(Investigative Ophthalmology and Visual Science. 2001;42:2878-2884.)
© 2001
by The Association for Research in Vision and Ophthalmology, Inc.
Acute Rejection of Orthotopic Corneal Xenografts in Mice Depends on CD4+ T Cells and Self-AntigenPresenting Cells
Kazumi Tanaka1,
Koh-hei Sonoda2 and
J. Wayne Streilein3
1 From the Department of Ophthalmology, Yokohama City University of Medicine, Japan; the
2 Department of Ophthalmology, Kyusyu University Graduate School of Medical Sciences, Fukuoka, Japan; and
3 Schepens Eye Research Institute and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
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Abstract
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PURPOSE. Guinea pig corneal xenografts have been reported to be rejected acutely
in eyes of normal adult mice. Rejection of this type is independent of
xenoreactive antibodies, and mice deficient in CD8+ and NK
T cells are unable to reject guinea pig corneal grafts acutely.
Therefore, a study was conducted to determine the extent and manner by
which CD4+ T cells are responsible for rejection of
orthotopic corneal xenografts.
METHODS. Xenogeneic corneas were prepared from eyes of normal guinea pigs and
grafted orthotopically into normal eyes of C57BL/6 mice, class II major
histocompatibility complex (MHC) knockout (KO) mice, and class II MHC
KO mice reconstituted with syngeneic (C57BL/6) CD4+ T cells
and/or bone marrow cells. Graft survival was assessed clinically, and
success of cellular reconstitution was assayed using flow cytometric
analysis of peripheral blood leukocytes. T cells from rejector mice
were analyzed for proliferative responses to guinea pig xenoantigens in
vitro.
RESULTS. Median survival times (MST) of corneal xenografts in MHC class II KO
mice was significantly delayed (31 days) compared with grafts in
wild-type C57BL/6 eyes (9 days). Acute rejection was restored almost
completely when MHC class II KO mice were reconstituted simultaneously
with C57BL/6 bone marrow and CD4+ T cells, but not when the
KO mice were reconstituted with either CD4+ T cells or bone
marrow cells alone. Mice that rejected guinea pig corneas possessed
only CD4+ T cells capable of responding to guinea pig
xenoantigens in vitro.
CONCLUSIONS. Acute rejection of orthotopic corneal xenografts in mice is mediated by
CD4+ T cells that detect guinea pig xenoantigens that are
presented on MHC class II+ syngeneic antigen-presenting
cells. These results strongly suggest that rejection occurs exclusively
through the indirect pathway of T-cell
activation.
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Introduction
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The vulnerability of solid-tissue xenografts to immune
rejection exceeds that of solid-tissue allografts, in part because
so-called natural antibodies are often present in the sera of normal
animals, and these antibodies recognize xenoantigens on the
grafts.1
2
3
As a consequence, xenografts undergo
hyperacute vascular rejection within minutes to hours of engraftment,
due to the binding of complement-fixing, xenoreactive antibodies to
vascular endothelium, or they undergo acute vascular rejection (delayed
xenograft rejection) that is mediated within 2 to 3 days by antibodies
that focus macrophages, NK cells, and/or neutrophils on the graft
vasculature, leading to endothelial cell activation and eventual
destruction.4
5
6
The cornea differs from other types of
solid-tissue xenografts in that it is avascular and therefore, it may
not be vulnerable to hyperacute rejection. In addition, the graft forms
the anterior wall of the anterior chamber of the eye, and this
compartment is filled with aqueous humor that contains several potent
inhibitors of complement activation.7
These special
features of the cornea probably account for the experimental evidence
that antibody-mediated hyperacute rejection does not occur when guinea
pig corneas are grafted into eyes of normal mice.8
It is
pertinent that the guinea pigmouse donorrecipient combination is
discordant,9
10
that is, sera of normal mice contain
complement-fixing, xenoreactive anti-guinea pig antibodies.
