MDMs and MiDMs. If one cell type is present (20/75 cells), its nearly
and MiDMs to axoglial units and
(n = 169) and MiDMs (n = 86) to
always (18/20 segments) MDMs.
axoglial units (n = 29 intact axons, characterize presence of myelin debris.
46 demyelinated axons).
To detect relationship of MDMs with In all, 49 MDMs interacting with axoglial units in absence of nearby
Reconstruction of 3D shape of four
axoglial units at EAE onset.
MiDMs, 2-3 MDMs were attached to each (n = 18) axoglial unit.
representative MDMs at axoglial
MDMs have close relationship with nodes of Ranvier (7 MDMs/75
units.
axoglial units). 3D reconstructions showed four representative MDMs
at axoglial units: show one carrying out active demyelination, three at
nodes of Ranvier.
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Figure 1. MDMs and MiDMs exhibit different time courses of accumulation in the CNS of mice with EAE and morphological characteristics
can distinguish them. (A) Immunohistochemistry shows expression of CD11b for red RFP+ MDMs and green GFP+ MiDMs in the spinal cords of
Cx3cr1gfp/+::Ccr2rfp/+ mice at EAE onset. Bars: 25 m. We studied 6 mice at EAE onset from 3 EAE inductions. In each EAE induction, 810 mice were used and
2 mice were selected from each induction. (B) Flow cytometric analysis of CCR2-RFP+ and CX3CR1-GFP+ populations in cells gated for F4/80 expression
(top); CD45 expression of F4/80+RFP+ MDMs and F4/80+GFP+ MiDMs populations (middle); and MDMs and MiDMs numbers at EAE onset, peak, and recovery
(bottom). We studied 3 mice for naive groups; 12 for onset; 15 for peak; 13 for recovery from 5 EAE inductions. For each induction, 810 mice were used
and 23 mice were selected at each time point (onset, peak, and recovery) for analysis. (C) Confocal microscopy assessment of myeloid cell morphology in
lumbar spinal cord from mice at EAE onset. We studied 54 MDMs and 51 MiDMs of 5 EAE onset mice from 3 EAE inductions for (CE); 2 sections/mouse;
46 cells/section; 812 cells/mouse. In each EAE induction, 810 mice were induced and 12 EAE onset mice were selected from each experiment. Bars,
25 m. (D) Cell volumes of 500 m3; surface areas of 1,000 m2; primary process numbers 3 or 5; solidity3D of 0.4; and Formfactor3D of 0.3 discriminate between MDMs and MiDMs. (E) Model plot of cell volume against primary process number to distinguish MDMs (red symbols and pink area) from
MiDMs (green symbols and green area).
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1535
in MDMs and MiDMs (unpublished data). MDMs had bilobulated or irregular nuclei, whereas MiDMs had round nuclei (unpublished data). MDMs, but not MiDMs, frequently
contained osmiophilic granules and microvilli (unpublished
data). Collectively, these ultrastructural features provided confirmatory ultrastructural characteristics to distinguish MDMs
from MiDMs.
MDMs initiated demyelination at EAE onset
Results from confocal and EM analysis yielded a secure basis
for examining the relationships of MDMs and MiDMs to axoglial units at EAE onset (n = 7 mice; 14 lesions) using serial
block-face scanning electron microscopy (SBF-SEM), as presented diagrammatically (Table 1). We quantified contacts
made by MDMs (n = 169) and MiDMs (n = 86) with axoglial
units (n = 75; Fig. 2), and observed that most (55/75; 73%) of
all segments (both intact and demyelinated) contacted both
MDMs and MiDMs (Fig. 2). Where only one myeloid cell
type was present (20/75; 27%), nearly all axoglial units made
contacts to MDMs (Fig. 2). In particular, 8/29 intact and 10/46
Figure 2. SBF-SEM shows MDMs initiating demyelination at EAE onset. Quantitation of MiDMs and MDMs interacting with axoglial units in SBFSEM images of CNS at EAE onset. Intact (69%) and demyelinated (76%) segments interacted with MDMs and MiDMs. Red and pink, MDMs; green and
light green, MiDMs; yellow, both MDMs and MiDMs. We studied 29 intact axon segments, 46 demyelinated axon segments, 86 MiDMs, and 169 MDMs in
14 lesions of 7 EAE onset mice from 3 EAE inductions as follows: 810 mice were immunized at each experiment and 23 onset mice were selected from
each induction.
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1537
and axolemma near the paranode complex (Fig. 4 A). The axoglial unit appeared otherwise healthy and no myelin debris
was found in the MDM cytosol. This observation suggested
that initial MDMaxoglial contacts might occur at nodes of
Ranvier. Further, we detected an intratubal (Stoll et al., 1989)
MDMs with myelin debris interposed between compact myelin and axolemma near a node of Ranvier (Fig. 4 B). Additionally we identified an MDM apposed to a node of Ranvier
and actively phagocytizing myelin (Fig. 4 C). At this node,
paranode loops were disrupted and surrounded by MDM cytosol (Fig. 4 C), indicating likely involvement in damaging myelin near the node. No MiDMs contacted nodes of Ranvier.
Nodal pathology without demyelination
at EAE onset in Ccr2rfp/rfp::Cx3cr1gfp/+ mice
We interpreted our ultrastructural findings to indicate that
MDMs recognized altered nodal structure and initiated demyelination at EAE onset. CCR2 is essential for monocyte recruitment to CNS tissues during immune-mediated inflammation
(Fife et al., 2000; Izikson et al., 2000; Savarin et al., 2010). To
Ar ticle
Figure 5. Nodal pathology without demyelination at EAE onset in Ccr2rfp/rfp::Cx3cr1gfp/+ mice. (A) Magnitude of weight loss in Ccr2rfp/+::Cx3cr1gfp/+ and
Ccr2rfp/rfp::Cx3cr1gfp/+ mice at preonset and onset stages of EAE. Clinical score in Ccr2rfp/+::Cx3cr1gfp/+ and Ccr2rfp/rfp::Cx3cr1gfp/+ mice at EAE onset stage. (B) Days
at disease preonset and onset stages of EAE. We studied 28 Ccr2rfp/+::Cx3cr1gfp/+ mice and 26 Ccr2rfp/rfp::Cx3cr1gfp/+ mice for A and B. Data were collected from
12 EAE inductions in Ccr2rfp/+::Cx3cr1gfp/+ mice and 19 EAE inductions in Ccr2rfp/rfp::Cx3cr1gfp/+ mice as follows: 810 mice were immunized at each induction and
13 EAE recovery mice were selected from each immunization. **, P < 0.01; ***, P < 0.001. (C) SBF-SEM imaging of MDMs with nodes of Ranvier phagocytosis in
Ccr2rfp/+::Cx3cr1gfp/+ mice at EAE preonset. Pink, MDM cytosol; red arrow, myelin inclusion of MDM connecting to the node of Ranvier. We studied 3 tissues from 3
Ccr2rfp/+::Cx3cr1gfp/+ EAE mice at preonset stage from 3 EAE inductions: 810 mice were immunized at each experiment and one EAE preonset mouse was selected
from each induction. Bar, 2 m. (D) SBF-SEM of disrupted nodes (black arrows) in preonset spinal cord tissues of Ccr2rfp/rfp::Cx3cr1gfp/+ mice. Bar, 2 m. (E) SBFSEM of neutrophil is with myelin phagocytosis from internode at preonset stage of Ccr2rfp/rfp::Cx3cr1gfp/+ mouse. Blue, neutrophil cytosol. For DE, we studied
three tissues from three Ccr2rfp/rfp::Cx3cr1gfp/+ EAE mice at preonset stage from 3 EAE inductions: 810 mice were immunized at each experiment and one EAE
preonset mouse was selected from each induction. Bar: 2 m. (F) Histochemical staining and with aurohalophosphate complexes (black gold staining) and quantification of demyelinated area of Ccr2rfp/+::Cx3cr1gfp/+ mice and Ccr2rfp/+::Cx3cr1gfp/+ mice. We studied 5 naive Ccr2rfp/+::Cx3cr1gfp/+ mice, 5 naive Ccr2rfp/rfp
::Cx3cr1gfp/+ mice, 5 onset Ccr2rfp/+::Cx3cr1gfp/+ mice, and 5 onset Ccr2rfp/rfp::Cx3cr1gfp/+ mice from 3 EAE inductions as follows: 810 mice were immunized at each
experiment and 12 onset mice were selected from each induction. **, P < 0.01. Bar: 250 m.
