In this paper we show for the first time that allergen-specific CD4+CD25+ T regulatory cells can suppress multiple pathophysiological features of allergic airway disease in vivo. Transfer of these allergen-specific CD4+CD25+ T regulatory cells reduced AHR, Th2 cell and eosinophil recruitment, and Th2 cytokine secretion. Importantly, we show that this effect is dependent on IL-10 because a neutralizing anti–IL-10R antibody abrogated suppression by CD4+CD25+ regulatory T cells. Moreover these effects were found to be independent of production of IL-10 by the CD4+CD25+ regulatory cells themselves.
Previous studies have determined that CD4
+CD25
+ regulatory T cells are able to regulate autoimmune immunopathologies, which are generally of a Th1 cell type (
7,
15,
16), although a recent study using a
Leishmania major infection model in SCID mice confirmed that both Th1 and Th2 cell function can be suppressed by naturally occurring CD4
+ CD25
+ T regulatory cells (
17). Other studies have implied that CD4
+CD25
+ T cells may be able to suppress some aspects of allergic pathology, but these have all involved complex transgenic models or cell transfer into T cell–deficient recipient mice (
10–
12). We have shown that transfer of CD4
+CD25
+ T regulatory cells into a classical model of systemic allergen sensitization in immunocompetent mice reduces multiple pathophysiological parameters, including both allergen-induced airway inflammation and AHR. These findings support our conclusions from human studies in vitro, which argue that an imbalance between suppression and activation exists in patients with allergic disease (
9).
Transfer of allergen-specific CD4
+CD25
+ T cells into OVA-sensitized mice reduced eosinophilia and AHR, together with Th2 cell numbers and Th2 cytokine production. This implies that there is an effect on either Th2 cell trafficking or in local expansion of allergen-specific Th2 cells. However, the lack of effect on Th2-attracting chemokines such as CCL22, CCL17, and CCL11 suggests that Th2 cell recruitment can still occur. Although we saw decreases in Th2 cytokine secretion after transfer of CD4
+CD25
+ T cells, there was no accompanying reduction in serum IgE production. This might seem surprising because CD4
+ CD25
+ T cells have previously been reported to suppress IgE in a transgenic model of hyper IgE (
18). In addition, patients with immunodysregulation, polyendocrinopathy, enteropathy, X-linked syndrome who lack CD4
+CD25
+ regulatory T cells because of a mutation in Foxp3 exhibit elevated serum IgE levels (
19). However, IL-10 has been shown to actually increase IgE production from B cells that have already switched but inhibits germline class switch (
20). The lack of change in IgE in our model probably reflects the comparably short time course of the model and the timing of CD4
+CD25
+ T cell transfer.
The mechanism of suppression by allergen-specific CD4
+ CD25
+ T regulatory cells is controversial. In vitro, the phenomenon is contact dependent but can be observed in the absence of either IL-10 or TGF-β (
9,
21,
22). In contrast, in vivo experiments in a colitis model suggest that IL-10 and TGF-β are involved in the suppression mediated by these cells (
15). However, the effect may be model dependent because it was not observed in a gastritis model (
23). We show that IL-10 but not TGF-β is up-regulated in the lung after transfer of allergen-specific CD4
+CD25
+ T regulatory cells and that this is observed together with an abrogation of AHR and allergic inflammation. Moreover, we highlight the importance of this IL-10 by showing that neutralizing anti–IL-10R antibody treatment abolished the suppressive effect of the CD4
+CD25
+ regulatory T cells so that AHR, eosinophilia, and Th2 cytokine levels were comparable to those seen in the absence of regulatory cells. IL-10 has previously been reported to be a potential regulatory factor in allergen-induced airway inflammation because transfer of engineered IL-10–producing T cells reduced AHR and inflammation in a murine model (
24). Although this study showed that neutralization of IL-10 in the lung worsened allergic inflammation, we did not find that anti–IL-10R treatment had any effect on OVA-sensitized mice in the absence of transferred CD4
+CD25
+ regulatory T cells. This may be because of differences in the time of IL-10 neutralization. Oh et al. administered anti–IL-10 during both sensitization and challenge phases of allergen-induced airway inflammation, whereas we have blocked during the challenge phase only (
24).
