Abstract
Dendritic cells (DC) are the most important subset of antigen presenting cells (APC) that are able to polarize the immune response to pro-inflammatory or anti-inflammatory response. This duality places DC in the axis between tolerance and immunogenicity. The regulation of polarization is the key point in autoimmune diseases and organ transplantation. In order to manipulate this duality, DC have been generated ex vivo with a tolerogenic or immunogenic profile since several years. During the last decade, cell therapy using tolerogenic DC (TolDC) has been shown to be safe and effective both in autoimmune diseases and transplantation models in animals. Since 2011, recipient TolDC has been tested in clinical trials in type 1 diabetes, rheumatoid arthritis and Crohn’s diseases with favourable results in terms of safety. Indeed, other clinical trials are ongoing including a phase I/II clinical assay in kidney transplantation. In this review, we will discuss the potential of TolDC that has been demonstrated in animal models and used in clinical trials.
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Abbreviations
- GM-CSF:
-
Granulocyte-macrophage colony-stimulating factor
- IL:
-
Interleukin
- TGF-β:
-
Transforming growth factor-beta
- CD:
-
Cluster of differentiation
- DEC:
-
Dendritic and epithelial cells
- MHC:
-
Major histocompatibility complex
- NF-kB:
-
Nuclear factor kappa-light-chain-enhancer of activated B-cells
- AAV:
-
Adeno-associated virus
- PD-1:
-
Programmed cell death protein-1
- PDL-1:
-
Programmed cell death ligand-1
- IFN-γ:
-
Interferon gamma
- HLA:
-
Human leukocyte antigen
- CTLA-4:
-
Cytotoxic T-lymphocyte associated protein 4
- LAG-3:
-
lymphocyte-activation gene-3
- Th:
-
T-cell helper
- MOG:
-
Myelin oligodendrocyte glycoprotein
References
Papers of particular interest, published recently, have been highlighted as: •Of importance ••Of major importance
Steinman RM, Cohn ZA. Identification of a novel cell type in peripheral lymphoid organs of mice. I. Morphology, quantitation, tissue distribution. J Exp Med. 1973;137:1142–62.
Steinman RM, Cohn ZA. Identification of a novel cell type in peripheral lymphoid organs of mice. II. Functional properties in vitro. J Exp Med. 1974;139:380–97.
Mbongue J, Nicholas D, Firek A, Langridge W. The role of dendritic cells in tissue-specific autoimmunity. J Immunol Res. 2014;2014:857143.
Hubo M, Trinschek B, Kryczanowsky F, Tuettenberg A, Steinbrink K, Jonuleit H. Costimulatory molecules on immunogenic versus tolerogenic human dendritic cells. Front Immunol. 2013;4:1–14.
Ezzelarab M, Thomson AW. Tolerogenic dendritic cells and their role in transplantation. Semin Immunol. 2011;23:252–63.
Ohnmacht C, Pullner A, King SBS, Drexler I, Meier S, Brocker T, et al. Constitutive ablation of dendritic cells breaks self-tolerance of CD4 T cells and results in spontaneous fatal autoimmunity. J Exp Med. 2009;206:549–59.
Butterfield LH. Dendritic cells in cancer immunotherapy clinical trials: are we making progress? Front Immunol. 2013;4:452.
Maldonado RA, von Andrian UH. How tolerogenic dendritic cells induce regulatory T cells. Adv Immunol. 2010;108:111-65.
Yang J, Bernier SM, Ichim TE, Li M, Xia X, Zhou D, et al. LF15-0195 generates tolerogenic dendritic cells by suppression of NF-kB signaling through inhibition of IKK activity that inhibited Th1 polarization and increased Th2. J Leukoc Biol. 2003;74:438–47.
Bluestone JA. Mechanisms of tolerance. Immunol Rev. 2011;241:5–19.
Thompson AG, Thomas R. Induction of immune tolerance by dendritic cells: implications for preventative and therapeutic immunotherapy of autoimmune disease. Immunol Cell Biol. 2002;80:509–19.
Faivre V, Lukaszewicz AC, Alves A, Charron D, Payen D, Haziot A. Human monocytes differentiate into dendritic cells subsets that induce anergic and regulatory T cells in sepsis. PLoS One. 2012;7:e47209.
Louvet C, Chiffoleau E, Heslan M, Tesson L, Heslan J-M, Brion R, et al. Identification of a new member of the CD20/FceRIb family overexpressed in tolerated allografts. Am J Transplant. 2005;5:2143–53.
