This study demonstrates that RUNX transcription factors 1 and 3 play an important role in the generation of FOXP3
+ iT reg cells by TGF-β. TGF-β mediates RUNX induction and FOXP3 is efficiently up-regulated by RUNX1 and RUNX3 in human CD4
+ T cells. There are three putative RUNX binding sites in the proximal
FOXP3 promoter. One binding site was predicted as a binding site for RUNX2. Promoter enzyme immunoassay results showed that binding of RUNX1 and RUNX3 also occurred at this site (as well as at the other two), which were initially identified as RUNX1 binding sites. This finding is not surprising because RUNX proteins bind to promoter or enhancer elements of their target genes via the runt domain, which is conserved between members of the RUNX family. The RUNX protein that actually induces the expression of FOXP3 might therefore be dependent on the availability of the specific RUNX family member at certain stages of T cell development. RUNX proteins are able to increase or inhibit transcriptional activity of their target genes depending on the cell type and the target gene (
Otto et al., 2003). Mutation of only one of the three binding sites had only a little effect on the promoter activity; however, when two binding sites were mutated, the FOXP3 promoter activity dropped to a greater extent. The most striking effect was observed when all three binding sites were mutated. We therefore assume that these binding sites have partially redundant functions, but binding to at least two sites seems to be necessary for full promoter activation.
TGF-β promotes or inhibits the proliferation, differentiation, and survival of a wide array of different cells. It is also produced in activated T cells and it inhibits T cell proliferation (
Kehrl et al., 1986;
Siegel and Massagué, 2003). It was shown that TGF-β is mandatory for the maintenance of peripheral T reg cells and their expression of Foxp3 (
Marie et al., 2005;
Rubtsov and Rudensky, 2007). RUNX transcription factors are targets of the TGF-β superfamily and they are involved in the TGF-β pathway. They interact directly with regulatory SMADs (
Miyazawa et al., 2002;
Ito and Miyazono, 2003). TGF-β can activate RUNX genes at the transcriptional level, and at the posttranscriptional level through activation or stabilization of RUNX proteins (
Jin et al., 2004). It was shown that RUNX2 regulates the expression of TGF-β type I receptor (
Ji et al., 2001), suggesting that other mechanisms for their function could be involved. The fusion proteins RUNX1-EVI1 and RUNX1-ETO block TGF-β inhibition of leukemic cell growth. RUNX3 plays an important role in TGF-β–mediated growth control in epithelial cells, as loss of RUNX3 leads to decreased sensitivity to TGF-β and hyperproliferation of the gastric mucosa (
Blyth et al., 2005). The present study demonstrates that RUNX3 expression is more dominant in circulating human T reg cells and tonsil T reg cells compared with RUNX1. This could be dependent on the stage of the cells and organ from which they were isolated.
We observed that single siRNA interference of either RUNX1 or RUNX3 alone shows a slight decrease in Foxp3
+ T reg cell induction, which could be caused by redundancy of these proteins. For this reason, we decided to use
CbfβF/F CD4-cre mice. Foxp3 induction by TGF-β is reduced in CD4
+ T cells of
CbfbF/F CD4-cre mice compared with
CbfbF/+
CD4-cre mice. Retinoic acid is secreted by a subset of dendritic cells in the gut-associated lymphoid tissue. It inhibits the IL-6–driven induction of Th17 cells and facilitates the differentiation of naive T cells to Foxp3
+ T reg cells (
Mucida et al., 2007). We observed an increased number of Foxp3
+ cells by retinoic acid and TGF-β compared with TGF-β treatment alone in
CbfbF/+
CD4-cre mice and
CbfbF/F CD4-cre mice. In addition, we showed a defective in vivo generation of T reg cells from
Cbfb-deficient CD4
+ T cells in Rag2
−/− mice. These data in mice confirm the human data that RUNX proteins play an important role for TGF-β–dependent FOXP3 induction, as well as in the suppressive capacity of iT reg cells. As an additional support for this concept, the overexpression of RUNX1 induced increased FOXP3 protein expression without any requirement of TGF-β and anti-CD3 and anti-CD28 stimulation in human primary CD4
+ cells. In both human and mouse systems, reduced Foxp3 expression was associated with reduced T reg cell suppressive activity.
In a recent study, the role of Runx–CBFβ was investigated in nT reg cell development in the thymus (
Rudra et al., 2009). It was reported that Foxp3 expression in nT reg cells is unstable in the absence of Runx–CBFβ complexes.
Cbfb-deficient nT reg cells progressively lose Foxp3 upon division, and there is no evidence of increased death of
Cbfb-deficient nT reg cells in that study. The experiments in
Cbfb-deficient
CD4-cre T cells in mice and the knockdown experiments in humans in this study suggest that the induction of Foxp3 expression is a major contributing factor in the in vivo conversion experiment. Here, we observed that there is a twofold increased Foxp3
+ iT reg cell generation in vivo. This is in the same range with previously published studies targeting different mechanisms in Foxp3 induction (
Maynard et al., 2007;
Sun et al., 2007). Whether the diminished capacity of
Cbfb-deficient
CD4-cre T cells in the generation of Foxp3 may be caused by peripheral expansion of
Cbfb-deficient non–T reg cells or survival problems faced by
Cbfb-deficient iT reg cells after Foxp3 induction remains to be elucidated.
