We have investigated the RSV G protein-specific memory CD4
+ T cell response in the lungs of G-primed wild-type BALB/c mice following intranasal challenge RSV infection using expression of the TCR Vβ14 gene product as a marker of the G-specific memory CD4
+ T cell population (
6,
7). We found that RSV G-specific memory CD4
+ T cells rapidly accumulate in the lungs between days 3–5 p.i. in G-primed mice, with the most marked expansion in number among the dominant set of Vβ14-expressing G-specific effector CD4
+ T cells. The accumulation of G-specific memory CD4
+ T cells in the lung cannot be readily accounted for by the prior proliferation of memory T cell precursors and their maturation into effector CD4
+ T cells in lymphoid organs, such as the DLN and spleen, before migration to the lungs. However, memory CD4
+ T cell trafficking through and activation within lymph nodes draining the respiratory tract is apparently required, because FTY720-mediated blockade of CD4
+ T cell egress from lymph nodes before infection prevented subsequent effector cell accumulation in the lungs. Memory T cell activation and rapid migration from the DLN to the lungs is followed by a burst of proliferation by this responding T cell population, as demonstrated by an analysis of the DNA content of lung-infiltrating cells. A very high frequency (~50%) of G-specific CD4
+Vβ14
+ T cells in the lung are in S/G
2/M phases of the cell cycle during the rapid accumulation of cells in the lung between days 3 and 5 p.i. The proliferative expansion of these T cells in the lungs is also associated with the acquisition of effector activity (anti-viral cytokine production) by the CD4
+Vβ14
+ T cell pool infiltrating the lungs, suggesting that differentiation and cell division are concurrent for this population. Taken together, these data suggest (but do not formally prove) a model in which the recall response to viral infection at a mucosal surface (such as the lungs) is primarily mediated by quiescent, recirculating memory CD4
+ T cells that must first traffic through the DLN to respond to infection. These cells encounter Ag in the DLN, activate, rapidly egress from the nodes (before the onset of cell division), and migrate to the mucosal surface where the cells proliferate extensively and differentiate into mature effector cells at the major site of Ag deposition, in this instance, the respiratory tract.
This model implies an intrinsic difference in the responses of memory and naive T cells activated by antigenic stimulation in peripheral lymph nodes. The primary CD4
+ T cell response to viral respiratory infection has been well-documented and is characterized by the retention of Ag-specific T cells in DLN, during which multiple rounds of division occur over the first several days following Ag encounter and initial activation, followed by the migration of responding cells to the site of infection, (the lungs), beginning as late as day 6 p.i. In addition, these newly activated primary CD4
+ T cells acquire the capacity to secrete cytokines during proliferation and differentiation within the DLN (
9). In contrast, our data suggest that memory CD4
+ T cells may only need to be retained in the DLN for a limited time (possibly much <24 h) to allow their activation and subsequent rapid egress from the nodes to the lungs without extensive proliferation in the nodes. A potential explanation for this observation has been suggested by Smith and colleagues, who propose that optimal clonal expansion and terminal differentiation of activated naive CD4
+ T cells requires interaction with B cells in lymph node follicles, whereas memory CD4
+ T cells may be capable of bypassing this requirement (
19). These findings are in keeping with the extensive evidence that, when compared with naive T cells, memory T cells have a lower activation threshold, a lesser dependence on costimulation, a more rapid expression of effector activity, and altered responsiveness to certain cytokines (
20–
22). Furthermore, naive and memory T cells differ in the expression of cell surface adhesion molecules and chemokine receptors (
23), which likely play an important role in regulating the transit time and localization of T cells (naive and memory) in the nodes. Our results suggest that, upon encounter with Ag and activation in the DLN, memory T cells have a markedly reduced retention time in the nodes compared with naive T cells, resulting in their rapid migration to the site of infection where T cell proliferation ensues. However, we cannot formally exclude the possibility that different (distinct) subsets of memory CD4
+ T cells selectively respond preferentially in the DLN and the lung respectively.