Rutella S, Danese S, Leone G. Tolerogenic dendritic cells: cytokine modulation comes of age. Blood. 2006;108:1435–40.
Gaudreau S, Guindi C, Ménard M, Besin G, Dupuis G, Amrani A. Granulocyte-macrophage colony-stimulating factor prevents diabetes development in NOD mice by inducing tolerogenic dendritic cells that sustain the suppressive function of CD4+CD25+ regulatory T cells. J Immunol. 2007;179:3638–47.
Naranjo-Gómez M, Raïch-Regué D, Oñate C, Grau-López L, Ramo-Tello C, Pujol-Borrell R, et al. Comparative study of clinical grade human tolerogenic dendritic cells. J. Transl. Med. 2011;9:89.
Moreau A, Varey E, Bouchet-Delbos L, Cuturi MC. Cell therapy using tolerogenic dendritic cells in transplantation. Transplant Res. 2012;1:13.
Huang H, Dawicki W, Zhang X, Town J, Gordon JR. Tolerogenic dendritic cells induce CD4+CD25hiFoxp3+ regulatory T cell differentiation from CD4+CD25−/loFoxp3− effector T cells. J Immunol. 2010;185:5003–10.
Torres-Aguilar H, Aguilar-Ruiz SR, González-Pérez G, Munguía R, Bajaña S, Meraz-Ríos M a, et al. Tolerogenic dendritic cells generated with different immunosuppressive cytokines induce antigen-specific anergy and regulatory properties in memory CD4+ T cells. J. Immunol. 2010;184:1765–75.
Mansilla MJ, Sellès-Moreno C, Fàbregas-Puig S, Amoedo J, Navarro-Barriuso J, Teniente-Serra A, et al. Beneficial effect of tolerogenic dendritic cells pulsed with MOG autoantigen in experimental autoimmune encephalomyelitis. CNS Neurosci Ther. 2015;21:222–30.
Turnquist HR, Raimondi G, Zahorchak AF, Fischer RT, Wang Z, Thomson AW. Rapamycin-conditioned dendritic cells are poor stimulators of allogeneic CD4+ T Cells, but enrich for antigen-specific Foxp3+ T regulatory cells and promote organ transplant tolerance. J Immunol. 2007;178:7018–31.
Machen J, Harnaha J, Lakomy R, Styche A, Trucco M, Giannoukakis N. Antisense oligonucleotides down-regulating costimulation confer diabetes-preventive properties to nonobese diabetic mouse dendritic cells. J Immunol. 2004;173:4331–41.
Zhu M, Wei MF, Liu F, Shi HF, Wang G. Interleukin-10 modified dendritic cells induce allo-hyporesponsiveness and prolong small intestine allograft survival. World J Gastroenterol. 2003;9:2509–12.
Lutz MB, Suri RM, Niimi M, Ogilvie ALJ, Kukutsch NA, Rössner S, et al. Immature dendritic cells generated with low doses of GM-CSF in the absence of IL-4 are maturation resistant and prolong allograft survival in vivo. Eur J Immunol. 2000;30:1813–22.
Gallagher MP, Kelly PJ, Jardine M, Perkovic V, Cass A, Craig JC, et al. Long-term cancer risk of immunosuppressive regimens after kidney transplantation. J Am Soc Nephrol. 2010;21:852–8.
Herrera OB, Golshayan D, Tibbott R, Ochoa FS, James MJ, Marelli-Berg FM, et al. A novel pathway of alloantigen presentation by dendritic cells. J Immunol. 2004;173:4828–37.
Fu F, Li Y, Qian S, Lu L, Chambers F, Starzl TE, et al. Costimulatory molecule-deficient dendritic cell progenitors (MHC class II+, CD80dim, CD86-) prolong cardiac allograft survival in nonimmunosuppressed recipients. Transplantation. 1996;62:659–65.
DePaz H a, Oluwole OO, Adeyeri AO, Witkowski P, Jin MX, Hardy MA, et al. Immature rat myeloid dendritic cells generated in low-dose granulocyte macrophage-colony stimulating factor prolong donor-specific rat cardiac allograft survival. Transplantation. 2003;75:521–8.
Divito SJ, Wang Z, Shufesky WJ, Liu Q, Tkacheva OA, Montecalvo A, et al. Endogenous dendritic cells mediate the effects of intravenously injected therapeutic immunosuppressive dendritic cells in transplantation. Blood. 2010;116:2694–705.