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1539
Figure 6. Inflammatory signature in MiDMs versus MDMs in the CNS of Cx3cr1gfp/+::Ccr2rfp/+ mice with EAE. (A) Quantitative nCounter expression profiling of 179 inflammation related genes was performed in CNS-derived GFP+ microglia and RFP+ recruited monocytes from naive and EAE mice
at onset, peak and recovery stages. Each row of the heat map represents an individual gene and each column an individual group from pool of 5 mice at
each time point. The relative abundance of transcripts is indicated by a color (red, higher; green, median; blue, low). For AH, we studied five mice in each
time point (onset, peak, recovery) from 3 EAE inductions; 810 mice were immunized in each induction. (B) Heat map of differentially expressed microglia
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having concave nucleus (Fig. 5 C, left) had multiple intracellular myelin inclusions, one of which (Fig. 5 C, left middle) was
physically connected to a myelin sheath (Fig. 5 C, right middle) at a paranode (Fig. 5 C, right), indicating active ongoing
demyelination at a node of Ranvier. By distinct contrast, EAE
onset tissues of Ccr2rfp/rfp::Cx3cr1gfp/+ mice were characterized
by nodal pathology often without cellular infiltrates (Fig. 5 D).
In one instance, we detected a neutrophil abstracting myelin
from the myelin internode (Fig. 5, left and right) despite a
nearby disrupted node (Fig. 5, left) in tissues from a Ccr2rfp/rfp::
Cx3cr1gfp/+ mouse. Importantly, there was no evidence for
neutrophil recognition of disrupted nodes of Ranvier. We interpreted these observations to suggest that MDMs specifically
recognized nodal components to initiate demyelination, and that
absence of MDMs at disrupted nodes of Ccr2rfp/rfp::Cx3cr1gfp/+
mice with EAE was caused by the virtual absence of infiltrating monocytes (Saederup et al., 2010).
To quantify the outcome of these ultrastructural differences,
we monitored demyelination using histochemical staining with
aurohalophosphate complexes at disease onset in Ccr2rfp/rfp::
Cx3cr1gfp/+ and Ccr2rfp/+::Cx3cr1gfp/+ mice. Demyelination was
significantly reduced at EAE onset in CCR2-deficient mice
(Fig. 5 F), indicating the importance of MDM recognition of
disrupted nodes for efficient inflammatory demyelination. Furthermore, as nodal pathology was equivalent in Ccr2rfp/rfp::
Cx3cr1gfp/+ (Fig. 5 D) and Ccr2rfp/+::Cx3cr1gfp/+ mice at the
preonset stage of EAE, the results suggested that inflammatory
nodal disruption could be reversible if MDMs were prevented
from initiating demyelination at those sites.
Expression profiling demonstrates differential
MiDMs and MDMs gene expression
across the time course of an EAE attack
We reasoned that different phenotypes (Fig. 1) and effector
properties (Figs. 24) of MDMs and MiDMs should be reflected in distinct gene expression profiles in the dynamic CNS
microenvironment during EAE. To address this hypothesis,
nCounter digital multiplexed gene expression analysis (Kulkarni,
2011) was performed using directly ex vivo naive microglia
and splenic F4/80+ macrophages (here termed monocytes and
considered similar to microglia by expression profiling; Gautier
et al., 2012), as well as flow-sorted MiDMs or MDMs across the
time course of an EAE attack. Microglia and MiDMs clustered together during unsupervised hierarchical clustering, as
did monocytes and MDMs (Fig. 6, A and B). In both MiDMs
and MDMs, naive and recovery-stage expression profiles were
more alike than were onset and peak-stage profiles (Fig. 6,
A and B) suggesting a return to homeostasis at EAE recovery.
and monocyte genes. (C) Enriched monocyte genes as compared with resident microglia. Bars represent fold changes of gene expression across naive and
all disease stages versus resident microglia. (D) Enriched microglia genes as compared with recruited monocytes. Bars represent fold changes of gene
expression across naive and all disease stages versus recruited monocytes. (EH) K-means clustering of inflammation genes in resident microglia and
recruited monocytes. K-means clustering was used to generate 5 disease stagerelated clusters in MiDMs. Heat map (E) and expression profile (F) of inflammation genes in MiDMs are shown by generated clusters. MDM expression matrix overlaid on microglial based clusters shows (G) heat map and
(H) expression profile.
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genes included a large spectrum of intracellular signaling components from the MAP-kinase pathways, as well as TGF and
receptor, both of which are implicated in the nave microglial
phenotype (Butovsky et al., 2014).
These five gene groups were also analyzed for MDM expression patterns during EAE (Fig. 6, G and H). None of the
gene groups showed coordinate regulation patterns in MDMs,
as were observed in MiDMs (Fig. 6 H). This observation underscored disparate responses of MiDMs and MDMs to the
inflammatory CNS microenvironment of EAE, despite their
being present in close proximity (Fig. 1 A).
Expression patterns at EAE onset
in relation to MiDM and MDM function
To determine whether gene expression patterns could be informative for understanding the relationships of cells to axoglial elements in tissues at EAE onset, we interrogated naive
versus onset MDM and MiDM gene expression related to
cellular functions (Fig. 7). MiDMs showed highly significant
up-regulation of functions associated with cell movement, chemoattraction, and migration (Fig. 7 B). In the Ingenuity IPA
database, the terms cell movement, chemoattraction, and migration indicated production of chemokines such as CCL2,
CCL3, CCL4, CCL5, and CCL7, which are up-regulated at
onset and further increased at peak (Fig. 6, E and F, green
group and genes). In other respects, MiDMs exhibited a repressed metabolic and activation phenotype by comparison
to naive microglia (Fig. 7 B) including proliferation, RNA
metabolism, cytoskeletal organization, microtubule dynamics,
extension of processes, phagocytosis and generation of reactive oxygen species.
MDMs showed up-regulation of functions associated to
macrophages, including phagocytosis, calcium signaling, production of prostanoids, adhesion, autophagy, and cell clearance
(Fig. 7 B).This pathway analysis corresponded well to effector
properties displayed by MDMs in our SBF-SEM analysis
(Figs. 24). No functions were reported to be down-regulated
in MDMs at EAE onset as compared with naive monocytes.
A comprehensive listing (Table S1) of all genes regulated
by at least twofold in MiDMs or MDMs as compared with
expression levels in naive mice affirmed and extended these
interpretations. At EAE onset when SBF-SEM analyses were
performed, MiDMs predominantly suppressed the distinctive
gene expression pattern which correlates to their unique phenotype (Chiu et al., 2013), reflected by the observation that
MiDMs down-regulated far more genes than were up-regulated
(Table S1). In contrast, MDMs up-regulated far more genes
than did MiDMs and up-regulated more transcripts than were
down-regulated. Additionally, the extent of gene up-regulation
in MDMs exceeded that seen in MiDMs.
MiDM and MDM gene expression kinetics reflected
return toward homeostasis in recovery stage
These expression profiles showed consonant changes for the
vast majority of genes analyzed: if a gene was up-regulated at
any time point, then its expression level showed an increase at
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cells found in isolation attached to axoglial units and demonstrated destructive interactions with myelinated axons in 3D
reconstructions. Second, MDMs were unexpectedly observed
at nodes of Ranvier in 9% of axoglial units and showed remarkably invasive behavior, including extension of microvilli (Fig. 4 A)
or localization of cell soma (Fig. 4 B) between axolemma and
myelin sheath. Our observed frequency of MDMnodal interaction represents a minimum estimate as MDMs found at heminodes adjacent to a demyelinated segment (Fig. 3 B) were not
scored. Comparison of Ccr2rfp/rfp::Cx3cr1gfp/+ and Ccr2rfp/+::
Cx3cr1gfp/+ mice at and before EAE onset emphasized the
Figure 7. Affected functions in MiDMs and MDMs at EAE onset. nCounter inflammatory gene expression data were uploaded to IPA. Genes with
fold change (EAE onset vs. Naive) 1.5 or 1.5 were included in downstream effects analysis. (A) MDMs up-regulated functions, sorted by activation
z-score. (B) MiDMs up-regulated (left) and down-regulated (right) functions, sorted by activation z score. The bias term indicates imbalanced numbers of
up- and down-regulated genes associated with a distal function requiring significance at the P < 0.01 level. We studied pooled samples from 5 mice in
each time point (onset, peak, recovery) from 3 EAE inductions; 810 mice were immunized in each induction.