The involvement of RUNX proteins in autoimmune diseases has been previously suggested (
Alarcón-Riquelme, 2003). A mutation in the RUNX1 binding site in the promoter of programmed cell death 1 gene (
PDCD-1) has been implicated in systemic lupus erythematosus pathogenesis (
Prokunina et al., 2002). Polymorphisms that alter RUNX1 binding to other genes have also been described in rheumatoid arthritis linkage at 5q31 in Japanese patients (
Tokuhiro et al., 2003) and in a psoriasis linkage at 17q25 (
Prokunina et al., 2002;
Helms et al., 2003).
RUNX3-deficient mice spontaneously develop inflammatory bowel disease and hyperplastic gastritis-like lesions (
Brenner et al., 2004). These disease symptoms resemble those occurring after depletion of Foxp3-expressing T reg cells (
Sakaguchi, 2004). Derepression of Th2 cytokines might also account for some of the observed disease symptoms, as it was shown that T-bet first induces Runx3 in Th1 cells and then partners with Runx3 to direct lineage-specific gene activation. Runx3/Cbfβ are both required for the activation of the
Ifng gene and silencing of the
Il4 gene in Th1 cells (
Djuretic et al., 2007;
Naoe et al., 2007). Runx proteins also play an essential role during T lymphocyte differentiation in the thymus (
Taniuchi et al., 2002). Runx1 regulates the transitions of developing thymocytes from the CD4
− CD8
− double-negative stage to the CD4
+ CD8
+ double-positive stage and from the DP stage to the mature single-positive stage (
Egawa et al., 2007). Runx1 and Runx3 deficiencies caused marked reductions in mature thymocytes and T cells of the CD4
+ helper and CD8
+ cytotoxic T cell lineages. In addition, inactivation of both Runx1 and Runx3 at the double-positive stages resulted in a severe blockage in the development of CD8
+ mature thymocytes. These results indicate that Runx proteins have important roles at multiple stages of T cell development and in the homeostasis of mature T cells, and suggest that they may play a role in nT reg cell development, which remains to be elucidated. Furthermore, it was shown that Runx1 activates
IL-2 and
IFN-γ gene expression in conventional CD4
+ T cells by binding to their respective promoter. RUNX1 interacts physically with Foxp3 protein, and it was demonstrated that this interaction might be responsible for the suppression of IL-2 and IFN-γ production and up-regulation of T reg cell–associated molecules (
Ono et al., 2007).
It has been shown that Foxp3 also influences Th17 differentiation. Specifically, Foxp3 physically interacts with RORγt, and this interaction inhibits RORγt function (
Zhou et al., 2008). This relationship of RORγt and Foxp3 and probably yet unknown mechanisms might be the basis of the observation that the differentiation of Th17 cells and T reg cells is often reciprocal (
Bettelli et al., 2006). Recently, data suggests that Runx1 may also be involved in regulating
Il17 transcription, functioning in complex with RORγt to activate transcription (
Zhang et al., 2008).
The Runx3-deficient mice develop spontaneous Th2-dominated autoimmune colitis and asthma (
Brenner et al., 2004;
Fainaru et al., 2005).
Cbfbf/f Cd4 mice also show a spontaneous Th2 dominated disease, with increased serum IgA, IgG1, and IgE titers and lymphocyte and eosinophil infiltration of the lung (
Naoe et al., 2007). All these phenotypes were previously attributed to a loss of Th2 silencing whereas our findings additionally suggest that loss of T reg function plays a role. We have shown a link between Foxp3 induction in iT reg cells and RUNX1 and RUNX3. RUNX proteins play a central role in pathways regulating cell growth and differentiation, and their interaction with the TGF-β pathway is of particular interest.
Foxp3 protein interacts not only with RUNX proteins but also with several other transcriptional partners, such as NFAT and possibly NF-κB; with histone acetyl transferases, such as TIP60; and histone deacetyl transferase (HDAC) complexes, such as HDAC7 and HDAC9 (
Wu et al., 2006;
Sakaguchi et al., 2008). NFAT forms a complex with AP-1 and NF-κB and regulates the expression of IL-2, IL-4, IFN-γ, and CTLA4 in conventional T cells, which leads to the activation and differentiation to effector T cells (
Dolganov et al., 1996;
Hu et al., 2007). The NFAT–AP-1 complex also binds to the
Foxp3 promoter after TCR triggering and regulates its gene expression positively (
Mantel et al., 2006). It was shown that NFAT and Smad3 cooperate to induce
Foxp3 expression through its enhancer (
Tone et al., 2008), but no TGF-β response element was identified in the
Foxp3 gene or in the surrounding regions. The initial induction of RUNX1 and RUNX3 and the subsequent binding of these transcription factors to the
Foxp3 promoter that we showed here might explain the relatively late induction of
Foxp3 mRNA that peaks 24–48 h after stimulation. The interaction of Foxp3 and NFAT is dependent on their cooperative binding to DNA (
Wu et al., 2006). RUNX1 alone, or together with its interacting partners p300 and CREB-binding protein, may cooperate with the NFAT transcription complex to activate the
IL-2 promoter (
Sakaguchi et al., 2008). Similar to this interaction, NFAT may also cooperate with RUNX1 or RUNX3 to activate Foxp3, but further studies are necessary to elaborate on this concept.
In conclusion, our findings elucidate the role of RUNX proteins in iT reg cell development and function. The induction of the transcription factors RUNX1 and RUNX3 by TGF-β and the subsequent up-regulation of Foxp3 play a role in iT reg cell generation and its suppressive capacity.