Rainienė T, Izvolskaja N, Dainys B, Kučinskis G, Razukas V. Donor-specific transfusions as a way of tolerance induction to living donor kidney transplant. Biologija. 2009;55:99–104.
Yu G, Xu X, Vu MD, Kilpatrick ED, Li XC. NK cells promote transplant tolerance by killing donor antigen-presenting cells. J Exp Med. 2006;203:1851–8.
Pêche H, Trinité B, Martinet B, Cuturi MC. Prolongation of heart allograft survival by immature dendritic cells generated from recipient type bone marrow progenitors. Am J Transplant. 2005;5:255–67.
Bériou G, Pêche H, Guillonneau C, Merieau E, Cuturi MC. Donor-specific allograft tolerance by administration of recipient-derived immature dendritic cells and suboptimal immunosuppression. Transplantation. 2005;79:969–72.
Baas MC, Kuhn C, Valette F, Mangez C, Duarte MS, Hill M, et al. Combining autologous dendritic cell therapy with CD3 antibodies promotes regulatory T cells and permanent islet allograft acceptance. J Immunol. 2014;193:4696–703.
Taner T, Hackstein H, Wang Z, Morelli AE, Thomson AW. Rapamycin-treated, alloantigen-pulsed host dendritic cells induce Ag-specific T cell regulation and prolong graft survival. Am J Transplant. 2005;5:228–36.
Moreau A, Vandamme C, Segovia M, Devaux M, Guilbaud M, Tilly G, et al. Generation and in vivo evaluation of IL10-treated dendritic cells in a nonhuman primate model of AAV-based gene transfer. Mol Ther — Methods Clin Dev. 2014;1:14028.
Moreau A, Chiffoleau E, Beriou G, Deschamps J-Y, Heslan M, Ashton-Chess J, et al. Superiority of bone marrow-derived dendritic cells over monocyte-derived ones for the expansion of regulatory T cells in the Macaque. Transplantation. 2008;85:1351–6.
Chikuma S, Terawaki S, Hayashi T, Nabeshima R, Yoshida T, Shibayama S, et al. PD-1-mediated suppression of IL-2 production induces CD8+ T cell anergy in vivo. J Immunol. 2009;182:6682–9.
Huang H, Ma Y, Dawicki W, Zhang X, Gordon JR. Comparison of induced versus natural regulatory T cells of the same TCR specificity for induction of tolerance to an environmental antigen. J Immunol. 2013;191:1136–43.
Baatar D, Olkhanud P, Sumitomo K, Taub D, Gress R, Biragyn A. Human peripheral blood T regulatory cells (Tregs), functionally primed CCR4+ Tregs and unprimed CCR4− Tregs, regulate effector T cells using FasL. J Immunol. 2007;178:4891–900.
Schinnerling K, García-González P, Aguillón JC. Gene expression profiling of human monocyte-derived dendritic cells—searching for molecular regulators of tolerogenicity. Front Immunol. 2015;6:1–10.
Awasthi A, Carrier Y, Peron JPS, Bettelli E, Kamanaka M, Flavell RA, et al. A dominant function for interleukin 27 in generating interleukin 10-producing anti-inflammatory T cells. Nat Immunol. 2007;8:1380–9.
Hill M, Tanguy-Royer S, Royer P, Chauveau C, Asghar K, Tesson L, et al. IDO expands human CD4+CD25high regulatory T cells by promoting maturation of LPS-treated dendritic cells. Eur J Immunol. 2007;37:3054–62.
Moreau a, Hill M, Thébault P, Deschamps JY, Chiffoleau E, Chauveau C, et al. Tolerogenic dendritic cells actively inhibit T cells through heme oxygenase-1 in rodents and in nonhuman primates. FASEB J. 2009;23:3070–7.
Hill M, Thebault P, Segovia M, Louvet C, Bériou G, Tilly G, et al. Cell therapy with autologous tolerogenic dendritic cells induces allograft tolerance through interferon-gamma and Epstein-Barr virus-induced gene 3. Am J Transplant. 2011;11:2036–45.
Dixon KO, van der Kooij SW, Vignali DAA, van Kooten C. Human tolerogenic dendritic cells produce IL-35 in the absence of other IL-12 family members. Eur J Immunol. 2015;45:1736–47.
Gregori S, Tomasoni D, Pacciani V, Scirpoli M, Battaglia M, Magnani CF, et al. Differentiation of type 1 T regulatory cells (Tr1) by tolerogenic DC-10 requires the IL-10 – dependent ILT4 / HLA-G pathway. Blood. 2010;116:935–44.
