Abstract

CD4+ and CD8+ effector T cell subpopulations can display regulatory potential characterized by expression of the prototypically anti-inflammatory cytokine IL-10. However, the underlying cellular mechanisms that regulate expression of IL-10 in different T cell subpopulations are not yet fully elucidated. We recently showed that TNF inhibitors (TNFi) promote IL-10 expression in human CD4+ T cells, including IL-17+ CD4+ T cells. Here, we further characterized the regulation of IL-10 expression via blockade of TNF signaling or other cytokine/co-stimulatory pathways, in human T cell subpopulations. Addition of the TNFi drug adalimumab to anti-CD3-stimulated human CD4+ T cell/monocyte cocultures led to increased percentages of IL-10+ cells in pro-inflammatory IL-17+, IFNγ+, TNFα+, GM-CSF+, and IL-4+ CD4+ T cell subpopulations. Conversely, exogenous TNFα strongly decreased IL-10+ cell frequencies. TNF blockade also regulated IL-10 expression in CD4+ T cells upon antigenic stimulation. Using time course experiments in whole peripheral blood mononuclear cell (PBMC) cultures, we show that TNF blockade maintained, rather than increased, IL-10+ cell frequencies in both CD4+ and CD8+ T cells following in vitro stimulation in a dose- and time-dependent manner. Blockade of IL-17, IFNγ, IL-6R, or CD80/CD86-mediated co-stimulation did not significantly regulate IL-10 expression within CD4+ or CD8+ T cell subpopulations. We show that TNF blockade acts directly on effector CD4+ T cells, in the absence of monocytes or CD4+ CD25highCD127low regulatory T cells and independently of IL-27, resulting in higher IL-10+ frequencies after 3 days in culture. IL-10/IL-10R blockade reduced the frequency of IL-10-expressing cells both in the presence and absence of TNF blockade. Addition of recombinant IL-10 alone was insufficient to drive an increase in IL-10+ CD4+ T cell frequencies in 3-day CD4+ T cell/monocyte cocultures, but resulted in increased IL-10 expression at later time points in whole PBMC cultures. Together, these data provide additional insights into the regulation of IL-10 expression in human T cells by TNF blockade. The maintenance of an IL-10+ phenotype across a broad range of effector T cell subsets may represent an underappreciated mechanism of action underlying this widely used therapeutic strategy.

Highlights

  • The treatment of immune-mediated inflammatory diseases has improved considerably over the last 20 years with the advent of biological therapeutics

  • We show that T cell stimulation in the presence of TNF blockade maintains the proportion of cells expressing the antiinflammatory cytokine IL-10

  • TNF blockade regulates IL-10 expression whether CD4+ T cells are stimulated in the presence or absence of monocytes, and when an antigenic stimulus is used in place of monoclonal anti-CD3 stimulation

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Summary

Introduction

The treatment of immune-mediated inflammatory diseases has improved considerably over the last 20 years with the advent of biological therapeutics. TNFα inhibitors (TNFi) have revolutionized treatment of RA and have been used in over a million patients worldwide [2]. In some inflammatory diseases such as Sjögren’s syndrome [4, 5] and multiple sclerosis [6], TNFi have not shown clinical efficacy. Paradoxically, some patients treated with TNFi develop de novo autoimmune diseases [7]. These observations indicate that the underlying mechanisms relating to TNF blockade in humans are incompletely understood and require further exploration. TNFα inhibitors have been shown to affect downstream cytokine pathways (IL-1, IL-6, and IL-8) [2], modulate APC function [12], and promote regulatory T cell (Treg) expansion [13,14,15] opposite findings regarding the latter have been reported [16,17,18,19]

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