Although corneal xenografts are not vulnerable to antibody-mediated
rejection, they are highly susceptible to acute, cell-mediated
xenograft rejection.3
Guinea pig corneas grafted
orthotopically to eyes of C57BL/6 mice are rapidly destroyed, with a
median survival time (MST) of approximately 9 days, and similar grafts
placed in eyes of BALB/c recipients have an MST of approximately 16
days.8
Formal proof of the irrelevancy of antibodies to
corneal xenograft rejection in this system was reported by Tanaka et
al.8
who showed that the time and tempo of corneal
xenograft rejection is identical in normal mice compared with mice in
which the µ chain of immunoglobulin had been disrupted. In the study
by Tanaka et al., mice with a disrupted ß-2 microglobulin (ß2µ)
gene also rejected guinea pig corneal grafts in an acute manner similar
to normal mice. This finding strongly suggests that the acute phase of
cell-mediated xenograft rejection in mice is neither mediated by
CD8+ cytotoxic T cells nor by NK T cells (both of
which are depleted in ß2µ knockout mice). Alternatively, Tanaka et
al. showed that mice deficient in CD4+ T cells no
longer reject guinea pig corneal grafts acutely (MST, 27days), implying
that mice reject corneal xenografts acutely, using xenoreactive
CD4+ T cells.8
Another feature of the cornea that distinguishes it, as a graft, from
other solid tissues is the virtual absence of bone marrowderived
cells, termed passenger leukocytes.11
12
13
14
In solid organ
allografts, such as skin, heart, and kidney, class II major
histocompatibility complex (MHC)+ passenger
leukocytes (dendritic cells, macrophages) make the definitive
contribution to the grafts capacity to sensitize its recipient,
especially alloreactive T cells of the so-called direct typeT cells
that directly recognize MHC class I and II alloantigens. Because
existing evidence indicates that CD4+ T cells are
primarily responsible for the acute phase of cell-mediated xenograft
rejection of orthotopic corneal xenografts in mice, it is of interest
to know whether xenodestructive CD4+ T cells are
activated through the direct or indirect pathways of antigen
recognition. This critical matter was addressed by experiments in the
current study.
Using C57BL/6 mice with a targeted disruption of class II MHC genes,
our results indicate that the ability of these mice to reject
orthotopic guinea pig corneal grafts acutely (within 2 weeks) requires
that the recipients be reconstituted with both
CD4+ T cells and class IIexpressing bone
marrowderived cells. These results indicate that acute cellular
rejection of guinea pig corneal grafts is mediated by
CD4+ T cells that recognize guinea pig antigens
exclusively by the indirect pathway.
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Materials and Methods
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Animals and Anesthesia
Hartley guinea pigs (450550 g) were purchased from Elm Hill
Breeding Laboratories (Cheslmsford, MA), and inbred strain 13 guinea
pigs (550600 g) were purchased from Crest Caviary (Prunedale, CA).
C57BL/6 mice were obtained from our animal facility or purchased from
Taconic Farm (Germantown, NY). MHC class IIdeficient mice
(C57BL/6Tac-[KO]Abb N5) were purchased from Taconic Farm.
All mice were males, 8 to 12 weeks old, and were treated according to
the ARVO Statement for the Use of Animals in Ophthalmic and Vision
Research. In all experiments, mice were used as recipients and guinea
pigs were used as donors. Corneal grafts were prepared from eyes
enucleated after the donor guinea pigs were killed. For experimental
manipulations, mice were deeply anesthetized with an intraperitoneal
injection of 3 mg ketamine and 0.0075 mg xylazine.
Orthotopic Corneal Grafting
Donor guinea pig corneas were excised by a 2.0-mm diameter
trephine and placed in Hanks balanced salt solution until grafting.
