immune senescence Flashcards

1
Q

introduction

A

ageing associated with progressive decline in immune system function
all components of immune response affected = haematopoiesis, T cells, B cells, innate immunity
considerable clinical challenges, particularly in ageing populations = increased incidence of acute/chronic infection, malignancy, autoimmune disease
important that we better understand mechanisms = may aid development of therapies to reverse/lessen senescence, may aid induction of better vaccine-related immunity in older adults

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2
Q

decline in haematopoiesis

A

decline in size and proliferative potential of LT-HSC pool

intrinsic defects in HSCs combined with extrinsic defects in stromal cells of niche

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3
Q

evidence for intrinsic defects in HSCs

A

bone marrow chimera experiments
reconstituted irradiated mice with mixture of young and old HSCs - over time, haematopoietic cells purely/predominately derived from young cells
as cells develop in same niche/microenvironment = old HSCs must show intrinsic defects that reduce function

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4
Q

intrinsic defects

A

reduced expression of adhesion molecules (e.g. VCAM, a4 + a5 integrins) = reduced adhesion to stromal cells of niche = reduced quiescence, protection from exhaustion
reduced homing to endosteal region, relocate to further sites = less protected from environmental insults/autoimmunity/inflammation/oxidative stress

Dykstra et al (2011)

  • transplanted irradiated mice with mixture of young and old HSCs expressing different fluorescent proteins (CFP, GFP or dared) combined in known ratio = sacrificed animals 16-21h later and analysed fluorescence ratio in bone marrow sections using FC, comparing to pre-transplantation ratio
  • old cells show 2-fold reduced homing efficiency
  • also reduced bone marrow engraftment and reconstitution of haematopoietic cells (more than half of mice transplanted with old cells had <1% donor chimerism, only 2/19 had when transplanted with old cells)
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5
Q

extrinsic defects

A

progressive myeloid bias with age = less able to produce lymphoid progenitors and progeny
when young, HSCs divide asymmetrically –> 1 LT-HSC, 1 MPP, which differentiate into CLP and CMP in equal measure –> less able to produce CLP with age

also reduction in GH/IFG1 axis –> CAR cells differentiate into adipocytes = negative regulators of haematopoiesis
also results in loss of CXCL12 = contribute to nighttime waves of haemtopoiesis

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6
Q

myeloid bias and OPN

A

Osteopontin (OPN/Spp1)
• OPN is expressed by stromal cells in the bone marrow and exists in two isoforms, intracellular and secreted (soluble)
• Both isoforms favour lymphoid specification by different mechanisms; sOPN induces proliferation of lymphoid progenitors, while iOPN causes apoptosis of myeloid progenitors
• Loss of OPN with age due to changes in osteoblastic niche may contribute to the progressive skewing towards the myeloid lineage

Kanayama et al (2017) = found that iOPN inhibits myelopoiesis whilst sOPN promotes lymphopoiesis
• Found that irradiated WT mice transplanted with Spp1 KO bone marrow showed increased myeloid cell populations and decreased lymphoid cell populations in multiple organs 7 weeks after transplant
- Conclusion: OPN inhibits myelopoiesis and promotes lymphopoiesis

• Then compared phenotype of
1. irradiated mice transplanted with BM from Spp1 KO mice = no sOPN or iOPN
2. BM from LSL-iOPN mice transferred into irradiated WT mice = iOPN but no sOPN due to deletion of signal sequence that targets OPN to secretory vesicles
• Proportion of myeloid progenitors at week 3, and neutrophils/monocytes/macrophages at week 7, was higher in Spp1 KO chimeras than LSL-iOPN chimeras
• No significant difference in proportion of T + B cells  iOPN does not expand lymphoid cells
• Conclusion: iOPN restricts myeloid cell development, sOPN expands lymphoid cells = coordinate to tip balance of myeloid vs lymphoid progenitors

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7
Q

myeloid bias and RANTES

A

Increased secretion of RANTES/CCL5 may also contribute to myeloid bias in old age
Ergen et al (2012)
1. Detected higher levels of RANTES expression in BM of older mice = cytometric bead arrays
2. More RANTES  reduced lymphopoiesis and increased myelopoiesis
- Overexpressed RANTES-GFP in BM using retroviral vector, and transplanted into irradiated mice  significant decrease in T cells, slight increase in myeloid cells, increased expression of regulators of myeloid differentiation (e.g. GATA1, GATA2) and reduced expression of regulators of lymphoid differentiation (e.g. Ikaros) (q-RTPCR)
- Treated ex vivo HSCs with RANTES before transplantation  same skewing towards myelopoiesis and away from lymphopoiesis
3. RANTES KO mice  more lymphocytes and fewer myeloid progenitors in CBC
failed to identify main source of RANTES in BM = what declines with age?
only in mice = translatable into humans?

