Stem Cells, Vol. 19, No. 5, 388-396,
September 2001
© 2001 AlphaMed Press
Chemokine Regulation of Normal and Pathologic Immune Responses
Kent Christopherson, II,
Robert Hromas
Indiana University Cancer Center and the Walther Oncology Institute, Indianapolis, Indiana, USA
Key Words. Chemokine • Chemotaxis • Homing • Hematopoiesis • T cell
Robert Hromas, Ph.D., Indiana University Cancer Center and the Walther Oncology Institute, R4-202, 1044 W. Walnut St., Indianapolis, Indiana 46202, USA. Telephone: 317-274-1036; Fax: 317-274-0396; e-mail: rhromas{at}iupui.edu
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ABSTRACT
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Chemokines are small basic proteins that are the major mediators of all leukocyte migration. There are at least 46 distinct chemokines, and 19 chemokine receptors, making it easily the largest cytokine family. Chemokines can be both beneficial and harmful, by either stimulating an appropriate immune response to microbial invasion, or by mediating pathologic tissue destruction in many types of human disease. Chemokines have been implicated in the tissue destruction seen in autoimmune diseases, atherosclerosis, allograft rejection, and neoplasia. Chemokines also play essential roles in normal lymphocyte trafficking to primary and secondary lymphoid organs for antigen presentation and lymphocyte maturation. Chemokines also regulate hematopoietic stem and progenitor cell homing and proliferation. Therefore, it is likely that chemokines will become important targets for pharmacologic intervention in a wide variety of human diseases in the future.
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INTRODUCTION
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Chemokines are a large family of cytokines that direct normal leukocyte migration and have been implicated in the regulation of leukocyte development, angiogenesis, tumor growth, and metastasis [1-4]. They perform both beneficial roles in normal host defense against infection and harmful roles in autoimmune diseases [5-7]. Chemokines have been shown to mediate inflammatory tissue destruction in a wide variety of human diseases, such as rheumatoid arthritis, myocardial infarction, and adult respiratory distress syndrome [8-14].
Chemokines are 8-12 kD heparin-binding proteins that are rich in basic amino acids and contain conserved cysteine motifs forming essential disulfide bonds between the first and thirds and the second and fourth cysteines. They are single polypeptides ranging from 70 to 100 amino acids in length and share varying degrees (20%-95%) of amino acid sequence identity. The number and spacing of the first cysteines in the amino acid sequence are used to classify chemokines into four subfamilies: C, CC, CXC, and CX3C (Table 1
) [15-17]. If the first two cysteines are adjacent to each other, they are classified in the CC family (also known as the beta family) consisting of CCL1-27. The CXC family (also referred to as the alpha family) consisting of CXCL1-15 has a single amino acid between the initial two cysteines. Two more recently discovered chemokines (lymphotactin/XCL1-2 and fractalkine/ CX3CL1) represent the first members of the C and CX3C subfamilies. Most CXC members are located in a gene cluster on human chromosome 4 at q12-21, whereas most CC members are in a cluster on human chromosome 17 at q11-32.
Chemokines act through chemokine receptors (XCR1, CCR1-11, CXCR1-5, and CX3CR1) (Table 2
), which are a subfamily of G-protein coupled seven-transmembrane receptors [16-18]. Chemokine receptors share 25%-80% amino acid sequence identity. Redundancy exists in the signaling of chemokines through chemokine receptors. Many chemokines bind to more than one chemokine receptor, and many chemokine receptors bind more than one chemokine (Table 2
). Chemokine receptors probably signal through the Gß
subunit to activate phospholipase C and phosphatidylinositol-3 kinase [16-19]. This in turn ultimately leads to activation of the cytoskeletal regulatory kinases FAK and Pyk-2 [20, 21] that mediate chemotaxis, and in some cases activation of the MAP kinase proliferative pathway [16, 20].
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CHEMOKINES AND DISEASE
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Chemokines are important in a wide variety of human diseases. They play a role in autoimmune diseases, allograft rejection, infection, allergies, neoplasia, and vascular abnormalities [7, 22-24].
In autoimmune diseases, chemokines are implicated in the pathology of rheumatoid arthritis, lupus, and multiple sclerosis. Chemokines have been reported to be mediators of inflammatory tissue destruction in rheumatoid arthritis. For example, macrophage inhibitory protein (MIP)-1
and MIP-2 levels were reported to be increased in arthritic joints, and their levels were shown to increase with the severity of rheumatoid arthritis [10]. In addition, interleukin 8 (IL-8) and membrane cofactor protein-1 (MCP-1) have also been found in the synovial fluid of patients with rheumatoid arthritis [11, 22].
