1. Reprogrammed Foxp3+ Regulatory T Cells Provide Essential Help to Support Cross-presentation and CD8+ T Cell Priming in Naive Mice
Madhav D. Sharma, De-Yan Hou, Babak Baban, Pandelakis A. Koni, Yukai He, Phillip R. Chandler, Bruce R. Blazar, Andrew L. Mellor and David H. Munn,

2. Introduction
Foxp3+ regulatory T (Treg) cells are a unique cell population.
self-tolerance VS support the early phase of normal immune responses
an unexpected degree of phenotypic plasticity
lose their suppressor phenotype and become “reprogrammed” into T helper-like cells
resemble proinflammatory effector cells
in mice dying of infection, in chronic autoimmune disorders, or in mice rejecting tissue allografts

3. Introduction
Treg cell reprogramming can be regulated in vitro by the enzyme indoleamine 2,3-dioxygenase.
Hosts with established tumors -> elevated levels of IDO in tumor-draining lymph nodes
tumor-induced IDO -> activate Foxp3+ Treg cells for enhanced suppressor activity
if IDO is blocked, (Sharma et al., 2009)
Treg cells in tumor-bearing hosts become unstable
undergo reprogramming into helper-like T cells, expressing IL-17 and other proinflammatory cytokines

4. Vaccination (OVA + TLR9-ligand CpG-1826 + incomplete Freund's adjuvant)
Foxp3GFP
OVA-specific OT-I cells (CD8+, recognizing the SIINFEKL peptide of OVA)
CD4+ cells in vaccine-draining lymph nodes (LNs) after immunization
activation
Treg cells were the first and most rapid responders to vaccine-induced activation

5. acquisition of a polyfunctional “helper-like” phenotype
activated Treg cells showed evidence of phenotypic plasticity (reprogramming) after vaccination?
in vitro with PMA plus ionomycin -> express proinflammatory cytokines (IL-2, IL-17, TNFα)
acquisition of a polyfunctional “helper-like” phenotype

6. Treg Cells Undergo Reprogramming in Vaccine-Draining Lymph Nodes

7. CD40L is an important functional mediator of T cell help ( Bennett et al., 1998)
in vivo induction of cell-surface CD40-ligand expression on Treg cells
->measured directly ex vivo, without requiring in vitro stimulation
CD40L was upregulated on a subset of Treg cells beginning at approximately 15 hr after vaccination

8. Confirm by 2nd reporter strain ( YFP )
Treg cells responded rapidly to vaccination
After vaccination, many Treg cells express proinflammatory cytokines and CD40L,
-> helper T cell phenotype.

9. Reprogrammed Treg Cells Upregulate Cell-Surface CD40 Ligand

10. the degree of Treg cell reprogramming closely tracked the ability of the vaccination to stimulate CD8+ T cell responses
TLR9->MyD88->IL-6 => drive Treg reprogramming

11. Treg Cell Reprogramming Is Driven by CpG-Induced Inflammatory Signals

12. the functional activity of converted Treg cells?
Host : Tcra−/− mice
adoptive transfer
OVA+CpG+IFA vaccine
CFSE-labeled OT-I cells
the OT-I cells in mice receiving the Treg cell fraction showed a robust proliferative response to vaccination

13. Reprogrammed Treg Cells Provide Help for Cross-presentation

14. CFSE-labeled OT-I cells
CD40L is a key molecular mechanism by which helper T cells activate (“license”) DCs to cross-present antigens to CD8+ T cells (Bennett et al., 1998 )
surface CD40L expressed by reprogrammed Treg cells allowed them to activate host DCs?
Host : Tcra−/− mice
adoptive transfer
OVA+CpG+IFA vaccine
CFSE-labeled OT-I cells
DC activation
-> CD80, CD86
Treg cell population that rapidly underwent reprogramming,
-> upregulated CD40L, and licensed DCs for cross-presentation.

15. CD40L on Reprogrammed Treg Cells Drives DC Activation and CD8+ T Cell Proliferation

16. CD40L-sufficient Treg cells could rescue selective T helper cell defect in Cd40lg−/− mice?
Host : Cd40lg−/−
adoptive transfer
OVA+CpG+IFA vaccine
CFSE-labeled OT-I cells

17. Reprogrammed Treg Cells Rescue the Helper Defect in Cd40lg−/− Hosts

18. The lack of helper activity in the conventional (non-Treg) CD4+ cells was somewhat surprising, because these are the classical “T helper” cells.
failure of conventional CD4+ cells to provide help due to the low number of OVA-specific clones.
conventional (non-Treg) CD4+ cells were isolated from TCR-transgenic OT-II mice
Reprogrammed Treg cells provide immediate, spontaneous help for new antigens, without requiring prior preactivation.

