Described almost 30 years ago, IL-2 has long been thought to be a T cell growth factor. It was also labeled a Th cytokine based on in vitro work. These proposals are not far from the truth. In fact, as shown in this study and elsewhere, IL-2 is a T cell growth factor. However, the outcome of that growth depends on which cell is responding. We propose that the main role of Th cell-derived IL-2 in vivo is to support Treg cell homeostasis and function, which leads to the mediation of self-tolerance. However, in the absence of Treg cells, Th cell-derived IL-2 supports immunity.
In this study we show that the mechanism by which IL-2 supports T
reg cells is related to regulation of the expression of CD25 on T
reg cells and the maintenance of Foxp3 expression in the periphery. Because IL-2 up-regulates its own receptor (
47), these results show that IL-2 was constantly being used by T
reg cells. This paracrine action of Th cell-derived IL-2 is related to T
reg survival and the suppressive mechanism, because it appears that other Th cell-derived cytokines are not sufficient to fully compensate for these important functions. However, there is evidence that other common γ-chain (γ
c) cytokines, such as IL-4, are critical for the induction of Foxp3 expression (
20,
45,
48), and that in the absence of γ
c signaling, Foxp3
+ T cells do not exist (
8). Therefore, the nonredundant function of IL-2 may be attributed to the maintenance of Foxp3 expression in the periphery. This paracrine effect of IL-2 signaling may help explain why adoptively transferred WT T
reg cells can prevent autoimmunity in CD25
−/− and IL-2Rβ
−/− mice, which have a source of IL-2, but not in IL-2
−/− mice (
18,
33). These data also explain why CD25
−/− Foxp3
+ T cells cannot survive after transfer into a lymphopenic setting. Our data show a critical link between IL-2 signaling and Foxp3 expression in T
reg cells in the periphery. However, whether IL-2 supports CD25
+Foxp3
+ T cells that come from CD25
− precursors that were Foxp3
−, Foxp3
+, or both is still not clear.
Our findings also suggest that constitutive expression of CD25 on T
reg cells allows competition for IL-2 in vivo to be an important mechanism that T
reg cells use to acquire this growth factor. High expression of CD25 increases the sensitivity of IL-2 binding to the IL-2R ~100-fold compared with the low-affinity receptor (
16). This may confer a survival advantage to T
reg cells when they need to traffic to extralymphoid tissue sites where IL-2 is limiting (
14). This is supported by the fact that ectopic expression of Foxp3 in CD4
+ or CD8
+ T cells and naturally expressing Foxp3
+ T cells always induces the high-affinity IL-2R (
14,
49,
50).
It has been shown in vitro that the mechanism of suppression by T
reg cells requires IL-2 from responding T cells, and that anti-IL-2 or exogenous IL-2 or IL-4 added to cultures can abrogate suppression (
20). This seems paradoxical, but in the case of high doses of IL-2 or IL-4, T
reg cells could suppress IL-2 mRNA in responder T cells, even though T responders could still divide. This emphasizes the importance of signaling through CD25 and IL-4R on T
reg cell function during states of inflammation.
In cases of higher amounts of IL-2, as in exogenous administration to cancer patients (
51) or elimination of cytokine sinks (
46), proliferation of effector T cells can still occur. However, in the long term, this may be the Achilles’ heel of immunotherapy, because T
reg cells may compensate their levels due to the long exposure to IL-2, as we demonstrate in IL-2 transgenic mice and recently demonstrated in patients (
52,
53). This may help explain the fixed 15–20% response rate to high dose IL-2 therapy in patients with cancer (
51).
Therefore, to prevent activation of T
reg cells, we used anti-IL-2, which decreases T
reg cell Foxp3 expression (
8,
10), and replaced exogenous IL-2 with IL-15, a cytokine that does not support T
reg cells (
45), but instead supports CD8
+ T cell immunity (
31). Addition of IL-15 was necessary, because CD8
+ T cells also need IL-2 signaling to cause effective immunity. As a result, this treatment regimen enhanced adoptive immunotherapy more than IL-15 or IL-2 alone. These conditions may have provoked CD8
+ T cells to take on a central memory, rather than an effector memory, phenotype, which we have shown preserves their antitumor efficacy in vivo (
30,
43).
This is an important finding for immunotherapy. We believe that IL-2 consumption by T
reg cells is coupled to their suppressive mechanism in vivo. This feedback loop maintains immunological balance in the immune system, keeping T
reg cells alive and auto-reactive T cells in check (
16). IL-2 signaling, in addition to TCR stimuli to self Ags (
54), probably activates the program of suppression, which may include mechanisms such as reverse signaling through engagement of B7 molecules on effector T cells (
55), competition for cytokines (
56–
58), secretion of immunosuppressive cytokines (
56,
57,
59), or direct killing (
60). T
reg cells may also negatively condition APCs (
61,
62). Regardless, the results presented in this study help explain why T
reg cells constitutively express the high-affinity IL-2Rα and why blocking their access to IL-2 can inhibit their suppressive ability.
