Previous studies have shown an accumulation of memory CD4+ T cells (TMs) that was associated with aging. Although aging has been linked to a shift from naïve to a memory-dominant population, very little is known about the consequences of those changes on CD4 driven alloimmune responses. We studied age-dependent immune responses to cardiac allografts from DBA/2 donor mice into old and young B6 recipients during a primary immune response and following sensitization. Cardiac transplant survival data reflected age-specific modifications of CD4+ TMs during an initial alloantigen encounter and following sensitization. Primary allografts were rejected in a significantly slower fashion in older recipients (6.8 ± 0.7 vs. 10.0 ± 1.3d, p< 0.001). In sharp contrast, cardiac allografts transplanted following an initial sensitization with donor-specific skin grafts at -4 wks were rejected at a comparable and accelerated tempo in both, old and young recipients (4.9 ± 0.1 vs. 5.6 ± 0.6 d, p=ns). Next, wE delineated the impact of aging on CD4+ TMs before and following donor-specific sensitization. We found that the frequency of CD4+ TMs increased significantly with age in naive mice. However, old naive CD4+ TMs expressed less IFN-γ, IL-2 and IL-17 (IFN-γ, IL-17, p< 0.01; IL-2; p< 0.05 compared to young CD4+ TMs). Of note, following sensitization, old CD4+ TMs demonstrated increased IL-17 and IFN-γ but decreased IL-2 levels (IFN-γ, p< 0.05; IL-17, p< 0.01; IL-2, p< 0.05). Moreover, peripheral memory like CD4+CD25+CD44hiFoxp3+ Tregs which have the capacity to secret IL-17 had significantly increased following donor-specific sensitization in old recipients (p< 0.01). Next, we performed adoptive transfer experiments of old and young CD4+TMs from sensitized animals into RAG-1 KO mice testing their functional capacity in vivo. We were able to confirm an age-independent capacity of effector memory CD4+ T cells following sensitization as skin transplants were effectively and rapidly rejected by both young and old primed effector memory CD4+T cells. In vitro, we observed a similar colonial expansion of old and young sensitized CD4+ memory T cells by 3H incorporation (p=ns). Old memory T-cells are functional compromised. However, effector capacities appeared intact and were age-independent following sensitization. The functional capacities of memory CD4+ T cells during primary and secondary immune responses are of critical clinical significance when transplanting older recipients.
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