The graft bed was prepared by excising with Vannas scissors a 1.5-mm
site from the central cornea of the right eye. The graft was placed in
the recipient bed and secured with 12 interrupted 11-0 nylon sutures
(Sharpoint; Vanguard, Houston, TX) such that the epithelial surfaces of
the donor and the recipient corneas were juxtaposed. Antibiotic
ointment was applied to the corneal surface, and the lids were closed
with an 8-0 nylon tarsorrhaphy. Tarsorrhaphy was maintained (except for
clinical inspection purposes) until graft rejection was documented.
Corneal sutures were removed on day 8.
Assessment of Graft Survival
Grafts were evaluated by slit lamp biomicroscopy three times a
week. The day of rejection was defined as that when graft transparency
was lostthat is, iris margin and iris structure were not visible
through the graft, and graft clarity never recovered subsequently.
CD4+ T Cell Reconstitution of Class II MHC KO Mice
Cervical, inguinal, and mesenteric lymph nodes and spleen were
obtained from naive C57BL/6 mice. Spleen cells, depleted of red blood
cells by lysis with Tris-NH4Cl, and lymph node
cells were pressed through nylon mesh to produce a single-cell
suspension. To obtain primed CD4+ T cells,
draining lymph nodes were obtained from C57BL/6 mice immunized by
subcutaneous injected of guinea pig spleen cells (1 x
107) 2 weeks previously. T cells from these lymph
nodes were purified to more than 90% by a T-cell enrichment column.
After staining with rat anti-mouse CD8 antibody,
CD4+ T cells were purified to more than 90% by a
CD4 T-cell separation kit (Immulan; cat. no. BL-7154; Biotecx
Laboratories, Inc., Houston, TX). Purified CD4+ T
cells were injected intravenously into MHC class II KO mice. Corneal
xenotransplantation was performed on the day after reconstitution with
CD4+ T cells.
Bone Marrow Transplantation into Class II KO Mice
Untreated bone marrow cells (3050 x
106) from naive C57BL/6 mice were injected
intravenously into MHC class II KO mice on four consecutive days
(total, 150200 x 106 bone marrow cells).
Flow Cytometric Analysis of Lymphoid Cells from Reconstituted Mice
At 2 weeks after CD4+ T cell
reconstitution, peripheral blood cells, depleted of red blood cells by
lysis with Tris-NH4Cl, were triple-stained with
Cy-Chrome-5conjugated anti-TCRß chain mAb (H57-597),
phycoerythrin-conjugated anti-mouse CD4 mAb (RM 4.5) and
FITC-conjugated anti-mouse CD8 mAb (53-6.7; all from PharMingen, San
Diego, CA). At 4 weeks after bone marrow transplantation,
peripheral blood cells, depleted of red blood cells, were
double-stained with phycoerythrin-conjugated anti-mouse CD45 mAb
(30-F11) and FITC-conjugated anti-mouse I-Ab mAb
(25-9-17; PharMingen). The stained cells were analyzed by flow
cytometry (Epics XL Analyzer; Coulter, Inc., Hialeah, FL).
In Vitro Proliferation Assay
Lymph nodes cells were removed from naive C57BL/6 mice or from
C57BL/6 mice that had received orthotopic strain 13 guinea pig corneal
xenotransplants 2 weeks previously and had already rejected the grafts.
Culture conditions were chosen based on the preliminary experiments
(data not shown). Murine responder lymph node cells (5 x
105 cells) and x-irradiated (2000 rads) 13 guinea
pig stimulator spleen cells (5 x 105 cells)
were added in a final volume of 200 µl of culture medium composed of
RPMI 1640 medium, 10 mM HEPES, 0.1 mM nonessential amino acids, 1 mM
sodium pyruvate, 100 U/ml penicillin, 100 µg/ml streptomycin (all
from BioWhitaker, Walkersville, MD), and 1 x
10-5 M 2-ME (Sigma Chemical Co., St. Louis, MO),
supplemented with heat-inactivated 10% fetal calf serum (Sigma) to
triplicate wells of 96-well flat-bottomed microculture plates (Corning,
Corning, NY). The cultures were incubated at 37°C in humidified air
containing 5% CO2 for varying lengths of time.