Svajger U, Rozman P. Tolerogenic dendritic cells: molecular and cellular mechanisms in transplantation. J Leukoc Biol. 2014;95:53–69.
Zou T, Caton AJ, Koretzky GA, Kambayashi T. Dendritic cells induce regulatory T cell proliferation through antigen-dependent and -independent interactions. J Immunol. 2010;185:2790–9.
Mahnke K, Johnson TS, Ring S, Enk AH. Tolerogenic dendritic cells and regulatory T cells: a two-way relationship. J Dermatol Sci Elsevier. 2016;46:159–67.
Onishi Y, Fehervari Z, Yamaguchi T, Sakaguchi S. Foxp3+ natural regulatory T cells preferentially form aggregates on dendritic cells in vitro and actively inhibit their maturation. Proc Natl Acad Sci U S A. 2008;105:10113–8.
Hsu SM, Mathew R, Taylor AW, Stein-Streilein J. Ex-vivo tolerogenic F4/80+ antigen-presenting cells (APC) induce efferent CD8+ regulatory T cell-dependent suppression of experimental autoimmune uveitis. Clin Exp Immunol. 2014;176:37–48.
Qian L, Qian C, Chen Y, Bai Y, Bao Y, Lu L, et al. Regulatory dendritic cells program B cells to differentiate into CD19hi FcgIIb hi regulatory B cells through IFN-b and CD40L. Blood. 2012;120:581–91.
Yang H, Cheng EY, Sharma VK, Lagman M, Chang C, Song P, et al. Dendritic cells with TGF-b1 and IL-2 differentiate naïve CD4+ T cells into alloantigen specific and allograft protective FoxP3 regulatory T cells. Transplantation. 2012;93:580–8.
Beres AJ, Drobyski WR. The role of regulatory T cells in the biology of graft versus host disease. Front Immunol. 2013;4:163.
Gagliani N, Magnani CF, Huber S, Gianolini ME, Pala M, Licona-Limon P, et al. Coexpression of CD49b and LAG-3 identifies human and mouse T regulatory type 1 cells. Nat Med. 2013;19:739–46.
Vicente R, Quentin J, Mausset-Bonnefont AL, Chuchana P, Martire D, Cren M, et al. Nonclassical CD4+CD49b+ regulatory T cells as a better alternative to conventional CD4+CD25+ T cells to dampen arthritis severity. J Immunol. 2016;196:298–309.
Gagliani N, Jofra T, Valle A, Stabilini A, Morsiani C, Gregori S, et al. Transplant tolerance to pancreatic islets is initiated in the graft and sustained in the spleen. Am J Transplant. 2013;13:1963–75.
Dhodapkar MV, Steinman RM. Antigen-bearing immature dendritic cells induce peptide-specific CD8+ regulatory T cells in vivo in humans. Blood. 2002;100:174–7.
Ezzelarab MB, Lu L, Guo H, Zahorchak AF, Shufesky WF, Cooper DKC, et al. Eomesoderminlo CTLA4hi alloreactive CD8+ memory T cells are associated with prolonged renal transplant survival induced by regulatory dendritic cell infusion in CTLA4 immunoglobulin-treated nonhuman primates. Transplantation. 2016;100:91–102.
Giannoukakis N, Phillips B, Finegold D, Harnaha J, Trucco M. Phase I (Safety) Study of autologous tolerogenic dendritic cells in Type 1 diabetic patients. Diabetes Care. 2011;34:2026–32. First clinical study using TolDC. This study showed the safety of TolDC in type-1 diabetes patients.
Stoop JN, Harry RA, Von Delwig A, Isaacs JD, Robinson JH, Hilkens CMU. Therapeutic effect of tolerogenic dendritic cells in established collagen-induced arthritis is associated with a reduction in Th17 responses. Arthritis Rheum. 2010;62:3656–65.
Hermansson A, Johansson DK, Ketelhuth DFJ, Andersson J, Zhou X, Hansson GK. Immunotherapy with tolerogenic apolipoprotein B-100-loaded dendritic cells attenuates atherosclerosis in hypercholesterolemic mice. Circulation. 2011;123:1083–91.
Li H, Wang C-C, Zhang M, Li X-L, Zhang P, Yue L-T, et al. Statin-modified dendritic cells regulate humoral immunity in experimental autoimmune myasthenia gravis. Mol. Cell. Neurosci. 2015;68:284–92.
