In the present study, we show that the IL-10 that prevents immunopatholgy and mortality in mice infected with T. gondii derives from conventional Th1 cells that acquire the ability to produce this cytokine as a consequence of the normal immune response to the parasite. Interestingly, the CD4 T lymphocytes that provide this regulatory function can simultaneously serve as effector cells for NO-dependent control of parasite growth and do not appear to represent a distinct lineage or novel CD4 subset. We hypothesize that such Ag-driven IL-10+IFN-γ+ CD4+ T cells play a major role in immune regulation during infection with intracellular pathogens by governing the extent of APC activation and are thus functionally distinct from Foxp3+CD25+ T reg cells, as well as other previously described CD4+ T reg cell populations.
Previous reports have indicated that
T. gondii–infected IL-10 KO mice display markedly enhanced APC function, as indicated by increased proinflammatory cytokine production, which is likely to underlie their augmented Th1 response and, ultimately, their acute mortality (
22,
26,
27,
30). We show in this paper that these sequelae can be recapitulated in WT animals by blockade of IL-10R signaling, thus emphasizing the direct role of IL-10 in the prevention of parasite-induced pathology. Moreover, we demonstrate that this IL-10–mediated protection is critical in both acute and chronic phases of
T. gondii infection despite the presence of other down-regulatory mechanisms (
33–
35).
The results presented in this paper support the previous observations of Roers et al. (
28) that CD4
+ T lymphocytes are the major source of host-protective IL-10 in
T. gondii infection and, furthermore, establish that IL-12p40 production is dramatically up-regulated in the absence of these cells. The latter observation was somewhat unexpected given the well-established paradigm that CD4-dependent CD40/CD40L co-stimulation of APCs (
36,
37) augments rather than suppresses IL-12 production. However, in most of the situations in which this positive interaction was observed, the CD4
+ T cells involved were not secreting IL-10. Thus, our findings suggest that, in the appropriate setting, IL-10 production by CD4
+ T cells can override the enhancing effect of co-stimulation on IL-12 synthesis.
Systemic
T. gondii infection typically induces a highly polarized Th1 cell environment in which it is difficult to detect CD4
+ lymphocytes with an IL-4–producing Th2 cell phenotype (
29,
32). Instead, all of the CD4-derived IL-10 measured in our experiments was associated with IFN-γ–producing cells. CD25
+ T reg cells have been described to secrete both IL-10 and IFN-γ (
38,
12). Nevertheless, the
T. gondii–induced IL-10–producing CD4 cells studied were found to be both Foxp3
− and, when characterized in the chronic phase, CD25
−, and therefore are clearly distinct from naturally occurring T reg cells. Moreover, they can be distinguished from the Foxp3
− IL-10–producing CD4
+ T reg cells characterized by Vieira et al. (
14), because the latter population does not produce IFN-γ. The additional possibility that these
T. gondii–induced IL-10
+ CD4 T lymphocytes represent Tr1 cells, an IL-10
+ regulatory CD4
+ subset with a heterogeneous cytokine production profile (
10), is also unlikely, based on their developmental requirements. Thus, although Tr1 cells require IL-10 as well as culture with weakly activated DCs for their differentiation (
39,
40), the IL-10
+ CD4
+ lymphocytes studied in this paper develop even when IL-10R signaling is blocked (not depicted) and under the conditions of strong DC activation associated with
T. gondii infection (
41) and, unlike Tr1 cells, are not anergic to signaling through the T cell receptor (). Instead, our results are most consistent with these cells representing conventional Th1 cells, a hypothesis further supported by their T-bet
+ phenotype and in vitro effector function.
IL-10
+ CD4
+ regulatory cells with a Th1 cell phenotype have been described in other settings. Stock et al. (
42) used heat-killed
Listeria to induce a population of IL-10
+IFN-γ
+ CD4
+ lymphocytes, which upon transfer suppressed Th2 cell–mediated airway hypersensitivity. However, this regulatory population was characterized as Foxp3
+, and its activity in suppressing Th1 responses was not examined. Interestingly, IL-10
+Foxp3
− CD4
+ regulatory cells with a Th1 cell phenotype recently have been demonstrated to be induced during the exposure of mice to a nonhealing strain of
Leishmania major and to play a major role in determining host susceptibility (see Anderson et al. [
43] on p. 283 of this issue). Whether these cells, as well as a similar population described in an
L. donovani infection model (
44), are functionally identical to the
T. gondii–induced cells studied in this paper remains to be determined. In this regard, it should be noted that we identified a similar IL-10
+ CD4
+ population in mice acutely infected with
T. cruzi (Fig. S1), a related protozoan pathogen, and CD4
+ T cells coexpressing IL-10
+IFN-γ
+ have been described in several other infections, including murine
Mycobacterium avium (
32) and
Brucella abortus (
45), as well as in short-term T cell clones derived from patients with
M. tuberculosis (
46) or tuberculin-positive individuals (
15). That such cells have not been more widely recognized and characterized may stem from their unstable IL-10–producing phenotype in vitro.