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Figure 8. Restoration of affected inflammatory genes in resident microglia and recruited monocytes at recovery stage. For each gene, fold
change of all different disease stages versus naive state were calculated. Genes that contained at least one fold change >2 or < 0.5 and average fold
change for peak and onset >2 or <0.5 were presented. (A) Microglial up-regulated; (B) Microglial down-regulated; (C) monocyte up-regulated; (D) monocyte
down-regulated. We studied pooled samples from five mice in each time point (onset, peak, recovery) from three EAE inductions; 810 mice were immunized in each induction. FC, fold change.
1544
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Figure 9. Function networks in MiDMs and MDMs. nCounter inflammatory gene expression data were uploaded to IPA. Genes with fold change
(EAE onset vs. Naive) 1.5 or 1.5 were included in upstream regulators analysis. Predicted upstream regulators were manually curated to form functional clusters. Clusters were uploaded to IPA using Z scores as reference value for each gene. Networks were generated for each cluster consisting of
uploaded genes and additional predicted molecules. (A) Typical example of functions with dissimilar activation pattern in MiDMs and MDMs: HIF1A.
(B) Function with similar activation pattern in MiDMs and MDMs: Type I IFN. Red object denotes positive (>2) z score and green object denotes negative
JEM Vol. 211, No. 8
1545
opsonins (Nauta et al., 2004); and stress-induced eat-me signals (Hochreiter-Hufford and Ravichandran, 2013), it may be
feasible to identify a direct molecular pathway for initiating demyelination in this model. Third, we characterized a molecular signature for resident microglia at EAE onset. Grouping of
regulated genes into functional categories demonstrated a
remarkable down-regulation of microglial metabolism at the
nuclear, cytoplasmic and cytoskeletal levels.
In our initial experiments we found that the presence of
myelin debris at the peak of EAE did not discriminate MDMs
from MiDMs. We considered that SBF-SEM would exhibit
advantages for spatial resolution (Denk and Horstmann, 2004)
required for characterizing relationships of myeloid cells to
axoglial units during the inflammatory demyelinating process
at EAE onset.To take advantage of this technique we developed
methods based on cell volume and process number (Fig. 1 E),
to distinguish MDMs from MiDMs in 0.2-m confocal optical
sections, and translated this approach directly to SBF-SEM
image sets at 0.2-m intervals.We also noted differential nuclear
morphology, mitochondrial shape, and osmiophilic granule
content between MDMs and MiDMs. These characteristics of
MDMs and MiDMs may not be universally present in other
pathological circumstances but demonstrate an approach
to ultrastructural distinction of myeloid cell populations in
tissue sections.
Gene expression profiling across the time course of EAE
yielded intriguing kinetics as analyzed by k-means clustering.
Five patterns were observed. Red group genes (increased at
onset) comprised the smallest number and involved several surface molecules: CCR1, CCR7, CXCR2, and CD40. Of these,
CCR7 and CD40 have been reported on activated microglia,
including those observed in MS tissue sections (Kiviskk et al.,
2004; Serafini et al., 2006). GAPDH was up-regulated in
MiDMs at onset. Although often regarded as a housekeeping
gene, GAPDH is found in complexes that limit the translation
of inflammatory gene transcripts in activated mouse macrophages (Mukhopadhyay et al., 2009; Arif et al., 2012). As previously reported (Chiu et al., 2013), MiDM gene expression
during the course of EAE did not correspond to the M1/M2
pattern of peripheral macrophage responses to infection or tissue injury. Microglial morphological transformation can be
relatively uniform regardless of the inflammatory process that
provokes it. Despite this apparent uniformity, gene expression
by morphologically identical microglia can differ drastically
contingent on context (Perry et al., 2007).
Unsupervised hierarchical clustering provided insight into
gene expression patterns of MDMs and MiDMs. Naive and
recovery patterns were similar for both cell types. At disease
onset, microglia showed drastic down-regulation of the expression profile observed in cells from healthy brain. Brisk microglial proliferation (Ajami et al., 2011) may have accelerated
(<2) z-score. Orange object denotes predicted activation of the network object. Blue object denotes predicted inhibition of the network object. Predicted
relationships (connecting lines): orange, leads to activation; blue, leads to inhibition; yellow, finding inconsistent with state of downstream molecule;
gray, effect not predicted.
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1549
INSIGHTS
The real thing: How to make human DC subsets
The developmental relationship between monocytes, dendritic cells (DCs), and macrophages has been
well defined in mice, but human DC development is less well understood and has been hampered by
the lack of a suitable culture system. Now, two papers published in this issue describe a novel in vitro
culture system for human DC progenitors and the use of this system to elucidate the pathway of human
DC development.
The extent to which mouse studies are useful to understand the human immune system is debatable.
One
expectsand observesimportant similarities, but there are also differences in the way the building
Insight from
blocks of the immune system are assembled in different species of vertebrates that have evolved in different
Frederic
contexts and milieus, and with different lifespans. Laboratory mice, maintained as inbred strains under
Geissmann
selected housing conditions, are amendable to controlled genetic studies. However, genetic and environmental
variations are difficult to control in human studies, and experimental limitations make it difficult to assess whether "mouse"
immunology "works" in humans.
The two studies in this issue, by Lee et al. and Breton et al., represent an important advance in the DC field. The work
describes, at the population and single cell level, a hierarchy of human myeloid precursors that closely parallel the hierarchy in
the mouse bone marrow and blood. The authors used a combination of technically impressive qualitative and quantitative
approaches, including in vitro differentiation of human hematopoietic precursors cultured on a stromal cell line with defined
sets of cytokines, in vivo "cultures" of human precursors in immunodeficient NOD-scid g mice, and observational studies in
humans. This allowed them to map out the development of monocytes, conventional DCs (cDCs), and plasmacytoid DCs
(pDCs), and the sequential relationship between the different precursor populations. They showed that a granulocytemonocyte-DC progenitor (hGMDP) develops into a monocyte-DC progenitor (hMDP), which itself differentiates into monocytes and into a common DC progenitor (hCDP) that produces the three major human DC subsets (CD1c+ cDCs, CD141+ cDCs,
and pDCs). Furthermore, they report the identification of an immediate DC precursor (hpre-cDC) that originates from the
hCDP, circulates in the human blood,
and increases in response to plasma levels
of the cytokine FLT3.
These results are a significant advance
in the field. They illustrate the similarities between mice and humans regarding
the development of monocytes, cDCs,
and pDCs, and provide a guideand
experimental systemsto further interrogate the genetic and molecular
control of human monocyte/DC development and their functions in disease.
It is possible to imagine that DC-based
therapy may benefit from knowledge
Schematic of the developmental relationship between human monocytes, cDCs, and pDCs.
of the "real thing."
Breton, G., et al. 2015. J. Exp. Med. http://dx.doi.org/10.1084/jem.20141441.
Lee, J., et al. 2015. J. Exp. Med. http://dx.doi.org/10.1084/jem.20141442.
Frederic Geissmann, Centre for Molecular and Cellular Biology of Inflammation, Kings College London: frederic.geissmann@kcl.ac.uk
Ar ticle
of Microbiology and Immunology, Columbia University Medical Center, New York, NY 10032
of Molecular Immunology and 3Howard Hughes Medical Institute, The Rockefeller University, New York, NY 10065
4Case Western Reserve University, Cleveland, OH 44106
2Laboratory
CORRESPONDENCE
Kang Liu:
kl2529@columbia.edu
OR
Michel C. Nussenzweig:
nussen@rockefeller.edu
Abbreviations used: cDC, conventional DC; CDP, common
dendritic progenitor; CLP,
common lymphoid progenitor;
CML, chronic myelogenous
leukemia; CMP, common
myeloid progenitor; GMP,
granulocyte-macrophage
progenitor; hGMDP, human
granulocyte-monocyte-DC
progenitor; hMDP, human
monocyte-dendritic progenitor;
HSC, hematopoietic stem cell;
HSPC, hematopoietic stem
and progenitor cell; LMPP,
lymphoid-primed multipotent
progenitor; MDP, macrophage/
dendritic progenitor; MLP,
multilymphoid progenitor;
MPP, multipotent progenitor;
NSG, NOD-scid-IL2Rgnull;
pDC, plasmacytoid DC; SCF,
stem cell factor.