There are excellent animal model data that chemokines mediate multiple sclerosis (MS) [22, 25]. Mice deficient in CCR2 or MCP-1 fail to get experimental autoimmune encephalitis, the best animal model of MS. In addition, there are data from humans that indicate that chemokine levels are elevated in the cerebrospinal fluid of MS patients, and that central nervous system T-cells in MS are highly enriched for certain chemokine receptors [26].
Chemokines also play a pivotal role in allograft rejection [27]. Local graft production of non-specific inflammatory cytokines such as interferon-
stimulate the production of chemokines, which in turn attract CCR7+ T cells and dendritic cells to the graft for neo-antigen presentation, and then CXCR3+ cytotoxic T cells to mediate graft rejection. CXCR3/ mice have markedly prolonged allograft survival.
Chemokines have been found to mediate HIV infection [28]. Reports have shown that the CC chemokines MIP-1
, MIP-1ß, and RANTES inhibit HIV-1 production in newly infected peripheral blood mononuclear cells [28]. The HIV coreceptors that function with CD4 are the chemokine receptors CCR5 and CXCR4, suggesting a mechanism for the inhibition of HIV infection by some chemokines [29-31].
Chemokines play a role in allergic reactions [5, 9, 22, 23]. Eotaxin, MCP-3, and RANTES are present at the asthma disease site in bronchial airways [5]. Through serial neutralization of chemokines using injected anti-sera, it has been shown that chemokines orchestrate the accumulation of bronchial leukocytes in airway hypersensitivity models [32].
Chemokines also mediate many vascular lesions as well, such as atherosclerosis and post-infarct reperfusion tissue destruction [2, 5, 7, 8]. In atherosclerosis, it appears that the initiating step in the origin of an atherosclerotic plaque is the induction of MCP-1 in vascular smooth muscle from flow shear stress in hypertension [33]. This stimulates the infiltration of the vascular wall by monocytes, which begin to lay down cholesterol. In addition, IL-8, MCP-1, and MIP-2 are all possible mediators of neutrophil-mediated ischemic reperfusion injury in stroke or myocardial infarction [10, 13].
Chemokines have been implicated in angiogenesis, tumor growth, and metastasis [3, 5, 15]. It is established that ELR-CXC chemokines are angiogenic (stimulate endothelial cells resulting in increased vascularization) and most non-ELR-CXC chemokines are angiostatic (inhibit ELR-CXC chemokine stimulation of endothelial cells) [3]. In addition, chemokines are implicated in tumor metastasis by their involvement in the migration of tumor cells [3]. The chemokine receptor CXCR4 is reported to be highly expressed in human malignant breast cancer cells and metastases [34]. Based on these data, it is hypothesized that SDF-1 expression, at sites of metastasis, attract metastatic cancer cells expressing the receptor CXCR4. Neutralization of the CXCR4 receptor inhibits the metastasis of breast cancer cells to lymph nodes and lung tissue [34].
Chemokines have generated interest as tumor vaccines for their chemoattractant as well as their T cell and natural killer (NK) cell stimulatory properties. The CC chemokine TCA3/I-309 can induce tumor specific and long-lasting immunity in mice that have been immunized with tumor cells expressing TCA3 [35]. Tumor cells transduced with the CC chemokine MCP-1 also stimulate a specific immune response that protects immunized rats against further tumor cell challenge [36]. The transduction of lymphotactin into cells, simultaneously with IL-2 as a T-cell-stimulatory molecule, was also effective as a tumor vaccine [37].
We and others isolated a novel subfamily of CC chemokines, comprised of Exodus-1, Exodus-2, and Exodus-3, that plays an important role in human disease (Table 1
). They share an amino terminal DCCL (asp-cys-cys-leu) sequence that is unique among CC chemokines. Exodus-1 is also known as CCL20, Mip-3
and LARC [16, 38-40]. Exodus-2 is also known as CCL21, 6-Ckine, SLC, and TCA4 [16, 41-44]. Exodus-3 is also known as CCL19, Mip-3ß, CKß-11, and ELC [16, 39, 45].
We found that Exodus-3 (CCL19), through an NK and CD4+ cell mediated mechanism, inhibited breast cancer cell growth in the C3L5 mouse model [46]. We also found that Exodus-1, -2, and -3 (CCL19-21) inhibited chronic myelogenous leukemia progenitor proliferation [47]. This subfamily is unique in that property. Other chemokines that inhibit the normal human hematopoietic progenitor proliferation do not inhibit chronic myelogenous leukemia (CML) progenitors [47]. In addition, others also found that Exodus-2 and -3 (CCL21 and 19) also have potent immunotherapeutic activity against solid tumors, probably due to recruitment of T cells and NK cells to the target tumor [48-50].