Cultures were pulsed with 0.5 µCi of
[3H]thymidine 8 hours before termination, and
the samples were harvested onto glass filters using an automated well
harvester (Tomtec, Orange, CT). Radioactivity was assessed by liquid
scintillation spectrometry (Wallac, Gaithersburg, MD), and the amount
was expressed as counts per minute. For anti-CD4 blocking experiments,
azide-free, low-endotoxin purified anti-mouse L3T4 (GK1.5) was used,
and purified rat IgG2b
was used as an isotype
control (both from PharMingen). Antibodies were added to responder
cells (lymph node cells from C57BL/6 mice that had rejected orthotopic
strain 13 corneal xenotransplants), and the mixture was incubated on
ice for 1 hour. After incubation, stimulator cells (13 guinea pig
spleen cells) were added and managed the same as the other cultures.
Statistical Analysis
Statistical analysis of graft survival, enabling comparison of
MSTs, was performed using the Mantel-Cox rank test.
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Results
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Fate of Orthotopic Guinea Pig Corneal Grafts in Eyes of Mice
Deficient in Class II MHC Expression
C57BL/6 mice in which the MHC class II
Aßb gene had been
disrupted (class II KO) received orthotopic grafts of guinea pig
cornea. These mice were chosen because they are not only deficient in
MHC class II expression, but they also have been reported to by
profoundly deficient in CD4+ T
cells.15
Flow cytometry was performed to confirm that
these mice were deficient in CD4+ T cells (Fig. 1A)
. Normal C57BL/6 mice served as controls. The fate of these grafts was
evaluated clinically, as described previously,8
and the
results are displayed in Figure 1B
. Whereas normal C57BL/6 mice
rejected guinea pig corneal grafts acutely (MST, 9 days), mice
deficient in class II expression failed to reject guinea pig corneas at
a similar tempo. Instead, a high proportion of guinea pig corneal
grafts placed in eyes of class IIdeficient mice remained clear for a
protracted interval (MST, 31days). One graft remained permanently clear
(the experiment was terminated at 8 weeks). Thus, mice deficient in
class II MHC expression have a grossly impaired capacity to reject
guinea pig corneal grafts acutely. This pattern of rejection strongly
resembles that reported previously in mice genetically deficient in CD4
expression (CD4 KO mice).8

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Figure 1. (A) Detection of CD4+ and CD8
+ T cells in class II MHC KO mice. Peripheral
blood leukocytes were obtained from adult C57BL/6 and class II KO mice
and analyzed by flow cytometry for expression, first, of the TCRß
chain, and then for expression of CD4 and CD8. Histograms of a
representative experiment are presented. (B) Fate of guinea
pig corneal xenografts placed orthotopically into eyes of normal and
class II KO mice. Guinea pig corneas were grafted into normal eyes of
wild-type C57BL/6 mice and class II KO mice. Grafts were considered to
be rejected when opacity prevented visualization of the recipient pupil
and iris through the graft. Results are presented as a Kaplan-Meier
survival curve. MST of grafts were 31 days in class II KO mice and 9
days in wild-type mice (P < 0.0001).