In the mouse, DC differentiation is dependent on a hematopoietin, Flt3L, whose receptor, Flt3 (CD135), is expressed throughout DC
development (McKenna et al., 2000; Karsunky
et al., 2003; Waskow et al., 2008). In contrast,
other hematopoietin receptors such as monocyte
colony-stimulating factor receptor (M-CSFR
or CD115) and granulocyte macrophage colonystimulating factor receptor (GM-CSFR or
CD116) are restricted to hematopoietic progenitors of DCs but not expressed on all mature DCs (Kingston et al., 2009).
DC development in the human is far less
well understood than in the mouse. Human
monocytes can be induced to differentiate into
potent antigen-presenting cells with some
2015 Lee et al. This article is distributed under the terms of an Attribution
NoncommercialShare AlikeNo Mirror Sites license for the first six months after
the publication date (see http://www.rupress.org/terms). After six months it is
available under a Creative Commons License (AttributionNoncommercialShare
Alike 3.0 Unported license, as described at http://creativecommons.org/licenses/
by-nc-sa/3.0/).
385
phenotypic features of DCs after in vitro culture with cocktails of cytokines (Sallusto and Lanzavecchia, 1994). However,
these monocyte-derived DCs are more closely related to activated monocytes than to cDCs (Naik et al., 2006; Xu et al.,
2007; Cheong et al., 2010; Crozat et al., 2010). Progress in
defining the human DC lineage has been hampered, in part,
by a paucity of reliable markers to distinguish these cells from
monocytes, limited access to human tissues, the relatively
small number of circulating DCs in blood, and the lack of
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CD1c+ cDCs did not, which suggests that blood- and culturederived cells are not identical (Fig. 2 a and Fig. S2). Notably,
all of the culture-derived CD1c+ and CD141+ cDCs differed
from primary bloodderived counterparts in a similar manner in that they were enriched for expression of genes that
mediate cell division, as determined by Gene Set Enrichment
Analysis (GSEA; Fig. 2 e, Fig. S2, and Table S4).This alteration
in gene expression is likely the result of increased proliferation in the cultures caused by high levels of Flt3L. Consistent
with this idea, primary peripheral bloodderived CD141+
cDCs phenocopy the culture-derived cells by acquiring
CD1c expression when they are placed into the MS5+FSG
(Fig. 2 f) or skin culture (Haniffa et al., 2012), and peripheral
blood CD141+ cDCs also coexpress CD1c in individuals that
are treated with Flt3L (see accompanying manuscript Breton
et al. in this issue). Finally, both culture-derived and primary
CD1c+ cDCs purified from peripheral blood acquire CD14
expression in culture (Fig. 2 f ).
Gene array data were confirmed by flow cytometry using
selected markers. Similar to primary pDCs, culture-derived
pDCs express high levels of CD123 and CD45RA and low
levels of HLA-DR but differ from mature cDCs in that they
do not express CD11c or CD86 (Fig. 3 a). In contrast, culturederived CD1c+ and CD141+ cDCs resemble their primary
peripheral bloodderived counterparts in their differential
expression of CX3CR1 and CD172a and in expressing high
levels of CD11c, HLA-DR, and CD86 but not CD83 or
CD80 (MacDonald et al., 2002; Lindstedt et al., 2005; Mittag
et al., 2011). Of note, CD1a and DC-SIGN, which are expressed by monocyte-derived DCs and absent on primary
CD1c+ cDCs (Chang et al., 2000), are not expressed on
culture-derived CD1c+ or CD141+ cDCs (Fig. 3 a). In addition,
culture-derived CD141+ cDCs express CLEC9a (DNGR1;
Fig. 3 a), a marker specifically expressed on primary CD141+
cDCs (Poulin et al., 2010, 2012).
To examine the functional properties of cultured-derived
cDCs, we measured their responses to TLR ligands. Like their
primary bloodderived counterparts, only the culturederived pDCs produced IFN- in response to CpG (Fig. 3 b;
Ito et al., 2005; Liu, 2005). Similarly, culture-derived and primary CD141+ cDCs produced the highest amount of IFN-
and IL-12 in response to Poly(I:C) (Fig. 3 b; Kadowaki et al.,
2001; Poulin et al., 2010). We conclude that MS5+FSG supports differentiation of multiple hematopoietic lineages from
their progenitors, including human pDCs and CD1c+ and
CD141+ cDCs.
DC-restricted progenitors
Several different, early, CD34+ hematopoietic progenitors purified from human cord blood or BM are reported to give rise
to DCs (Chicha et al., 2004; Ishikawa et al., 2007; Doulatov
et al., 2010; Kohn et al., 2012). These include common lymphoid progenitors (CLPs; Galy et al., 1995; Chicha et al., 2004;
Ishikawa et al., 2007), common myeloid progenitors (CMPs;
Akashi et al., 2000; Manz et al., 2002; Chicha et al., 2004;
Ishikawa et al., 2007), granulocyte-macrophage progenitors
387
Figure 2. Culture-derived DCs resemble primary DCs. (ae) Transcriptional profiling of pDCs, monocytes, and CD1c+ and CD141+ cDCs purified
from primary peripheral blood (blood; six healthy individuals) or from culture of CD34+ cells in MS5+Flt3L for 14 d (culture; four cord blood donors) as
in Fig. S1. (a) Hierarchical clustering dendrogram of cultured versus primary pDCs, monocytes, and CD1c+ and CD141+ cDCs. This dendrogram was generated using the top 611 differentially expressed genes selected by unsupervised clustering (sparse hierarchical clustering using all genes; Table S5).
(b) Heat map showing the sparse hierarchical clustering of mRNAs expressed by primary and culture-derived pDCs and monocytes. This analysis showed
that a minimal number of 78 genes is enough to distinguish one cell type from another. The normalized expression values for the top 78 differentially
expressed genes (Table S1) are displayed. (c) Heat map showing the sparse hierarchical clustering of mRNAs expressed by primary and culture-derived
388
Ar ticle
CD1c+ and CD141+ cDCs. This analysis showed that a minimal number of 80 genes is enough to distinguish one cell type from another. The normalized
expression values for the top 80 differentially expressed genes (Table S2) are displayed. (d) Heat map showing the hierarchical clustering of mRNAs for
selected genes (Table S3) expressed by primary and culture-derived pDCs, monocytes, and CD1c+ and CD141+ cDCs. (e) Top 50 enriched KEGG metabolic
pathways (Table S4) for genes shared by both subsets of cultured cDCs but not primary cDCs according to GSEA analysis. (f) Phenotype change of blood
CD141+ and CD1c+ cDCs in culture. Blood CD141+ and CD1c+ cDCs were purified and cultured for 7 d in MS5+FSG. Flow cytometry plots of gated CD45+
cells show cell surface markers of output cells.
JEM Vol. 212, No. 3
389
Figure 4. Fractionation of cord blood progenitors based on cytokine receptor expression. (a and b) Flow cytometry plots show exhaustive separation of CD34+ cord blood cells into six populations, HSCs/MPPs, MLPs, B and NK progenitors (B/NK), CMPs, megakaryocytic and erythroid progenitors
(MEP), and GMPs (a), and expression of CD115, CD116, CD135, and CD123 on each of the cord blood CD34+ populations in a (b).
Ar ticle
hCDPs produced rare CFU, hMDPs produced mostly monocytes but no granulocytes, and hGMDPs produced both
monocytes and granulocytes but no erythrocytes (Fig. 5 f ).
To define the relationship between hCDPs, hMDPs, and
hGMDPs and previously reported DC progenitors, we performed cross-phenotyping experiments.We found that, GMPs
include hCDPs, hMDPs, and hGMDPs; myeloid DC progenitors overlap with hCDPs; LMPPs partially overlap with
hCDPs, hMDPs, and hGMDPs, whereas CLPs, MLPs, and
CMPs do not overlap with hCDPs, hMDPs, and hGMDPs
(Fig. 5 g). We conclude that populations containing hGMDPs,
hMDPs, and hCDPs can be isolated from human cord blood
by using cytokine receptor expression to distinguish them
from less committed leukocyte precursors.