Interestingly, a number of chemokine homologues have been found in the genomes of large DNA viruses [51]. It has been postulated that these chemokine homologues act as dominant negative inhibitors of normal chemokine function, blocking the recruitment of leukocytes to a viral infection. For example, we described the presence of two homologues of Mip-1
in the genome of Molluscum Contagiosum [52]. These chemokines inhibited the action of normal human Mip-1
. Others have found that Kaposi's sarcoma-associated herpes simplex virus (HSV) (HHV6) contains two chemokine homologues termed v-MIP I and II [53]. These two KHSV chemokines are pro-angiogenic, yet anti-chemotactic, explaining two of the major properties of Kaposi's sarcoma, the vascular and lingering nature of the lesion.
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CHEMOKINE REGULATION OF THE NORMAL IMMUNE RESPONSE
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Chemokines also mediate important functions of the normal immune response. Perhaps their most critical role is in acquired cellular immunity. The Exodus subfamily of chemokines (CCL20, 21, 19) mentioned plays the major role in regulating T cell and dendritic cell trafficking, and antigen presentation, the core of cell-mediated immunity. In our hands Exodus-2 (CCL21) was the most potent stimulator of T cell migration of any chemokine tested [41].
By Northern blot analysis, Exodus-2 is preferentially expressed in normal human lymphoid tissues [41]. Exodus-2 is also expressed in HEL cells, an erythroleukemia cell line. Utilizing immunohistochemistry, it was determined that Exodus-2 is also expressed by the endothelial cells lining the high endothelial venule (HEV) and dendritic cells, T cells, and node stromal cells in the T-cell zone of normal human lymphoid tissue [54, 55]. Exodus-2 is also expressed in the HEV of the lymph node and facilitates the adherence and migration of naïve T cells into the secondary lymphoid tissue so that they may interact with antigen presenting cells [54-60]. Exodus-2 expression by lymph node stromal cells can attract both the naïve T cells and the dendritic cells to the T-cell zone where antigen presentation can occur [59-63].
Exodus-2 and Exodus-3 also attract dendritic cells through the CCR7 receptor present on the surface of these cells [64-66]. The role of dendritic cells in antigen-mediated immunity is to capture and process antigen in peripheral tissues. Dendritic cells then migrate to secondary lymphoid organs and present antigen to naïve T cells. The migration of CCR7-expressing dendritic cells to secondary lymphoid tissues was demonstrated to be mediated by Exodus-2 using radiolabled dendritic cells in mice [66].
The co-localization of lymphocytes and antigen-presenting cells is the primary function of secondary lymphoid organs [59-63]. Secondary lymphoid organs act as the initiation site of antigen-mediated adaptive immune responses. Since the number of T cells specific for any one antigen is low, T cells survey many secondary lymphoid organs. This permits activated dendritic cells in the secondary lymphoid organs to come into contact with many naïve T cells. This nodal T-cell survey appears to be mediated by CCR7 ligand expression [59-63, 67].
Naïve T cells, after leaving the thymus, enter lymph nodes from the blood through the HEV [59-63, 67]. Activated dendritic cells (those that display antigens derived from the infecting agents located in peripheral tissues) enter through the afferent lymphatic vessels [59-63]. In humans, Exodus-2 has been shown to induce ICAM-1 (intercellular adhesion molecule-1)/LFA-1 (leukocyte function associated molecule-1) mediated adhesion of rolling lymphocytes on the blood vessel endothelium [54, 55]. This is the mechanism by which Exodus-2 induces adherence of naïve T cells to the HEV of the lymph node.
After entering the lymph node, naïve T cells and activated dendritic cells are localized to the T-cell zone. Exodus-2 and Exodus-3 are thought to function as gradients that co-localize naïve T cells and activated dendritic cells via the CCR7 receptor expressed on their cell surface [59-63]. Exodus-2 and Exodus-3 are both expressed by stromal cells in the T-cell zone, resulting in migration toward this area. It has also been suggested that T cells and dendritic cells in the T-cell zone are also expressing Exodus-2 to further set up an appropriate concentration gradient. In a similar manner, BLC (BCA-1) is thought to attract B cells to the B-cell follicle through interactions with CXCR5 [59, 60].
The importance of Exodus-2 and Exodus-3 in T-cell trafficking has been implied by studies involving plt (paucity of lymph node T cells) mice [68-74] and CCR7-deficient mice [75]. The naturally occurring plt mouse mutation shows a loss of Exodus-2 and Exodus-3 expression. The plt mouse phenotype is currently believed to be the result of the deletion of one (designated CCl21ser) of two copies of Exodus-2 that exists in the mouse genome and the deletion of the only functional copy of Exodus-3 [71, 72]. Naïve T cells and activated dendritic cells in these mice have a defect in their ability to traffic to lymph nodes or to T-cell zones of the spleen [69-74]. The plt mouse T-cell phenotype suggests that the CCR7 ligands Exodus-2 and -3 play the major role in the regulation of naïve T-cell trafficking through secondary lymphoid organs [56-59].