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8
Q

CAR cell depletion experiment

A

• Omatsu et al (2010)

  • ablation of CAR cells using CXCL12-DTR knock-in mice leads to a decrease in the pool of HSC, which are more profoundly quiescent than WT HSCs
  • HSC in CAR-depleted mice show increased expression of myeloid genes  bone marrow contains reduced numbers of lymphoid and erythroid progenitors
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9
Q

age-related changes in B cell compartment

A

CXCL12 is essential for early B cell commitment = loss of CAR cells therefore causes in frequency of pro-B cells
transition from pro to pre-B cells is impaired due to reduction in VDJ recombination
reduced numbers of immature B cells reaching spleen results in accumulation of quiescent memory cells in peripheral niches = memory responses not compromised but new responses to pathogens are significantly attenuated
humeral responses are shorter in aged individuals + less protective due to low Ab titres, preponderance of IgM and impaired SHM = low affinity Abs
changes may be due to poor Th cell function = required for GC formation and promoting somatic mutations

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10
Q

effects on T cell compartment = newborn vs elderly

A

In the new-born = huge contribution from thymus, T cell repertoire is polyclonal with many different specificities, homeostatic proliferation contributes only a small amount to maintaining number of T cells in periphery, most T cells are naïve with few memory cells

In the elderly = thymic output providing new specificities to the repertoire is low, homeostatic expansion is largely responsible for maintaining T cell numbers when mature T cells go through cell division both progenies express exactly the same T cell receptor , most T cells have a memory phenotype, low TCR diversity

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11
Q

thymic involution

A
  • Progressive loss of thymic mass and function from the neonatal period onwards, accelerated at puberty due to hormonal changes = permanent and irreversible
  • In the human, the thymus increases in size with involution = degeneration of the cortex leads to infiltration with adipocytes = leads to impaired thymic function
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12
Q

TRECs

A

Analysis of TCR excision circles (TRECs) permits monitoring of thymic output over time
• Cells that have recently emigrated from the thymus can be identified by episomal pieces of DNA = T cell receptor excision circle (TREC)
• Released during VDJ recombination = occurs following upregulation of VDJ recombinase enzyme at CD44+ 25+ stage
• Have no origins of replication = as the cell divides, they are progressively diluted, and thus the proportion of TREC-marked cells in the periphery is a surrogate of thymic activity
• TRECs act as molecular signature that marks these cells, enabling us to track them as they leave the thymus and enter the periphery = gives us some idea of T cell output from the thymus
• What is more, TRECs released at different stages of rearrangement can be tracked using qPCR, providing even more precise information

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13
Q

impact of thymic involution

A

Impact of thymic involution
• Hakim et al (2005) = used quantitative PCR to track emergence of RTE from the thymus in patients treated with BMT = must reinitiate thymopoiesis to recover T cell populations
• TREC frequency approximately 2 years after transplant was strongly correlated with age of patients = age affects ability to reinitiate thymopoiesis
- 30 years old = 10% contain sjTREC as evidence they have just emigrated from the thymus
- Mid 60s = drops to 0.1%
• Clearly a precipitous decline in thymic output with age
• Surprises in study
- Thymic output never decreases to zero = still modest increases in CD4+ T cells even in oldest individuals

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14
Q

homeostatic expansion

A
  • Achieved through homeostatic expansion = proliferation without activation
  • Homeostatic proliferation maintains normal T cell numbers in response to lymphopenia (e.g. haemorrhage, HIV)
  • Expansion is driven by exogenous cytokines of the common y chain family (e.g. IL-7 and IL-15), and by the TFs T-bet and Eo
  • Proliferation is dependent on recognition of self-peptide/MHC complexes on immature DC in secondary lymphoid tissues, and is therefore analogous to thymic positive selection
  • Homeostatic expansion is co-stimulation independent
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15
Q

decreased diversity of TCR

A

Thymic involution and homeostatic expansion results in a significantly decreased diversity of T cell repertoire
• Repertoire becomes progressively oligoclonal  progressive immune compromise
• • Diversity of T cells can be measured using Spectra typing = uses mRNA from T cells to amplify cDNA across CDR3 region of TCRB by PCR = generates information about heterogeneity of relative frequencies of different CDR3 length products = used to determine TCR repertoire diversity
• Hakim (2005) = when output of thymus is high, there is a very high diversity in usage of T cell receptor chain genes; when output is low, diversity of T cells produced is also very low
• Naylor et al (2005)
- Isolated CD4+ T cells from PBMC samples  sequenced random samples of TCR B-chains  determined frequency of these sequences in subsequent blood sample by limiting dilution and PCR/oligonucleotide hybridisation
- estimated TCR VB repertoire diversity in young and middle-aged adults as 20 million different TCR-B chains  pool severely contracted to 200,000 TCR-B specificities in elderly individuals (older than 70 years)
- limitation = limiting dilution systems always provide upper estimate because assay system may not be sensitive enough to detect a single TCR-B chain = good to replicate w another method
• results in reduced ability to mount immune responses to new pathogens