Single cell assays
To examine the developmental potential of individual cells in
the hGMDP, hMDP, and hCDP populations, we purified and
cultured single cells from each population. The relative clonal
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Figure 7. Relationship of hGMDPs to hMDPs and to hCDPs. (a) 10,000 hGMDPs were purified from cord blood and adoptively transferred into the
bone cavity of the preconditioned NSG mice (Materials and methods). 7 d later, BM cells were analyzed. Flow cytometry plots show phenotype of BM cells
from NSG mice receiving PBS or hGMDPs (n = 3 mice). (b) 200400 hGMDP, hMDP, and hCDP cells were purified and cultured in MS5+FSG. Cultures were
analyzed on days 1, 4, and 8. Flow cytometry plots gated on live CD45+Lin(CD3/19/56/14)DC(CD1c/141/303)CD45RA+ cells show cell surface markers
and frequency of hCDPs, hMDPs, and hGMDPs. Results are representative of three independent experiments.
DISCUSSION
We have delineated the developmental pathway that leads to
production of human DCs and enumerated these cells in cord
blood and BM. This pathway involves sequential loss of developmental potential from a progenitor that can produce granulocytes, monocytes, and DCs (hGMDPs), to one that produces
monocytes and DCs (hMDPs), to a committed DC progenitor
that produces cDCs and pDCs (hCDPs). Others have shown
that human GMPs, CLPs, and LMPPs can produce human DCs
(Chicha et al., 2004; Ishikawa et al., 2007; Kohn et al., 2012).
Our findings are not inconsistent with these observations because GMPs and LMPPs are heterogeneous groups of cells that
contain subpopulations with the cell surface features of DC progenitors, as revealed by cross-phenotyping (Fig. 5 g).
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for monocytes and DCs, but not for granulocytes. Additionally, mutations of IRF8 cause monocyte and DC deficiency
without affecting granulocytes (Hambleton et al., 2011), implying an IRF8-dependent developmental block in the transition from hGMDPs to hMDPs.
A second example involves chronic myelogenous leukemia (CML). CML is caused by BCR-Abl translocation and is
a myeloproliferative disease of granulocytes. CML patients
show a dramatic decrease of blood pDCs and cDCs but relatively normal numbers of monocytes (Boissel et al., 2004).
This is accompanied by a relative deficiency in CD34+CD123hi
hCDPs but only slightly reduced CD123intCD45RA+ cells,
which include hMDPs and hGMDPs (Diaz-Blanco et al.,
2007), suggesting a block in the transition from hMDPs to
hCDPs. The ability to purify human DC progenitors and follow their differentiation after transfer into NSG mice (Fig. 7 a;
Doulatov et al., 2010) should facilitate the study of human
DC differentiation in vivo.
Defining human DC progenitors required that we develop an efficient tissue culture method that supports development of all three major human DC subtypes: CD1c+
cDCs, CD141+ cDCs, and pDCs. Although others have
shown that human CD141+ cDCs could be obtained by expanding HSPCs in vitro and then subculturing them in SCF,
Flt3L, GM-CSF, and IL-4 (Poulin et al., 2010) and that stromal cells could facilitate pDC development (Spits et al., 2000;
Chicha et al., 2004; Olivier et al., 2006), defining DC progenitors required a culture system that would produce all
three types of DCs and also support development of monocytes, granulocytes, and lymphoid cells. Addition of stromal
cells to the cocktail of Flt3L, SCF, and GM-CSF is sufficient
to support efficient development of CD34+ human HSPCs
to lymphoid and myeloid cells, including B cells, NK cells,
granulocytes, and all three DC subsets without pre-expansion
of stem cells in vitro. Importantly, the DC subsets derived
from the stromal cell cultures closely resemble primary CD1c+
cDCs, CD141+ cDCs, and pDCs obtained from the blood of
normal donors as determined by gene expression, surface
phenotype, and cytokine production.
Flt3L, M-CSF, GM-CSF, and IL-3 exert distinct functions on development and homeostasis of monocytes, cDCs,
and pDCs (Schmid et al., 2010; Merad et al., 2013). Our
experiments show that human CD34+ progenitors are heterogeneous for expression of these cytokine receptors, but
they are all contained in the GMP fraction in cord blood.
GMP can be divided into five populations based on CD115,
CD116, and CD123 expression. Three of these populations
show potential to produce granulocytes, monocytes, and
DCs: hGMDPs, hMDPs, and hCDPs. In healthy individuals, these hGMDPs, hMDPs, and hCDPs are found in cord
blood and in the BM. They do not circulate and are not
found in peripheral lymphoid organs. Most of CD141+
cDCs derived from BM progenitors, particularly those derived from hCDPs, did not up-regulate CLEC9a. This may
result from subtle differences between progenitors from adult
BM and cord blood.
JEM Vol. 212, No. 3
Although the cell surface markers that define DC precursors are not entirely conserved between mouse and human,
there is significant overlap, especially in cytokine receptor
expression. Importantly, using cytokine receptor expression
is crucial for purification of lineage-restricted progenitors.
For instance, the originally discovered mouse MDPs
(LinCX3CR1-GFP+cKit+) lack granulocyte potential (Fogg
et al., 2006). However, a subpopulation with 13-fold higher
clonal efficiency to produce DC-monocyte/macrophage
(Sathe et al., 2014) can be purified using the CD115+CD135+
phenotype from the original MDP population. Moreover,
the sequential loss of granulocyte and monocyte potential in
humans parallels DC differentiation in the mouse. For example, in both species, MDP is a stage marked with loss of granulocyte potential and expression of CD115 (Fogg et al., 2006;
Waskow et al., 2008), the receptor which enables monocyte
and macrophage development (Witmer-Pack et al., 1993;
Greter et al., 2012). This degree of conservation is an indication of the relative importance of this pathway during vertebrate evolution.
MATERIALS AND METHODS
Cell samples. Human umbilical cord blood and leukophoretic peripheral
blood (buffy coat) were purchased from the New York Blood Center.
Human BM was obtained from total hip arthroplasty by J. Schreiber at Hospital for Special Surgery (New York). Tonsils were obtained from routine
tonsillectomies performed at the Babies and Childrens Hospital of ColumbiaPresbyterian Medical Center. Informed consent was obtained from the
patients, and/or samples were exempt from informed consent being residual
material after diagnosis and fully de-identified. All samples were collected
according to protocols approved by the Institutional Review Board at Columbia University Medical Center (CUMC) and The Rockefeller University. The specimens were kept on ice immediately after surgical removal.
Tonsil samples were minced, treated with 400 U/ml collagenase (Roche) at
37C for 20 min, and proceeded to cell isolation. BM samples were preserved in solution containing 1,000 U/ml heparin (National Drug Code
#63323-540-11) and digested in RPMI containing 20 mg/ml collagenase
IV (Sigma-Aldrich) for 15 min at 37C. After density centrifugation using
Ficoll-Hypaque (GE Healthcare), aliquots of mononuclear BM cells were
frozen and stored in liquid nitrogen for future analysis.
Cell isolation and flow cytometry. Fresh mononuclear cells were isolated by density centrifugation using Ficoll-Hypaque (GE Healthcare). Samples from cord blood, peripheral blood, BM, and tonsil were incubated with
fluorescent-labeled antibodies for direct analysis on the LSRII flow cytometers (BD) or further purification by fluorescence-activated cell sorting on the
Influx or FACSAria (BD), both using HeNe and argon lasers. Sorted population showed >95% purity.
For purification of differentiated DCs and monocytes from peripheral
blood and culture, cells were stained with LIVE/DEAD (Life Technologies),
CD45 (HI30, Alexa Fluor 700 [AF700]; BioLegend), CD66b (G10F5,
PerCP-Cy5.5; BioLegend), CD56 (B159, Pacific Blue; BD), CD19 (HIB19,
APC-Cy7; BioLegend), CD14 (TuK4, Qdot-655; Invitrogen), CLEC9a
(8F9, PE; BioLegend), CD1c (L161, PE-Cy7; BioLegend), CD303 (201A,
FITC; BioLegend), CD123 (6H6, Brilliant Violet [BV] 510; BioLegend),
and CD141 (AD5-14H12, APC; Miltenyi Biotec) for 40 min on ice. Alternatively, we used CD335 (9E2, BV421; BioLegend), CD11c (3.9, A700;
eBioscience), CD3 (S4.1, PE Texas Red; Invitrogen), and CD19 (SJ25-C1,
PE Texas Red; Invitrogen).