Mukherji B, Chakraborty NG, Yamasaki S, Okino T, Yamase H, Sporn JR, et al. Induction of antigen-specific cytolytic T cells in situ in human melanoma by immunization with synthetic peptide-pulsed autologous antigen presenting cells. Proc Natl Acad Sci U S A. 1995;92:8078–82.
Dhodapkar MV, Steinman RM, Sapp M, Desai H, Fossella C, Krasovsky J, et al. Rapid generation of broad T-cell immunity in humans after a single injection of mature dendritic cells. J Clin Invest. 1999;104:173–80.
Dhodapkar MV, Steinman RM, Krasovsky J, Munz C, Bhardwaj N. Antigen-specific inhibition of effector T cell function in humans after injection of immature dendritic cells. J Exp Med. 2001;193:233–8.
Palmer DH, Midgley RS, Mirza N, Torr EE, Ahmed F, Steele JC, et al. A phase II study of adoptive immunotherapy using dendritic cells pulsed with tumor lysate in patients with hepatocellular carcinoma. Hepatology. 2009;49:124–32.
Gowans EJ, Roberts S, Jones K, Dinatale I, Latour PA, Chua B, et al. A phase i clinical trial of dendritic cell immunotherapy in HCV-infected individuals. J. Hepatol. 2010;53:599–607.
Di Caro V, Phillips B, Engman C, Harnaha J, Trucco M, Giannoukakis N. Involvement of suppressive B-lymphocytes in the mechanism of tolerogenic dendritic cell reversal of type 1 diabetes in NOD mice. PLoS One. 2014;9:e83575.
Benham H, Nel HJ, Law SC, Mehdi AM, Street S, Ramnoruth N, et al. Citrullinated peptide dendritic cell immunotherapy in HLA risk genotype–positive rheumatoid arthritis patients. Sci. Transl. Med. 2015;7:290ra87–290ra87. First clinical trial using TolDC in remitting-relapsing multiple sclerosis. This study showed the safety of TolDC in patients with RR-MS disease. The authors observed biological activity.
Jauregui-Amezaga A, Cabezón R, Ramírez-Morros A, España C, Rimola J, Bru C, et al. Intraperitoneal administration of autologous tolerogenic dendritic cells for refractory Crohn’s disease: a phase I study. J. Crohns. Colitis. 2015;9:1071–8. First clinical trial using TolDC in Crohn’s disease. This study showed the safety of TolDC in patients with refractory Crohn’s disease.
Cabezón R, Ricart E, España C, Panés J, Benitez-Ribas D. Gram-negative enterobacteria induce tolerogenic maturation in dexamethasone conditioned dendritic cells. PLoS One. 2012;7:e52456.
Raïch-Regué D, Grau-López L, Naranjo-Gómez M, Ramo-Tello C, Pujol-Borrell R, Martínez-Cáceres E, et al. Stable antigen-specific T-cell hyporesponsiveness induced by tolerogenic dendritic cells from multiple sclerosis patients. Eur J Immunol. 2012;42:771–82.
Moreau A, Varey E, Bériou G, Hill M, Bouchet-Delbos L, Segovia M, et al. Tolerogenic dendritic cells and negative vaccination in transplantation: from rodents to clinical trials. Front Immunol. 2012;3:218.
Geissler EK, The ONE. Study compares cell therapy products in organ transplantation: introduction to a review series on suppressive monocyte-derived cells. Transplant Res. 2012;1:11.
Acknowledgments
The work performed in the INSERM Unit 1064 and presented in this review was funded by IMBIO-DC, Fondation Progreffe, DHU Oncogreffe, The ONE Study (FP7-260687) and BIODRIM (FP7-305147) European Union 7th Framework Programs. The work of INSERM U1064 was also supported by funds from IHU-CESTI (Investissement d’Avenir ANR-10-IBHU-005, Région Pays de la Loire and Nantes Métropole) and the Labex IGO project (n° ANR-11-LABX-0016-01).
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Maria Cristina Cuturi, Eros Marín and Aurélie Moreau declare no conflicts of interest.
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Marín, E., Cuturi, M.C. & Moreau, A. Potential of Tolerogenic Dendritic Cells in Transplantation. Curr Transpl Rep 3, 227–235 (2016). https://doi.org/10.1007/s40472-016-0109-6
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DOI: https://doi.org/10.1007/s40472-016-0109-6