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Attempts to Restore Acute Corneal Xenograft Rejection in Class
IIDeficient Mice with Syngeneic CD4+ T Cells
Class IIdeficient mice display a profound deficit of
CD4+ T cells, suggesting a reason that these mice
fail to reject guinea pig corneal grafts acutely. To test this
possibility, CD4+ T cells were harvested from
normal C57BL/6 mice and transfused intravenously (15 x
106, 20 x 106, or
25 x 106) into class II KO mice the day
before orthotopic guinea pig corneal grafting. To determine the extent
to which exogenous CD4+ T cells were present in
these mice subsequently, peripheral blood was obtained at 2 weeks after
CD4+ T cells injection, and analyzed by flow
cytometry for content of T-cell receptor (TCR)positive lymphocytes
that also expressed CD4. The result of a representative experiment is
presented in Figure 2A
. At 2 weeks after infusion, 7% of TCR-positive cells in class II KO
mice reconstituted with 25 x 106
CD4+ T cells expressed CD4. By contrast,
virtually no CD4+ T cells were detected in the
blood of untreated class IIdeficient mice. Orthotopic guinea pig
corneas were grafted into eyes of CD4-reconstituted mice the day after
infusion, and the fate of the grafts was evaluated clinically. Class II
KO mice reconstituted with CD4+ wild-type T cells
did not reject the grafts acutely (MST, 29 days; Fig. 2B
). In fact,
there was no difference between the rate of corneal xenograft rejection
in these mice and the rate observed in nonreconstituted class II KO
mice.
The failure of naive, syngeneic CD4+ T cells to
cause class II KO mice to reject guinea pig corneal grafts acutely can
be explained in more than one way. One possibility is that the
transfused CD4+ cells did not become sensitized
to guinea pig antigens in class II KO mice, because these mice contain
no class IIbearing antigen-presenting cells (APCs) to present guinea
pig xenoantigens (i.e., an indirect pathway). To test this possibility,
we attempted to reconstitute class II KO mice with presensitized
CD4+ T cells. Normal C57BL/6 mice were sensitized
to guinea pig antigens by subcutaneous immunization with strain 13
guinea pig spleen cells. Two weeks later, draining lymph nodes were
removed, rendered into single-cell suspensions, and fractionated into a
CD4-enriched population. These guinea pig-sensitized
CD4+ T cells were then infused (10 x
106 or 20 x 106) into
class II KO mice. When the peripheral blood of these mice was analyzed
at 2 weeks by flow cytometry for content of CD4+
T cells, 8.6% of TCR positive cells expressed CD4 (Fig. 2A)
.
Accordingly, the day after infusion, these mice received orthotopic
strain 13 guinea pig corneal grafts. The fates of these grafts in class
II KO and reconstituted mice are displayed in Figure 2C
. Whether
reconstituted with specifically sensitized CD4+ T
cells or not, class II KO mice did not reject strain 13 corneas
acutely, although they rejected the grafts in a chronic manner similar
to unreconstituted class II KO mice.
Attempt to Restore Acute Corneal Xenograft Rejection in Class
IIDeficient Mice with Class IIBearing Hematopoietic Cells
One explanation for the failure of specifically sensitized
CD4+ T cells to reconstitute acute corneal
xenograft rejection in class II KO mice is that murine T cells can only
recognize guinea pig xenoantigens through the indirect pathway. As
such, activation of CD4+ T cells would require
the presentation of guinea pig xenoantigens on selfclass II
molecules. In an effort to reconstitute the indirect pathway in class
II KO mice, bone marrow cells were harvested from normal C57BL/6 mice
and injected (150200 x 106) intravenously
into class II KO recipients. A similar experimental strategy has been
reported16
17
to produce significant hematopoietic
chimerism in unirradiated normal mice. At 4 weeks after this injection,
the blood of recipient mice was analyzed by flow cytometry and found to
contain a significant number (7.3%) of CD45+
leukocytes that expressed I-Ab. For comparison,
only 2.1% of CD45+ blood cells expressed
I-Ab in class II KO mice (Fig. 3A)
, whereas 65% of CD45+ blood cells expressed
class II MHC molecules in wild-type C57BL/6 mice.

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Figure 3. (A) Detection of class II MHC+ cells
in class II MHC KO mice reconstituted with syngeneic wild-type bone
marrow. Class II KO mice received intravenous inocula of hematopoietic
cells from normal C57BL/6 donors. Peripheral blood leukocytes were
collected 4 weeks later from these mice, from class II KO mice, and
from wild-type C57BL/6 donors and then separated by flow cytometry into
a CD45+ population that was then analyzed for the
proportion of cells expressing I-Ab molecules.