Exodus-2 and Exodus-3 both bind the CC chemokine receptor CCR7 [59-63]. The CCR7 receptor has been knocked out in mice. Two phenotypic aberrations resulted from the deletion of CCR7 [75]. The first abnormality was the disordered migration of lymphocytes to secondary lymphoid organs. The second abnormality was the failure of skin dendritic cells to migrate into draining lymph nodes. These two findings support the importance of Exodus-2 and Exodus-3 in trafficking of naïve T cells and activated dendritic cells through secondary lymphoid organs. However, since Exodus-2 and Exodus-3 share the CCR7 receptor, information obtained from CCR7-deficient mice does not answer questions about the distinct function of Exodus-2 alone versus Exodus-3 with respect to the trafficking of T cells through secondary lymphoid organs.
Chemokines also are essential mediators of normal NK cell function. We and others have found that the CCR7 ligands Exodus-2 and -3 are potent stimulators of normal human activated NK cell chemotaxis [76, 77]. Significantly, we also found that both of these chemokines stimulated the proliferation of activated NK cells. Thus, in certain situations chemokines are not only mediators of migration but also of cell expansion to mount an immune response to invasion. Lymphotactin has also been found to stimulate NK cell chemotaxis [78].
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CHEMOKINE REGULATION OF HEMATOPOIESIS
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Chemokines regulate development of hematopoietic cells in three ways. First, several members of the chemokine family inhibit proliferation of hematopoietic progenitors as measured by colony formation assays [79]. In general, with the exception mentioned above of the Exodus subfamily, this inhibition does not extend to CML progenitors [47, 80, 81]. This inhibition of normal hematopoietic progenitors can be seen both in vitro and with in vivo injection of chemokines into mice. Interestingly, this inhibition is quite synergistic, such that a combination of two chemokines in 10-fold lower doses produces the same level of inhibition as one chemokine in a 10-fold higher dose. Even one dose of chemokine in vivo can produce significant progenitor inhibition. This inhibition is protective against the cytotoxic effects on progenitors of cell cycle phase active antineoplastic agents [82, 83]. This finding led to human clinical trials with an analogue of Mip-1
(BB10010) in adjuvant chemotherapy of breast cancer in an effort to prevent chemotherapy-induced cytopenia. While there was indeed inhibition of hematopoietic progenitor proliferation prior to chemotherapy, it did not make an appreciable difference in preventing cytopenias [84].
Second, chemokines also regulate migration of hematopoietic progenitors. SDF-1 is essential for the embryonic trafficking of hematopoietic stem cells and progenitors from the fetal liver to the marrow [85, 86]. SDF-1 plays a critical role in mediating stem cell homing to the marrow after transplantation, and in stem cell mobilization for aphersis for peripheral blood stem cell transplantation [87, 88]. Other chemokines can also stimulate progenitor migration. For example, the CCR7 ligands Exodus-2 and -3 mediate chemotaxis of macrophage progenitors [89].
Third, chemokines have been suggested to participate in normal thymic T-cell development [59]. The chemokines SDF-1, Mig, IP-10/ITAC, MIP-1
, RANTES, CCR5, TECK, TARC/MDC, as well as Exodus-2 and -3 have all been suggested to be involved in lymphocyte localization and development in the thymus [59]. They do not actively attract T-cell precursors from the marrow to the thymus for further development, but localize pre-T cells to specific areas of the thymus for sequential developmental steps.
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SUMMARY
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Chemokines are a large family of cytokines that regulate all white blood cell trafficking, from hematopoietic stem cells to mature neutrophils and lymphocytes. The amazing redundancy in this family, where receptors bind many different chemokines and many different receptors are expressed on the same cell type, allows for fine regulation of the immune response. The selective expression of distinct chemokines in distinct tissues after different stimuli produces finely tuned leukocyte infiltrates in both normal and disease states.
Chemokines play critical roles in making sure leukocytes arrive in the proper environments for appropriate maturation, and arrive at sites of infection to deal with pathologic invasion. However, when inappropriately expressed, they can mediate many autoimmune and vascular diseases. They are attractive targets for clinical intervention in these diseases. In the future, it is likely that chemokines and their receptors will be central to a number of novel pharmacologic agents.
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Received May 17, 2001;
accepted for publication June 19, 2001.
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