With regard to CD25
−/− mice, the lack of full IL-2 signaling on T
reg cells probably explains the disease in these mice. Although CD25
−/− mice had normal levels of Foxp3
+ T cells, these probably represent cells that are either recent thymic emigrants or are being supported by other Th cell-derived γ
c cytokines during a state of active disease. However, it is unclear why CD25
−/− mice still have disease. Although recent evidence suggests that T
reg cells are unable to keep up with cells mediating disease (
8), these mice have normal levels of Foxp3
+ T cells, which, surprisingly, are just as suppressive as WT cells in vitro. So why do CD25
−/− mice develop fatal autoimmune disease? Are CD25
−/− T
reg cells dysfunctional in vivo? We believe that our results show that IL-2 signaling has an important role in suppression in vivo. We show that pmel-1 T cells were able to treat established tumors much better in CD25
−/− hosts than in WT hosts. In fact, 1-wk-cultured pmel-1 cells transferred alone with rFP vaccine into RAG-1
−/− mice or WT mice have never treated established tumors. Because, we were able to achieve treatment in CD25
−/− mice, this shows that CD25
−/− T
reg cells were not as efficient suppressors as WT cells and possibly that Th (CD25
−/−) cells contributed to the treatment effect. Considering that Th (CD25
−/−) cells were able to expand significantly better than Th (IL-2
−/−) cells and could help CD8
+ T cells induce tumor regression probably indicates that Th cells may be able to signal through the IL-2Rβγ in vivo. Therefore, these low-affinity signals may be sufficient to reach a threshold of activation to help CD8
+ T cells, but not enough to activate CD25
−/− Foxp3
+T
reg cells. This is also supported by the fact that T
reg cells could not suppress IL-2
−/− Th cells in vivo as efficiently as Th (WT) cells. Because Th cells do not need high-affinity IL-2R to generate help, but T
reg cells need high-affinity IL-2R to survive and initiate their suppressor program, CD25
−/−Foxp3
+ T
reg cells may be less efficient at suppressing in vivo; this explains why CD25
−/− mice develop autoimmune disease with age. These data are most consistent with a study that showed that Ag-specific CD25
−/− T
reg cells were not as efficient suppressors as WT cells in an in vitro assay (
9). Therefore, the suppression seen with co-transfer of WT CD25
+/+ T
reg cells with CD25
−/− T
h cells may indicate that IL-2 from Th (CD25
−/−) cells was supporting T
reg cell homeostasis and suppressor function. This was confirmed by higher amounts of CD25 and Foxp3 expression by T
reg cells mixed with Th (CD25
−/−) or Th (WT) cells.
Therefore, our data suggest that there may be two types of au-toimmunity that can occur in vivo: IL-2-independent autoimmu-nity, as seen in IL-2
−/− mice, which may be primarily CD4
+ T cell mediated due to the absence of T
reg and CD8
+ T cell function, and IL-2-dependent autoimmunity, which is primarily CD8
+ T cell mediated and requires the absence of T
reg cells. Although recent work shows a kinetic relationship between the requirement for IL-2 to activate T effector and T
reg cells in vivo (
63), this system only studied CD4
+ T cell-mediated disease and did not link IL-2 to CD8
+ T cell immunity. Our results link IL-2 with CD8
+ T cells and identify the source of IL-2 in vivo. Previous data from our group also showed that T
h cells from IL-2
−/− mice administered along with exogenous IL-2 did not support CD8 immunity in tumor-bearing RAG-1
−/− (
12). Therefore, for CD8 immunity, it appears that IL-2 may be important throughout the immune response.
Together, the results show a dual role for Th cell-derived IL-2 in vivo. Treg cells maintained self tolerance by using IL-2 from Th cells through their high-affinity IL-2R. This appeared to be directly linked to Foxp3 expression, which is known to be required for Treg cell function. Therefore, Th cell-derived IL-2 may be enhancing the transcription of Foxp3 in Treg cells, which is directly related to their suppressive characteristics in vivo. This action subsequently leads to the lack of effector T cell expansion, which paradoxically also requires IL-2. Although the precise mechanism of suppression is unclear, our work helps explain the IL-2 paradox: that is, IL-2 is important for both tolerance and immunity in vivo. The use of anti-IL-2 Abs (and/or anti-IL-4 Abs) along with other γc-signaling cytokines, which support CD8+ T cell immunity (IL-15 and IL-21), may offer an advantage over current therapies for advanced cancer and chronic infections. In contrast, IL-2 therapy may be useful for treating many autoimmune diseases.