Histograms of a representative experiment are presented. (B)
Fate of guinea pig corneal xenografts placed orthotopically into eyes
of class II KO mice reconstituted with syngeneic bone marrow cells.
Guinea pig corneas were grafted into normal eyes of class II KO mice or
class II KO mice that had received bone marrow cells from normal
C57BL/6 donors 4 weeks previously. Results of graft outcome are
presented as a Kaplan-Meier survival curve. MSTs of grafts are 31 days
in class II KO mice and 32 days in class II KO mice reconstituted with
C57BL/6 bone marrow cells. There is no significant difference between
these MSTs.
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We considered this to be evidence of successful reconstitution of class
II KO mice with hematopoietic cells expressing class II MHC molecules.
Therefore, at 4 weeks after hematopoietic reconstitution, guinea pig
corneas were grafted to the eyes of these mice, and the clinical course
of the grafts was observed. As the results displayed in Figure 3B
indicate, enhanced levels of class IIbearing leukocytes in
reconstituted class IIdeficient mice failed to promote acute
rejection of guinea pig corneal grafts. Once again, these mice rejected
guinea pig corneal grafts in a chronic fashion.
In the experiment just described, enhanced numbers of MHC class
IIbearing leukocytes in the blood were not accompanied by increased
levels of CD4+ T cells. Because
CD4+ T cells appear to be required for acute
corneal xenograft rejection, we attempted to reconstitute class II KO
mice with both class IIbearing hematopoietic cells and mature
CD4+ T cells. Class II KO mice received
intravenously an inoculum of C57BL/6 bone marrow cells (150200 x 106). Four weeks later, these mice received an
infusion of CD4+ T cells (30 x
106) from normal C57BL/6 donors. One day later,
they received orthotopic guinea pig corneal grafts. Doubly
reconstituted class II KO mice mounted acute and intense rejection
reactions against corneal xenografts (Fig. 4A)
. All grafts were destroyed acutely (MST, 11 days). Thus, that class II
KO mice did not reject orthotopic guinea pig corneal grafts acutely
rests, on the one hand, on the absence of class IIexpressing bone
marrowderived cells and, on the other hand, on the deficiency of
CD4+ T cells. The need for class II-bearing cells
in these mice implies that recipient APCs are required both for
sensitization and for expression of immunity directed at guinea pig
xenoantigens.

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Figure 4. (A) Fate of guinea pig corneal xenografts placed
orthotopically into eyes of class II KO mice reconstituted with
syngeneic CD4+ T cells and bone marrow cells.
Guinea pig corneas were grafted into normal eyes of class II KO mice or
class II KO mice that had received normal C57BL/6
CD4+ T cells 2 weeks previously and bone marrow
cells 4 weeks previously. Results of graft outcome are presented as a
Kaplan-Meier survival curve. MSTs of grafts were 31 days in class II KO
mice and 11 days in class II KO mice reconstituted with C57BL/6
CD4+ T cells and bone marrow cells
(P < 0.0001). (B) Detection of
CD4+ and CD8+ T cells in
class II MHC KO mice reconstituted with syngeneic
CD4+ T cells and bone marrow cells. Class II KO
mice received intravenous inocula of hematopoietic cells and
CD4+ T cells from normal C57BL/6 donors 4 and 2
weeks, respectively, before death. Peripheral blood leukocytes were
then collected from these mice and from class II KO mice and were
separated by flow cytometry into a TCRß-chain+
population that was then analyzed for the proportion of cells
expressing CD4 and CD8 molecules. Histograms of a representative
experiment are presented.
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Capacity of Murine T Cells to Proliferate in Response to Guinea Pig
Xenoantigens In Vitro
Our remaining experiments addressed the questions of whether
guinea pig xenoantigens are recognized by murine T cells through the
indirect pathway and whether the responding T cells are
CD4+ or CD8+. For these
experiments strain 13 guinea pigs served as donors of corneal
xenografts and as the source of spleen cells used for immunization of
mice and for stimulation of T cells in proliferative assays in vitro.