19. the response to vaccination in mice with established tumors?
the B16F10 is particularly immunosuppressive (Shields et al., 2010).
vaccinated with an altered peptide ligand (human gp100) in CpG + IFA
pmel-1 cells (CD8+, recognizing the shared self-tumor antigen gp100)
-> the progressive loss of T cell response to vaccination during B16F10 tumor growth

20. Established B16F10 Tumors Induce Progressive Unresponsiveness to Vaccine

21. B16 tumors upregulate host expression of the immunosuppressive enzyme IDO (Munn et al., 2004)
IDO can stabilize the suppressive phenotype of Treg cells and inhibit their reprogramming into helper-like cells (Sharma et al., 2009)
elevated IDO expression in hosts with established B16F10 tumors prevented Treg cells from undergoing normal reprogramming?
On day 7 of tumor growth
tumor-draining LNs
1MT in drinking water (beginning on day 6)
->systemic inhibitor of IDO

22. The effect of IDO was lost when Treg cells lacked the GCN2 kinase signaling pathway?
GCN2 (encoded by the Eif2ak4 gene) senses amino acid deprivation,
GCN2 pathway is required in target T cells in order for IDO to exert many of its effects. (Munn et al., 2005)
Treg cells from GCN2 KO (Eif2ak4−/− mice) or wt B6(Thy 1.2)
Host (Thy1.1)
Tumor implant
Vaccination 7 days later
Treg cells from GCN2-deficient mice were resistant to the effects of IDO.

23. Tumor-Induced IDO Blocks Treg Cell Reprogramming

24. cotransfer Treg cells(1) & non-Treg CD4+ cells(5) -> Tcra−/− hosts
The cells that we observed were derived from mature, pre-existing Foxp3+ Treg cells?
cotransfer Treg cells(1) & non-Treg CD4+ cells(5) -> Tcra−/− hosts
Foxp3GFP donors (Thy1.2+)
Foxp3GFP-Thy1.1.
CD4+GFP–
Host : Tcra−/− mice
cotransfer
Tumor implant
7 days later
gp100 vaccine
pmeI cells
4 days after vaccination
tumor-draining LN

25. Mature Pre-existing Treg Cells Undergo Vaccine-Induced Reprogramming

26. blocking IDO restored the CD8+ T cell responses that were progressively lost in hosts with established tumors?
C57BL/6 mice with day 7 established B16F10 tumors <- resting CFSE-labeled pmel-1 cells and vaccination with gp100+CpG+IFA
treated with 1MT at the time of vaccination
CXCR3 (CD8+ T cell maturation marker)

27. beneficial effect of 1MT on CD8+ T cell responses was specifically due to its ability to restore Treg cell reprogramming?
pmel-1 cells require CD4+ T cell help in order to achieve optimal antitumor efficacy (Antony et al., 2005)
host mice were preloaded with different CD4+ populations
All mice were implanted with B16F10 tumors, and on day 7 received pmel-1 cells and gp100 vaccine, with or without 1MT
Treg cell fraction supported proliferation of pmel-1 cells, granzyme B upregulation, and antitumor effect in the presence of 1MT
beneficial effects of 1MT on antitumor vaccination
restore Treg cell reprogramming and helper activity

28. Treg cells that could undergo reprogramming even in the presence of IDO would be able to bypass the need for 1MT treatment?
C57BL/6 host <- Eif2ak4−/− Treg cells or wt control Treg cells
tumors were implanted
on day 7 with vaccination and pmel-1 cells
Eif2ak4−/− Treg cells provided spontaneous help for pmel-1 T cells, even in the face of established tumors, without the need for 1MT treatment

29. Reprogrammed Treg Cells Support CD8+ T Cell Response to Antitumor Vaccine

30. CD40L was required for DC activation when tumor-bearing mice were treated with vaccine+1MT?
CD40L was an important downstream mediator of DC activation by 1MT+vaccination.

31. the relevant site of this critical CD40L expression was specifically on reprogrammed Treg cells?
Tcra−/− hosts
mice receiving CD40L-sufficient Treg
support full CD8+ T cell responses in the presence of 1MT
proliferation, granzyme B expression, and antitumor activity.

32. supporting a direct mechanistic contribution of the CD40 pathway.
defect in helper activity of Cd40lg−/− Treg cells
rescued by treating mice with a cross-linking antibody against CD40

33. Helper Activity of Reprogrammed Treg Cells for Antitumor Responses Requires CD40L

34. Dicussion
Highlights
► Reprogrammed Treg cells can provide essential help for early CD8+ T cell responses
► Treg cell reprogramming is suppressed by IDO in tumor-bearing hosts
► Blocking IDO restores Treg cell reprogramming and enhances antitumor vaccine efficacy
reprogrammed Treg cells
helper role for priming of CD8+ T cells
the failure of therapeutic immunization for tumor
inhibition of normal Treg cell reprogramming by tumor-induced IDO