For surface marker analysis, CD11c (3.9; BioLegend), HLA-DR (G46-6;
BD), CD80 (2D10, Biotin; BioLegend), CD83 (HB15e; BioLegend), CD86
(IT2.2; BioLegend), and DC-SIGN/CD209 (DCN46; BD) were used in
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progenitor cultures. Figs. S4S8 show hCDP (Fig. S4), hMDP (Figs. S5 and
S6), and hGMDP (Figs. S7 and S8) single cell lineage potential. Tables S1
S5 are included in a separate Excel file. Table S1 shows the top 78 regulated
genes in cultured and primary pDCs and monocytes. Table S2 shows the
top 80 regulated genes in cultured and primary CD1c+ cDCs and CD141+
cDCs. Table S3 shows comparison of selected gene expression for pDCs,
monocytes, CD1c+ cDCs, and CD141+ cDCs. Table S4 lists all metabolic
pathways enriched in cultured cDCs when compared with primary cDCs.
Table S5 shows the top 611 regulated genes in primary or cultured pDCs,
monocytes, CD1c+ cDCs, and CD141+ cDCs. Online supplemental material
is available at http://www.jem.org/cgi/content/full/jem.20141442/DC1.
This work was inspired by Ralph M. Steinman.
We thank Klara Velinzon (Flow Cytometry Core Facility, Laboratory of Molecular
Immunology, The Rockefeller University) for technical support with polychromatic
flow cytometry sorting and Dr. Chiara Borsotti (Columbia Center for Translational
Immunology, Columbia University Medical Center) for teaching intrabone cavity
injection. We thank Peter Wilkinson (Case Western Reserve University) and
Stephanie Richards (Collaborative Genomics Center, Vaccine and Gene Therapy
Institute of Florida) for their input in microarray analysis. We thank Heidi Schreiber
(Laboratory of Molecular Immunology, The Rockefeller University) for help with
human BM protocol and Joseph Schreiber for providing human BM specimen. We
thank Tibor Keller for giving us Flt3L.
Research reported in this publication was supported by the Empire State Stem
Cell Fund through New York State Department of Health Contract #C029562
(to K. Liu), Helmsley Foundation (to K. Liu), National Institutes of Health (NIH) grants
AI101251 (to K. Liu) and NS084776 (to S. Puhr), Iris and Junming Le Foundation
(to G. Breton), NIH grant 1U19AI111825-01 (to M.C. Nussenzweig), Clinical and
Translational Science Awards, The Rockefeller University Center for Clinical and
Translational Science (RUCCTS) grant no. UL1RR024143 from the National Center
for Research Resources, NIH, and NIH grant AI13013. The RUCCTS is supported, in
part, by a Clinical and Translational Science Award (CTSA) and the National Center
for Advancing Translational Sciences (NCATS), part of the NIH. M.C. Nussenzweig is
a Howard Hughes Medical Institute investigator.
The authors declare no competing financial interests.
Submitted: 30 July 2014
Accepted: 28 January 2015
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Progenitor of human dendritic cells | Lee et al.
Ar ticle
399
Article
University Medical Center, Department of Microbiology and Immunology, New York, NY 10032
of Molecular Immunology, 3Howard Hughes Medical Institute, The Rockefeller University, New York, NY 10065
4Department of Dermatology Brigham and Womens Hospital, Boston, MA 02115
5Hospital for Special Surgery, New York, NY 10021
6Celldex Therapeutics, Hampton, NJ 08827
2Laboratory
Two subsets of conventional dendritic cells (cDCs) with distinct cell surface markers and
functions exist in mouse and human. The two subsets of cDCs are specialized antigenpresenting cells that initiate T cell immunity and tolerance. In the mouse, a migratory cDC
precursor (pre-CDC) originates from defined progenitors in the bone marrow (BM). Small
numbers of short-lived pre-CDCs travel through the blood and replace cDCs in the peripheral
organs, maintaining homeostasis of the highly dynamic cDC pool. However, the identity and
distribution of the immediate precursor to human cDCs has not been defined. Using a tissue
culture system that supports the development of human DCs, we identify a migratory precursor (hpre-CDC) that exists in human cord blood, BM, blood, and peripheral lymphoid organs.
hpre-CDCs differ from premonocytes that are restricted to the BM. In contrast to earlier
progenitors with greater developmental potential, the hpre-CDC is restricted to producing
CD1c+ and CD141+ Clec9a+ cDCs. Studies in human volunteers demonstrate that hpre-CDCs
are a dynamic population that increases in response to levels of circulating Flt3L.
CORRESPONDENCE
Kang Liu:
kl2529@columbia.edu
OR
and Michel C. Nussenzweig:
nussen@rockefeller.edu
Abbreviation used: cDCs, conventional DCs; CDP, common
dendritic progenitor; pre-CDC,
cDC precursor; MS5+FSG,
MS5 stromal cells with Flt3L,
SCF, and GM-CSF cytokines.
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Figure 2. Screening of populations in the cord blood for committed cDC lineage potential. (a) Flow cytometry plots show gating of CD45+CD3
CD19CD56CD14CD66bCD1cCD141CD303 cells in human cord blood can be divided into four populations based on CD117, CD34, and CD135:
CD34+CD117+ (CD34+), CD34CD117 (CD117), CD34CD117+CD135 (CD135), and CD34CD117+CD135+ (CD135+). Numbers indicate the frequency
of respective gates. (b) Differentiation potential of 1,000 purified cells from each of 4 populations indicated in (a) in MS5+FSG cultures for 7 d. Flow cytometry plots show gated live human CD45+ cells. (c) Flow cytometry plots show CD135+ cells indicated as in (a) can be further separated into 4 populations
404
Ar ticle
with this notion, purified blood CD1c+ and CD141+ cDCs also
divided 34 times in culture (Fig. 4 c).Thus, hpre-CDCs have
a more limited proliferative capacity than CD34+ HSPCs
in vitro. Nevertheless, a single hpre-CDC may be able to give
rise to as many as 256 cDCs.
To determine the clonal efficiency of hpre-CDCs, we
compared them to CD34+ HSPCs and progenitors in limiting dilution assays. Whereas 1 in 4.57 CD34+ cells produced
CD45+ cells (i.e., granulocytes, monocytes, DCs, or lymphoid cells), 1 in 7.84 and 1 in 6.55 hpre-CDCs from cord
blood or peripheral blood, respectively, produced CD45+
cells during the culture period (Fig. 5 a). This is in line with
our observation that some hpre-CDCs remained undifferentiated in our cultures (Fig. 3 b). Although CD34+ HSPCs had
higher clonal potential, only 12 out of 43 (28%) were able to
produce cDCs (Fig. 5 c and Fig. S1), and both cord blood
and peripheral blood hpre-CDCs generated mainly cDCs
(Fig. 5 c, Fig. S2, and Fig. S3). Individual hpre-CDCs produced either CD1c+ cDCs or CD141+ cDCs or both (Fig. 5 b).
Of 81 cells assayed, 88% of all productive clones of cord
blood hpre-CDCs produced cDCs; 32% yielded only
CD141+ cDCs, 50% only to CD1c+ cDCs, and 6% produced
both CD1c+ and CD141+ cDCs (Fig. 5 c and Fig. S2). Of
105 cells assayed, 90% of hpre-CDCs from the PBMC produced only cDCs; 11% gave rise to CD141+ cDCs only, 65%
only to CD1c+ cDCs, and 14% produced both CD1c+ and
CD141+ cDCs (Fig. 5 c and Fig. S3). This demonstrates that
hpre-CDCs purified from peripheral or cord blood have
clonal efficiencies and differentiation potential similar to CD1c+
and CD141+ cDCs (Fig. 5 c). Only a very small fraction of
hpre-CDCs produced monocytes alone or monocytes and
DCs (Fig. 5 c; 11.5 and 10.5% from cord blood and peripheral blood, respectively). Thus, the hpre-CDC population in
peripheral and cord blood contains single cells with potential
to differentiate into both major subsets of human cDCs.