We have shown that the suppression by CD4
+CD25
+ regulatory T cells was not dependent on IL-10 production from allergen-specific T regulatory cells themselves, because the suppressive effect was preserved in CD4
+CD25
+ cells isolated from OVA-transgenic IL-10
−/− mice. Interestingly, Asseman et al. previously reported that IL-10
−/− CD4
+ CD25
+ T cells could inhibit colitis induced by transfer of naive but not antigen-experienced T cells (
25). In our model, suppression was seen after transfer of IL-10
−/− CD4
+ CD25
+ T cells into mice that had been sensitized to OVA and, thus, presumably OVA-experienced Th2 cells were present. The differential dependence on IL-10 may reflect differences in the degree of inflammation and T cell activation in the gut in the colitis model compared with our lung model but is in keeping with data from a gastritis model (
23). IL-10 expression in the airway was still elevated after transfer of IL-10
−/− CD4
+CD25
+ T cells, suggesting that the regulatory T cells may induce IL-10 production in another cell population within the lung. These could be CD4
+CD25
− T cells, which, in humans, have been reported to acquire a regulatory phenotype dependent on IL-10 production after in vitro co-culture with CD4
+CD25
+ T cells (
26). In addition, a recent report also suggests that CD4
+CD25
+ T cells might not be the only source of IL-10 in a model of infectious tolerance with CD4
+CD25
+ T cells during experimental allergic encephalomyelitis (
27). Here, we show for the first time that the percentage of pulmonary CD4
+IL-10–producing cells is increased after transfer of CD4
+CD25
+ regulatory T cells in vivo. Although we cannot exclude the possibility that other cells contribute to IL-10 production, we did not find expression in macrophages, dendritic cells, or granulocytes. Interestingly, we found IL-10 production by CD4
+ cells was similarly increased after transfer of IL-10–deficient CD4
+CD25
+ regulatory T cells. This implies that CD4
+CD25
+ regulatory T cells suppress inflammation via induction of IL-10 from CD4
+ T cells and that production of IL-10 from the regulatory cells themselves is not required. Thus, our data may reconcile the apparent contradiction in previous in vitro and in vivo reports because suppression in vivo may rely on the induction of IL-10 from recipient CD4
+ T cells.
The data presented in this paper suggest that induction of IL-10 in vivo by T regulatory cells may represent a novel treatment for allergic asthma. Indeed, it has been previously demonstrated that nonallergic individuals have a higher percentage of allergen-specific IL-10–producing cells, whereas allergic individuals are characterized by a higher percentage of allergen-specific IL-4–producing cells (
8). Strategies for inducing IL-10 may include expansion of the naturally occurring CD4
+CD25
+ population or enhancement of regulatory T cell function by drugs such as corticosteroids, as shown previously in vitro (
28). Alternatively it may be possible to induce populations of IL-10–producing or TGF-β surface-positive T regulatory cells in vivo, as has been described in several different murine systems using mycobacterial exposure, airway allergen delivery before sensitization and challenge, or in vitro derivation by stimulation in the presence of immunosuppressive drugs (
29,
30,
31,
16). Allergen immunotherapy has been used for many years to control symptoms in a variety of allergic diseases, and current data suggest that this may induce IL-10–producing regulatory T cell populations (
32,
33). Peptide therapy induced IL-10–producing regulatory cells in mice (
34), and recent data suggest that allergen-derived T cell peptides may also reduce features of asthma in humans through induction of IL-10 (
35).
In conclusion, we provide for the first time direct evidence to show that transfer of allergen-specific CD4+ CD25+ T regulatory cells to sensitized mice abrogates the features of allergic airway disease in vivo. These include reduced eosinophil and Th2 cell recruitment, AHR, and Th2 cytokine production. Down-regulation of inflammation was observed with a concomitant increase in pulmonary IL-10 production from CD4+ T cells. Blocking studies showed that the suppressive effect was dependent on IL-10, but, importantly, the effect was not dependent on IL-10 production from the CD4+CD25+ regulatory T cells themselves. Thus, our data suggest that strategies designed to maximize the function of T regulatory cells in vivo could be of benefit to allergic asthmatic patients in the future.