Perhaps the most unexpected finding of the present study is that the IL-10–producing Th1 lymphocytes arising in
T. gondii infection simultaneously display effector function in addition to their regulatory activity. Thus, these cells are able to stimulate infected macrophages to release NO and mediate intracellular killing of the parasite. The latter observation is consistent with the finding that the IL-10
+ subpopulation of Th1 lymphocytes is the same fraction that in ICS displays the brightest staining for IFN-γ. One interpretation is that this population consists of recently activated cells producing maximal levels of both cytokines but that the amounts of IL-10 secreted are insufficient to counteract the IFN-γ–mediated effector activity induced. Interestingly, preexposure to IFN-γ has recently been shown to reprogram several suppressive functions triggered by IL-10 signaling in macrophages (
47). Thus, an alternative explanation of our findings is that IFN-γ production in IL-10
+ Th1 cells selectively blocks the suppressive activity of IL-10 on parasite killing. Regardless of the mechanism by which Th1 cell–synthesized IL-10 fails to compromise microbicidal responses, our data strongly suggest that the major regulatory function of the cytokine in this situation is to suppress the production of IL-12, and perhaps other proinflammatory cytokines, by APCs. This in turn would act as a brake on IFN-γ synthesis by CD4
+ T cells (
48–
50), thereby preventing the pathological consequences of an uncontrolled Th1 response (Fig. S2, available at
http://www.jem.org/cgi/content/full/jem.20062175/DC1).
A critical question raised by our findings, as well as those from other studies (
15,
32,
45,
46,
51) documenting IL-10 production by Th1 cells, concerns the mechanism regulating the expression of the cytokine in this population. Our previous results (
32), as well as findings from preliminary experiments (not depicted), indicate that the production of this cytokine by
T. gondii–induced Th1 cells does not require IL-12, IL-18, IL-23, STAT4, IL-4, STAT6, or IFN-γ. Although the precise signaling pathway involved remains to be determined, our findings strongly suggest that, under the conditions of pathogen priming, IL-10 synthesis in Th1 lymphocytes represents a step in the differentiation program of these cells in which expression of the cytokine is delayed until complete activation is achieved. In direct contrast to IFN-γ, secretion of IL-10 is transient, and we speculate that this property is the result of its dependence on the state of cellular activation. These conclusions are both consistent with and extend the findings of Shaw et al. (
51), who observed that immediately after challenge infection, IFN-γ–producing CD4
+ T cells from
T. gondii–vaccinated mice transiently acquire the capacity to simultaneously secrete IL-10.
As already noted, the major down-regulatory cytokine IL-10 can be produced by multiple CD4
+ T lymphocyte populations. The immunobiological significance of this redundancy is a topic of great interest. IL-10 production by Th2 cells appears to arm them with the capacity to suppress their own function as well as to cross-regulate Th1 responses (
52,
53,
2,
15). In the case of naturally occurring CD25
+CD4
+ T reg cells, IL-10 synthesis appears to be constitutive and primarily functions to control autoreactivity or, when hijacked by certain pathogens, to promote latent infection (
21). Interestingly, because previous studies have demonstrated an inhibitory effect of TLR signaling on CD25
+CD4
+ T reg cell activity (
54), their functional capacity may be limited during infection with agents such as
T. gondii that express potent TLR agonist activity (
41). The IL-10–producing Th1 lymphocytes studied here have an overlapping but distinct profile of immunoregulatory properties that allows their expansion in the context of strong Ag-specific Th1 cell priming and serve the primary purpose of limiting collateral host damage while maintaining a potent effector response. Their IL-10 synthesis is deliberately unstable to avoid sustained suppression of effector function. We speculate that these regulatory cells are present during a wide variety of different infections but will be particularly prominent in those triggering extensive and highly polarized Th1 responses.