Purified responder lymph node cells were prepared from naïve
C57BL/6 mice and from C57Bl/6 mice that had received an orthotopic
strain 13 guinea pig cornea 2 weeks previously. At the time of lymph
node harvest, these mice had already rejected the corneal xenografts.
The responder cells were cultured with x-irradiated (2000 rads) 13
guinea pig spleen cells and assayed for proliferation. Naïve
murine T cells failed to proliferate at any time point in response to
guinea pig stimulator cells (Fig. 5A)
. By contrast, sensitized responder cells proliferated at each examined
time point, with peak proliferation observed on days 4 and 5 of
culture. This result supports our claim that the direct pathway of
recognition of guinea pig xenoantigens is not available in mice.
Moreover, this result supports our hypothesis that the indirect pathway
of xenoantigen recognition is open, because only T cells from
presensitized mice were capable of proliferation in these experiments.

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Figure 5. Capacity of murine T cells to proliferate in vitro in response to
guinea pig xenoantigens. (A) Lymph node cells from naive
C57BL/6 and from C57BL/6 mice that rejected orthotopic strain 13 guinea
pig corneal grafts were stimulated in vitro with x-irradiated strain 13
guinea pig spleen cells and cultured for 3 to 6 days.
[3H]thymidine was added during the terminal 8
hours of culture. Results are presented as mean counts per minute ± SD for triplicate cultures. (B) Cultures similar to those
described in (A) were established. Anti-CD4 or isotype
control antibodies were added to some cultures. After 3 to 7 days of
culture, proliferation was assessed as described. Results are presented
as mean counts per minute ± SD for triplicate cultures.
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To identify the type of proliferating T cell in these in vitro
stimulation assays, we repeated these experiments and included
additional cultures in which antibodies directed at
CD4+ or at CD8+ T cells
were included. The results of a representative experiment are displayed
in Figure 5B
. Sensitized murine T cells proliferated when stimulated
with guinea pig spleen cells in the presence of isotype control
antibodies to an extent similar to sensitized T cells stimulated in the
absence of antibodies. By contrast, little if any proliferation was
observed in cultures to which anti-CD4 antibodies had been added. In
companion experiments, no inhibition of T-cell proliferation was
observed when anti-CD8 antibodies were present (data not shown). This
finding indicates that CD4+ T cells are
sensitized in mice that receive and reject orthotopic guinea pig
corneas. We conclude that the CD4+ T cells
activated by orthotopic guinea pig grafts, which are responsible for
graft rejection, recognize guinea pig xenoantigens almost exclusively
by the indirect pathway.
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Discussion
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Immune privilege protects corneal xenografts placed in mouse eyes
from destruction by antibody-dependent mechanisms. This privilege does
not extend, however, to protection of these grafts from
T-celldependent rejection. Previous studies have revealed that
orthotopic guinea pig corneal grafts in normal mice undergo acute
rejection (within 23 weeks) by a mechanism that is almost exclusively
dependent on CD4+ T cells.8
In
orthotopic murine allografts, rejection is mediated largely (but not
completely) by T cells that recognize donor antigens through the
indirect pathway of allorecognition.18
19
Recipient APCs
(especially Langerhans cells) that migrate into the donor allografts
have been shown to be central to presentation of graft-derived
antigens, and recipient APCs are required for graft rejection by
(primarily) CD4+ T cells. The current studies in
the guinea pig corneal xenotransplantation model tested the hypothesis
that acute rejection of xenogeneic corneal grafts is also dictated by T
cells that recognize xenoantigens after presentation by recipient
APCsthat is, the indirect pathway of antigen recognition. In large
measure, our results support the validity of this hypothesis.