Progenitors of hpre-CDCs
We have identified a common DC progenitor in BM and
cord blood that produces pDCs and cDCs (hCDP; Lee et al.,
2015). To determine whether there exists a progenitorprogeny
relationship between the hCDP and hpre-CDC (Fig. 6 a),
we purified hCDPs from cord blood (Fig. 6 b) and tested
whether they differentiate into hpre-CDCs in MS5+FSG
culture. hCDPs down-regulated CD34 as early as 1 d after
culture and diverged into two populations: one group of cells
up-regulated CD303 and assumed a pDC phenotype, the other
group was CD303 but expressed CD45RA, CD117, and
CD116 resembling hpre-CDCs. The number of hpre-CDCs
based on CD116, CD115, and CD45RA: CD135+CD116 (CD116), CD135+CD116+CD45RA(CD45RA), CD135+CD116+CD45RA+CD115+ (CD115+), and
CD135+CD116+CD45RA+ CD115 (CD115). (d and e) Differentiation potential of 100 purified cells from each of 4 populations indicated in (c) in
MS5+FSG cultures for 7 d. (d) Flow cytometry plots of CD45+ cells gated as in (c), showing expression of CD141, CLEC9a, CD1c, and CD19. (e) Graphs
show mean output of pDC, CD1c+ cDC, CD141+ cDC and monocytes from each population from three independent experiments. (f) Histograms show expression of CD11c, HLA-DR, CD123, CD135, CD117, CD45RA, CD116, and CD115 on indicated cell-type. (g) Morphology of purified cord blood hpre-CDCs
by Giemsa staining of cytospin preparations (100). Dotted lines indicate cropping out of white space between cells. Bar, 10 m.
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405
(BM), three (PB), and two (tonsil) independent experiments are shown.
(c) Differentiation potential of purified premonocytes from cord blood
(CB) and BM in MS5+FSG cultures for 5 d. FACs plots show phenotype
of gated live human CD45+ culture-derived cells including monocytes
(orange) and CD1c+ cDCs (blue). Representative of three independent
experiments are shown.
Circulating precursors of human dendritic cells | Breton et al.
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Figure 4. Proliferative capacity of hpre-CDCs. (a) Expansion of purified hpre-CDCs or CD34+ HSPCs from peripheral blood (PB) or cord blood (CB) in
MS5+FSG cultures for 7 d. Graph shows the mean fold change of live human CD45+ cells from 100 input cells from three independent experiments. *, P <
0.005, unpaired two-tailed Students t test. (b and c) CD34+ HSPCs and hpre-CDCs were purified from CB, labeled with CFSE, and cultured in MS5+FSG for
2 or 7 d; proliferation was assessed by flow cytometry. FACs plots show (b) gated CD45+ culture-derived cells, including CD34+ cells (purple), CD34CD1c
CD141 cells (orange), CD141+ cDCs (red), and CD1c+ cDCs (blue) and (c) their CFSE dilution. Dotted lines mark last division by hpre-CDCs. Plots are representative of three independent experiments.
Other myeloid populations, such as monocytes and granulocytes also expand in response to Flt3L, starting on day 5
and peaking on day 14 after the initial injection (Fig. 7,
e and f). Interestingly, comparison of the fold change at day
14 indicates that Flt3L preferentially increases the number
of human cDCs and their progenitors rather than the other
myeloid subsets, i.e., pDCs, monocytes, and granulocytes in
blood (Fig. 7 g).
DISCUSSION
DCs turn over in tissues and must be replaced continuously to
maintain homoeostasis (Liu et al., 2007; Liu and Nussenzweig,
2010). In the mouse, lymphoid and nonlymphoid tissue
resident DCs are continually replenished by pre-CDCs,
which are produced in the BM, enter the circulation and then
emigrate into tissues to differentiate into both major subsets
of cDCs (Naik et al., 2006; Bogunovic et al., 2009; Ginhoux
et al., 2009; Liu et al., 2009; Varol et al., 2009). Defining
the mouse pre-CDC was essential to establishing that DCs
represent a unique cell lineage because pre-CDCs do not
produce monocytes, or pDCs; their differentiation potential
is restricted to cDCs.
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Figure 6. hpre-CDCs descend from hCDPs. (a) Flow cytometry plots show comparison of hCDP (purple) and hpre-CDC (orange) in cord blood. (b) Flow
cytometry plots of gated CD45+Lin(CD3/19/56/14)CD34+ show phenotype and purity of magnetically enriched cord blood (CB) CD34+ cells (presorting,
upper) and sorted cells (post-sorting, bottom). hCDPs were gated as CD34+CD38hiCD45RA+CD10CD123hi. (c) Differentiation kinetics of hCDPs purified
from CB in MS5+FSG cultures for 1, 2, or 4 d. FACs plots show culture output of live human CD45+ cells, including CD34+ cells (purple), pDC (green),
CD1c+ cDC (blue), CD141+ cDCs (red), and hpre-CDCs (orange). Representative of four independent experiments are shown. Graphs summarize composition of indicated populations among total hCD45+ cells. Bars are mean values from four independent experiments, and error bars are SEM.
within 1 min after entering the blood, indicating a t1/2 < 1 min
(Liu et al., 2007, 2009). Thus, a cell with a half-life in circu
lation of 24 h would have to be present in circulation at a
1,440-fold higher concentration than the pre-CDC to achieve
the same overall flux. Similar behavior has been demonstrated
for HSCs in the circulation (Wright et al., 2001). Like their
mouse counterparts, hpre-CDCs have limited expansion potential (Fig. 4 a; Liu et al., 2009), but their immediate progeny, CD1c+ and CD141+ cDCs, can proliferate to further
expand the DC pool in the periphery (Fig. 4 c; Kabashima
et al., 2005; Liu et al., 2009; KC et al., 2014). We speculate that
this highly dynamic pool of specialized antigen-presenting
cells allows rapid adaptation to acute antigenic challenges.
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from cord blood, peripheral blood, BM, and tonsil were incubated with
fluorescent-labeled antibodies for direct analysis on the BDLSR II flow
cytometers (BD) or further purification by fluorescence-activated cell sorting on the BD FACSAria or Influx, both using HeNe and argon lasers.
For isolation of rare hpre-CDCs from cord blood and peripheral blood,
an enrichment step was performed before sorting. In brief, mononuclear cells
were incubated with antibodies against CD135 (4G8; PE; BD) and CD117
(A3C6E2; Biotin; BioLegend) for 40 min at 4C. After washing, antibody
Circulating precursors of human dendritic cells | Breton et al.
Ar ticle
against PE (PE001; Biotin; BioLegend) was added and incubated for another
10 min at 4C. After washing, CD117+ and CD135+ cells were positively selected using anti-biotin MicroBeads and LS MACS magnetic columns (Mil
tenyi Biotec). For sorting hpre-CDCs, enriched cells (from CB or PB) or total
mononuclear cells (from CB, PB, BM, or tonsils) were stained for CD14
(TuK4; Qdot-655; Invitrogen), CD3 (OKT3; Brilliant Violet [BV] 650;
BioLegend), CD19 (HIB19; BV650; BioLegend), CD56 (HCD56; BV650;
BioLegend), CD66b (G10F5; PerCP-Cy5.5; BioLegend), CD303 (201A;
PerCP-Cy5.5; BioLegend), CD1c (L161; APC-Cy7; BioLegend), CD141
(M80; PE-Cy7; BioLegend), CD34 (581; Alexa Fluor 700; BioLegend),
CD117 (104D2; BV421; BioLegend), CD135 (4G8; PE; BD), CD45RA
(HI100; BV510; BioLegend), CD116 (4H1; FITC; BioLegend), and CD115
(9-4D2-1E4; APC; BioLegend) for 40 min on ice. hpre-CDCs were isolated
as Lin(CD3/19/56/14)Granulocyte(CD66b)pDC(CD303)cDC(CD1c/
CD141)CD34CD117+CD135+SSClo CD116+CD115CD45RA+.
In addition to these antibodies, for surface marker phenotype characterization of fully differentiated cells, CD45 (HI30; Alexa Fluor 700; BioLegend), CD34 (581; APC-Cy7; BioLegend), CD3 (UCHT1; Biotin; BD),
CD19 (HIB19; Biotin; BD), CD56 (B159; Biotin; BD), CD115 (12-3A31B10; PE; eBioscience), CD123 (9F5; PE; BD) and CD45RA (120458-42;
eBioscience; PE) were used alternatively, followed by a secondary stain with
streptavidin-conjugated PerCP-Cy5.5 for 40 min on ice.
