Treatment with GITR agonistic antibody corrects adaptive immune dysfunction in sepsis

Blood. 2007 Nov 15;110(10):3673-81. doi: 10.1182/blood-2007-04-087171. Epub 2007 Aug 9.

Abstract

Apoptosis of CD4(+) T cells and T(H)2 polarization are hallmarks of sepsis-induced immunoparalysis. In this study, we characterized sepsis-induced adaptive immune dysfunction and examined whether improving T-cell effector function can improve outcome to sepsis. We found that septic mice produced less antigen-specific T-cell-dependent IgM and IgG(2a) antibodies than sham-treated mice. As early as 24 hours after sepsis, CD4(+) T cells proliferated poorly to T-cell receptor stimulation, despite normal responses to phorbol myristate acetate and ionomycin, and possessed decreased levels of CD3zeta. Five days following immunization, CD4(+) T cells from septic mice displayed decreased antigen-specific proliferation and production of IL-2 and IFN-gamma but showed no difference in IL-4, IL-5, or IL-10 production. Treatment of mice with anti-GITR agonistic antibody restored CD4(+) T-cell proliferation, increased T(H)1 and T(H)2 cytokine production, partially prevented CD3zeta down-regulation, decreased bacteremia, and increased sepsis survival. Depletion of CD4(+) T cells but not CD25(+) regulatory T cells eliminated the survival benefit of anti-GITR treatment. These results indicate that CD4(+) T-cell dysfunction is a key component of sepsis and that improving T-cell effector function may be protective against sepsis-associated immunoparalysis.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antibodies / therapeutic use*
  • CD3 Complex / metabolism
  • Cell Proliferation
  • Cells, Cultured
  • Female
  • Glucocorticoid-Induced TNFR-Related Protein
  • Immune System Diseases / drug therapy*
  • Immune System Diseases / etiology
  • Immunity, Active / drug effects*
  • Immunotherapy
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C57BL
  • Mice, Transgenic
  • Receptors, Nerve Growth Factor / agonists*
  • Receptors, Nerve Growth Factor / immunology*
  • Receptors, Tumor Necrosis Factor / agonists*
  • Receptors, Tumor Necrosis Factor / immunology*
  • Sepsis / complications
  • Sepsis / drug therapy*
  • Sepsis / mortality
  • Survival Analysis
  • T-Lymphocytes / cytology
  • T-Lymphocytes / physiology

Substances

  • Antibodies
  • CD3 Complex
  • Glucocorticoid-Induced TNFR-Related Protein
  • Receptors, Nerve Growth Factor
  • Receptors, Tumor Necrosis Factor
  • Tnfrsf18 protein, mouse