We have previously reported that acute rejection of orthotopic guinea
pig corneal grafts failed to occur in mice in which the CD4 gene had
been disrupted experimentally.8
Now, in class II KO mice
that were also profoundly deprived of CD4+ T
cells as recipients,15
acute rejection of guinea pig
corneal grafts failed once again to occur. However, this deficit could
not be restored simply by providing class II KO mice with exogenous
CD4+ T cells. In fact, even exogenous
CD4+ T cells specifically sensitized in vivo to
guinea pig xenoantigens failed to promote acute rejection of corneal
xenografts in class II KO mice. These results further support the
contention that the CD4+ T cells that mediate
rejection of guinea pig corneal grafts do not recognize guinea pig
class II MHC molecules directly. Moreover, the observation that
naïve murine T cells infused into class II KO mice
reconstituted with normal hematopoietic cells promoted acute rejection
of orthotopic corneal xenografts confirms that bone marrowderived
recipient cells are necessary for presentation of guinea pig
xenoantigens to murine xenoreactive T cells. In aggregate, these
results lead us to conclude that the vulnerability of orthotopic guinea
pig corneal grafts to acute cellular rejection is dependent almost
exclusively on CD4+ T cells that recognize
xenoantigens presented by recipient APCsthat is, the indirect pathway
of antigen recognition.
Support for this interpretation of the in vivo experiments comes from
our in vitro studies of the proliferative capacity of normal and
presensitized murine lymph node cells. First, normal mouse lymph node
cells failed to proliferate when stimulated with guinea pig spleen
cells in vitro. Because normal C57BL/6 mouse lymph node cells
proliferate vigorously when stimulated with MHC-incompatible allogeneic
spleen cells in vitro, and because this type of proliferation is
believed to reflect direct recognition of MHC-encoded
alloantigens,20
our results strongly suggest that the
direct pathway of recognition of xenoantigens does not exist in C57BL/6
mice. However, lymph node cells from C57Bl/6 mice that had rejected
orthotopic strain 13 guinea pig corneas proliferated strongly when
stimulated with strain 13 spleen cells in vitro. This type of
proliferation correlates with the indirect pathway of recognition of
alloantigens. By analogy, we conclude that murine T cells can recognize
guinea pig xenoantigens through the indirect pathway. The finding that
anti-CD4, but not anti-CD8, antibodies inhibited proliferation of
presensitized mouse T cells in vitro confirms that the responding,
sensitized T cells are CD4+.
It is important to reconsider the ultimate fate of guinea pig corneas
in mouse eyes. Elimination of CD4+ T cells
enables these grafts to avoid the acute phase of cell-mediated
xenograft rejection. However, most of these grafts are eventually
destroyed in a chronic fashion. Thus, the final solution to the corneal
xenograft problem must avoid chronic as well as acute rejection. The
mediator(s) of chronic rejection, observed in CD4 and/or class
IIdeficient mice, remain to be identified. At the very least, we can
exclude CD4+ T cells from further consideration.
Our previous experiments using various KO mice eliminated antibodies,
CD8+ T cells, NK T cells, and complement from
consideration as the potential effectors of acute rejection of corneal
xenografts.8
In future experiments, we will reconsider
these effectors as mediators of chronic corneal xenograft rejection,
and we will extend our survey to include NK cells and macrophages.
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Acknowledgements
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The authors thank Marie Ortega for outstanding management of the
vivarium and Jacqueline Doherty for excellent laboratory management.
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Footnotes
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Supported by National Institutes of Health Grant EY10765 and a grant
from the Kawasaki Lions Club, Japan.
Submitted for publication March 8, 2001; revised May 22, 2001; accepted
June 27, 2001.
Commercial relationships policy: N.
The publication costs of this article were defrayed in part by page
charge payment. This article must therefore be marked
"advertisement" in accordance with 18 U.S.C.
1734
solely to indicate this fact.
Corresponding author: J. Wayne Streilein, Schepens Eye Research
Institute, 20 Staniford Street, Boston, MA 02114.
waynes{at}vision.eri.harvard.edu
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