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16
Q

clinical impact of thymic involution

A

• decreased diversity of the T cell repertoire and declining thymic output results in progressive immune compromise with age = important for vaccinations
• Thymic involution also results in imbalance of T cell subsets
- homeostatic expansion applies more to effector T cells than regulatory T cells
- effector T cells rapidly go into cell division in response to T cell loss, whereas regulatory T cells are much more reticent to do so
- predominance of effector T cells leads to increased incidence of autoimmunity
• low thymic output results in poor recovery of immune function following depletion of peripheral T cells

17
Q

impact of involution on recovery from chemo

A

• Mackall et al (1995)

  • Looked at impact of chemo on different aged patients
  • In 3-year-old child = before chemotherapy, immune system is composed of a population of naïve T cells (CD45RA positive) and memory T cells (CD45RO positive)
  • Onset of chemotherapy induces rapid decline in T cell numbers = small population of cells that survive are almost entirely memory T cells
  • Two months after cessation, we start to see a recovery = almost entire T cell repertoire regenerated by 6 months
  • In 23-year-old = chemo induces rapid decline in T cell numbers  begin to see recovery only over 8 months after cessation, and still deficiency at 15 months (though we do see reappearance of some naïve T cells)
  • Elderly individuals show very poor recovery from chemotherapy = thymus makes negligible contribution, very small proportion of naïve T cells
  • Immune system not even began to recover even 24 months after cessation

Mackall et al (1997) = prolonged T cell subset imbalance after chemo
• Compared CD4+ and CD8+ T cell regeneration in patients following intensive chemotherapy
• Used mathematical modelling to provide estimates of doubling times = significant quantitative differences between subtypes = imbalance in recovery
- 98% of CD8+ T cells recovered by 3 months post-therapy
- Only 35% of CD4+ T cells recovered by 3 months  still incomplete at up to 12 months
• However, CD8+ cells are completely reliant on CD4+ T cells for T cell help = abundance of CD8+ cells is of little benefit to the individual
• Mechanism unclear = but likely that thymic-independent pathways of CD8+ T cell generation are more efficient than CD4+  similar expansion of other clinical settings associated with impaired thymopoiesis (e.g. HIV, post-BMT)

18
Q

AIDS

A

Impact on T cell recovery after indinavir treatment for AIDS

• Vast majority of new T cells produced by homeostatic expansion not by thymus = very few naïve T cells recovered

19
Q

possible reasons for involution

A

Why does involution occur?
Hypotheses include
1. General wear and tear of the stroma, as thymus is very active early in life
- BUT why does thymus succumb more than other organs (e.g. gut)?

  1. Exhaustion of the MTS24+ stem cell pool
    - Why would thymus be more vulnerable to exhaustion of SCs than other tissues?
  2. Secondary to insufficiency of bone marrow progenitors
    • Investigated by Mackall et al (1998)
    • Took old mouse that had already undergone thymic involution  lethally irradiated it  rescued with bone marrow from young mouse  sufficient to restore architecture of thymus?
    • Used immunocytochemical staining using ER-TR4 and ER-TR5 antibodies which preferentially bind to CTEC and MTEC
    • NO  provision of a significant pool of young progenitors did not restore age-related histological abnormalities/involution/rejuvenate thymus
  3. Direct adaptation to reduce the risk of malignancy
    - Thymus supports the greatest rate of cellular proliferation of any organ
    - Proliferation is associated with recombination of the germ line genes and significant risk of mutation (very error-prone process)  high risk of leukaemia
    - BUT similar level of proliferation of B cells, also requiring recombination of receptor chain genes, in bone marrow  no involution here!
  4. The cortical epithelium is the target of chronic autoimmunity, as a consequence of positive selection
    - Positive selection in the thymus results in a repertoire that is inherently self-reactive
    - Self-reactivity is functionally silent in the periphery as self-peptides are not normally presented in the context of inflammation
    - Activated T cells may mount a response to cTEC upon recirculation through the thymus = killing of cTEC cells = autoimmunity
    - Evidence for autoimmune hypothesis
    - Thymic involution is progressive from birth onwards, correlating with increased exposure to pathogens
    - Strains of mice prone to autoimmunity display a significantly enhanced rate of thymic involution (particularly NOD mouse)
  5. Widely accepted hypothesis = the thymus represents part of the ‘disposable soma’
    - Neonatal thymus contains 1011 thymocytes, of which 20-25% arise de novo each day
    - Less than 5% of cells survive selection (cells die by neglect in situ in cortex and are removed by macrophages, or are actively deleted in negative selection): no other organ is so energetically wasteful
    - There is significant selection pressure to dispose of the thymus to conserve energy
    - The original selection pressure on homo sapiens was to dispense with energetically unfavourable tissues once immunity to local pathogens had been established and reproductive age had been reached
20
Q