Cultured cells were harvested and stained with LIVE/DEAD (Life
Technologies), CD45 (AF700), CD56 (B159; Pacific Blue; BD), CD66b
(G10F5; PerCP-Cy5.5; BioLegend), CD19 (HIB19; APC-Cy7; BioLegend), CLEC9a (8F9; PE; BioLegend), CD14 (Qdot-655), CD1c (L161; PECy7; BioLegend), CD303 (201A; FITC; BioLegend), CD123 (6H6; BV510;
BioLegend), CD141 (AD5-14H12; APC; Miltenyi Biotec) for 40 min on
ice and analyzed for lineage potential by flow cytometry. Absolute cell counts
have been calculated relative to a well containing a known number of CD45+
cells (i.e., 10,000 cells), which were added on the day of harvest.
For CFSE assays, cultured cells were stained with LIVE/DEAD (Life
Technologies), CD45 (AF700), CD34 (APC-Cy7), CLEC9a (PE), CD14
(Qdot-655), CD1c (PE-Cy7), and CD141 (APC) for 40 min on ice.
For progenitorprogeny relationship experiments, CD34+ cells were first
enriched from cord blood using CD34 MicroBead kit and LS MACS magnetic
columns (Miltenyi Biotec). Enriched CD34+ cells (4095% purity) were then
incubated with Lin (CD3/19/56/14; BV650), CD34 (AF700), CD38 (HIT2;
BV421; BioLegend), CD10 (HI10a; PE-Cy7; BioLegend), CD45RA (BV510),
CD123 (PE), CD116 (FITC), and CD115 (APC). hCDPs were sorted as Lin
CD34+CD38hiCD10CD45RA+CD123hiCD115. Cultured cells were harvested at specific time points and stained with LIVE/DEAD, CD45 (AF700),
CD14 (Qdot-655), CD3 (BV650), CD19 (BV650), CD56 (BV650), CD303
(FITC), CD1c (PE-Cy7), CD141 (APC), CD34 (APC-Cy7), CD117 (BV421),
CD123 (PE), CD45RA (BV510), and CD116 (FITC) for 40 min on ice.
Morphological analysis. Purified hpreDCs were analyzed by Giemsa staining of cytospin preparations. As few as 5 104 cells were cytospun for 5 min
at 800 rpm on a glass slide and then stained with the Hemacolor stain kit as
recommended by the manufacturer (HARLECO). Slides were then imaged
on an Axioplan 2 microscope at 100 magnification (Carl Zeiss).
Cell culture. MS5 BM stromal cells were maintained and passed in complete -MEM medium (Invitrogen) with 10% FCS and penicillin/streptomycin (Invitrogen). 24 h before hpre-CDC culture, MS5 stromal cells were
treated with 10 g/ml of mitomycin C (Sigma-Aldrich) for 3 h, washed, and
reseeded at 3.75 104 MS5 cells per well in 96-well plates. Purified populations were seeded in medium containing 100 ng of Flt3L/ml (Celldex),
20 ng/ml SCF (PeproTech), and 10 ng/ml GM-CSF (PeproTech). Cells
were harvested between day 1 and 14 for flow cytometry analysis.
To determine cellular divisions in culture, input populations were labeled for 15 min with 5 M CFSE (Molecular Probes) at 37C.
Limiting dilution assay. For limiting dilution experiments, cells were
sorted directly into 96-well plates containing MS5+FSG at 1, 2, 4, 8, or 16
JEM Vol. 212, No. 3
cells per well for CD34+ HSPCs, and at 1, 5 or 10 cells per well for hpreCDCs. The percentage of detection failure for cDCs was calculated as 100%
(1-k/n), where k is the number of positive wells and n the total number of wells
combined from three or four independent experiments (CB and PB, respectively). We classified each well as positive if more than 5 cells were detected for
cDCs or other lineages among live human CD45+ cells.Then, for every positive clone, we scored positive for cDCs or other lineages based on their respective gates to determine the clonal lineage potential. The frequency of
DC-producing precursors was determined by Loi de Poisson using the Extreme Limiting Dilution Analysis software provided by the Walter and Eliza Hall
Institute of Medical Research Bioinformatics (Parkville,Victoria, Australia.
Flt3L injection in volunteers. 3 healthy volunteers received a 25 g/kg/
day subcutaneous injection of CDX-301 (a clinical formulation of recombinant human Flt3L; Celldex) for 10 d. Blood samples were collected before
and at 5, 8, 10, 11, 12, 14, and 21 d after initial administration. PBMCs were
isolated from heparinized blood using Ficoll-Hypaque and stored in liquid
nitrogen for further analysis.
PBMCs were stained with CD116 (4H1; FITC; BioLegend), CD135
(4G8; PE; BD), CD66b (G10F5; PerCP-Cy5.5; BioLegend), CD335 (9E2,
PerCP-Cy5.5, BioLegend), CD303 (201A; PerCP Cy5.5; BioLegend),
CD141 (M80; PE-Cy7; BioLegend), CD117 (104D2; BV421; BioLegend),
CD123 (6H6; BV510; BioLegend), CD20 (2H7; BV605; BioLegend), CD3
(OKT3; BV605; BioLegend), CD45RA (MEM-56; Qdot 655; Life Technologies), LIVE/DEAD Fixable Blue Dead Cell Stain (Life Technologies),
CD14 (Tk4; Qdot 800; Life Technologies), CD115 APC (9-4D2-1E4;
APC; BioLegend), CD34 (581; Alexa Fluor 700; BioLegend), CD1c (L161;
APC-Cy7; BioLegend). For surface staining, titrated antibodies were added
to 2 million cells in 50 l PBS for 20 min at 4C.
Washed cells were fixed in 2% formaldehyde and stored at 4C until
analysis, which was performed using an LSR II flow cytometer (BD). The
whole sample was acquired and analysis was performed using Flow Jo 9.1
software (Tree Star). hpre-CDCs were isolated as Lin(CD3/20/335/14)
Granulocyte(CD66b)DC(CD303CD1c/CD141)CD34CD117+CD135+
CD116+ CD115CD45RA+CD123+.
Online supplemental material. Fig. S1 shows clonal output of cord blood
CD34+ HSPCs. Fig. S2 shows clonal output of cord blood hpre-CDCs. Fig. S3
shows clonal output of peripheral blood hpre-CDCs. Fig. S4 shows 14-color
gating strategy for identification of human hpre-CDCs in blood and that
hCDPs, hMDPs, and hGMDPs are undetectable in the blood before and after
Flt3L administration in healthy volunteers. Online supplemental material is
available at http://www.jem.org/cgi/content/full/jem.20141441/DC1.
This work was inspired by Dr. Ralph M. Steinman. We thank Klara Velinzon (Flow
Cytometry Core Facility, Laboratory of Molecular Immunology, The Rockefeller
University) for technical support with polychromatic flow cytometry sorting. We thank
Heidi Schreiber for help with human BM protocol (Laboratory of Molecular Immunology,
The Rockefeller University). We acknowledge the assistance of Arlene Hurley and the
clinical team at the Rockefeller University Hospital. We also thank James Pring, Popi
Sarma and Christine Trumpfheller for the management of the Flt3L patient samples
(Laboratory of Cellular Physiology and Immunology, The Rockefeller University).
Research reported in this publication was supported by the Empire State Stem
Cell Fund through New York State Department of Health Contract #C029562
(to K.Liu), Helmsley Foundation (to K. Liu), National Institute of Allergy and Infectious
Diseases of National Institutes of Health under award numbers of AI101251 (to K. Liu)
and U19AI111825 (to M.C. Nussenzweig), National Institute of Neurological Disorder
and Stroke of NIH under award number of NS084776 (to S. Puhr), Iris and Junming Le
Foundation (to G.Breton), the Dermatology Foundation (to N. Anandasabapathy),
National Institute of Arthritis and Musculoskeletal and Skin Diseases AR06346101A1 (to N. Anandasabapathy), and CTSA, RUCCTS grant no. UL1RR024143 from
the National Center for Research Resources, NIH, and by NIH grant AI13013. The
Rockefeller University Center for Clinical and Translational Science is supported, in
part, by a Clinical and Translational Science Award (CTSA), and the National Center for
Advancing Translational Sciences (NCATS), part of the NIH. The content is solely the
responsibility of the authors and does not necessarily represent the official views of
411
the National Institutes of Health or the Empire State Stem Cell Board, the NY State
Department of Health or the State of New York or any other applicable federal
funding agency. M.C. Nussenzweig is an HHMI Investigator.
T. Keler works for Celldex Therapeutics. The authors declare no additional
financial interests.
Submitted: 30 July 2014
Accepted: 30 January 2015
REFERENCES
Ar ticle
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