IL-22 in preventing involution

A

IL-22 drives endogenous transient thymic regeneration in mice  enhances survival and proliferation of thymocytes and TECs

Dudakov et al (2012)

  1. Compared thymic function in WT and IL-22KO mice
    - No difference in total thymic cellularity or composition at baseline
    - Following sublethal irradiation or HSCT, IL22KO mice displayed significantly impaired thymic regeneration compared to WT (significantly reduced numbers of all developing thymocytes, TECs and non-TECs)  persisted up to 98 days after insult
  2. Found that levels of intrathymic IL-22 increased by 2-3 fold in irradiated WT mice vs control mice that were not irradiated, as measured by ELISA
  3. Deduced that ILC subtype called lymphoid tissue-inducer cells (LTi) was responsible for IL-22 secretion
    - Frequency increased significantly after TBI
    - KO of RORyT (crucial for LTi development)  no effect on baseline intrathymic IL-22, but no significant increase in intrathymic IL-22 following TBI = crucial for IL-22 upregulation following thymic damage
  4. Secretion of IL-22 by LTi is dependent on IL-23 secreted by thymic DCs, which sense tissue damage via DAMPs
  5. Also showed that administration of recombinant IL-22 to mice after SL-TBI significantly increased thymic cellularity (and numbers of all thymocyte and TEC subsets) at days 7 and 28  similar effects following HSCT

Can we use IL-22 therapeutically?  experiments have shown that recombinant IL-22 is not effective at rejuvenating thymus in old mice so likely not

study showed no effect in non-irradiated mice

21
Q

hormone treatment for regeneration

A

Sutherland et al (2005)
- Androgen ablation results in complete restoration of aged male thymus in mice, with distinct cortical and medullary architecture
Brad administration followed by immunofluorescence staining w anti-BRDU antibodies revealed significant increase in proliferation
FACS profiles of annexin V staining revealed significant reduction in apoptotic cells

  • Sex steroid ablation for treatment of prostatic carcinoma (LHRH agonists) results in an increase in naïve TREC+ cells in peripheral blood (RT-PCR)
  • Will never be used clinically = only useful in men, many wouldn’t see castration as useful treatment for thymic involution
22
Q

reprogramming to produce TECs

A

Bredenkamp et al (2014)
• Working from principles of Waddington’s epigenetic landscape, they reprogrammed primary mouse embryonic fibroblasts (MEFs) into functional TECs through transduction with FOXN1 gene (master TF for thymus production)
• Used Cre-lox technology
- Crossed mice expressing tamoxifen-inducible Cre allele expressed under Rosa26 promoter, with mice in which FOXN1 cDNA was knocked into Rosa26 locus under control of CAG promoter, with LoxP-flanked STOP cassette inserted between CAG promoter and FOXN1 cDNA
• Following tamoxifen administration, iFOXN1 MEFs expressed TEC-specific genes at levels comparable to foetal TECs = e.g. Dll4, Cccl25, KitL (RT-PCR)
• When implanted under the kidney capsule of syngeneic adult mice, induced cells spontaneously formed a functional thymus able to select a normal T cell repertoire = histology, FC
• Potential clinical applications as reprogramming strategies are improved

23
Q

innate immunity

A

Neutrophils
• Impairment in neutrophil function likely a major contributor to increased incidence of infections in older adults
• Reduced chemotaxis and migration, compromised phagocytosis, reduced production of ROS, reduced GM-CSF signalling, impaired signal transduction
• Simell et al (2011) = evidence for reduced phagocytic killing in elderly
- Isolated polymorphonuclear neutrophils from young subjects + elderly adults significantly reduced phagocytic killing of Strep pneumococcus opsonised with antibodies and complement in vitro  reverse association between advancing age and killing efficiency
- Up to 2.8-fold decline in efficacy for some strains = significant

Macrophages/monocytes
• Skewing towards M2 (immunoregulatory) phenotype with old age
• Reduced TLR-induced pro-inflammatory cytokine production, reduced co-stimulatory molecule expression, reduced phagocytosis

Dendritic cells = reduced ability control tumour growth, reduced expression of co-stimulatory proteins etc

Natural killer cells = decreased cytotoxicity, reduced IFNy production, reduced cytokine and chemokine secretion

24
Q

IL-7 to improve cell-mediated immunity in old people

A

Aspinall et al (2007)
- treated old female rhesus macaques w subcutaneous injection of IL-7 for 14 days
- increase in CD4+ and CD8+ T cells, naive T cells (CD45RA+) for both subsets and TREC levels (FC)
greater HAI titres, and influenza-specific memory CD8+ T cells following vaccination w inactivated influenza vaccine