Although not formally analyzed in this report, our results suggest that the memory G-specific CD4
+ T cells mediating this recall response in the RSV-infected lungs most likely represent central memory CD4
+ T cells, as this memory T cell subset transits through secondary lymphoid organs and has the capacity for extensive proliferation after Ag contact, while the effector memory CD4
+ T cell subset can localize to peripheral tissues sites and rapidly produce cytokines in response to Ag (
22–
24). Using FTY720, a sphingosine-1-phosphate receptor agonist, we determined that the majority of the recall effector CD4
+ T cell response to RSV in the lungs of G-primed mice is contributed by a G-specific memory CD4
+ T cell component that requires activation in DLN to mediate the recall response (). In support of this interpretation, recent reports have demonstrated that the response of effector memory T cells is relatively short lived and subject to rapid turnover in vivo (
24–
26), with some even suggesting that effector memory cells may be derived from central memory precursors (
27). These studies and others (
28), taken in combination with our results, suggest that any G-specific memory T cell with the phenotype characteristic of effector memory T cells generated by vaccination is either short lived or represents a terminally differentiated pool of tissue-resident and/or circulating memory cells. If present, these cells may rapidly respond early in challenge infection (i.e., day 1–2), but they appear not to contribute substantially to the dominant effector T cell response producing enhanced injury in G-primed mice.
In addition, the FTY720 experiments further confirm the kinetic data within this study () suggesting that G-specific memory CD4
+ T cells present in the spleen do not contribute significantly to the subsequent recall response in the lungs. Because FTY720 strongly inhibits the egress of cells from the thymus, the peripheral and mesenteric lymph nodes, and Peyer’s patches, but inhibits less effectively those from the spleen or bone marrow (
29,
30), any responding T cells of splenic origin would not be blocked by treatment with the drug either before or during RSV infection. As demonstrates, there is inhibition of effector cell accumulation in the lungs of G-primed mice with FTY720 administration up to 24 h p.i. Although the effect of FTY720 administered on the recall CD4
+ T cell response in the lungs is not due to selective drug toxicity for CD4
+ T cells or an effect of the drug on viral Ag presentation in vivo, FTY720 administration has been reported to enhance regulatory T cell activation (
31). Although we do not detect elevated numbers of CD4
+CD25
+FoxP3
+ T cells in the DLN (or lungs) of FTY720-treated infected animals and only detect an effect of FTY720 when administered within the first 24 h of RSV infection, we cannot formally exclude the induction of a novel suppressor cell as the explanation for our findings. We did find that the effectiveness of FTY720 in inhibiting memory CD4
+ T cell responses to challenge RSV infection increased as the interval between primary immunization and challenge infection increased. We found that an interval of 2–3 mo between immunization and challenge was optimal in our system. However the optimal time for drug administration would be likely to vary significantly depending on the type and route of vaccination and the agent used for a challenge infection and would likely need to be optimized for specific experimental conditions.
We have also examined the memory CD8
+ T cell response to challenge RSV infection. (Ref.
32 and W. W, Stevens and T. J. Braciale, unpublished observations). Although the tempo of memory CD8
+ T cell accumulation in the infected lungs following RSV challenge (
32) directly parallels the tempo of the memory CD4
+ T cell response (), our preliminary analysis, using MHC class I tetramer staining, of memory CD8
+ T cells activating in the DLN suggests that there is an initial burst of CD8
+ T cell proliferation in the DLN (first evident at day 2 p.i.) associated with the detection of a small percentage (~10%) of activated RSV-specific CD8
+ T cells in the lungs (also at day 2 p.i.). In the case of the memory response, CD8
+ T cell proliferation in the lungs reaches maximum (by DNA content analysis) at day 3 p.i., whereas lung CD4
+ T cell proliferation reaches maximum at day 4 p.i. Importantly, again as with the CD4
+ T cell response, we detect no Ag-specific activated/proliferating memory CD8
+ T cells in the spleen (or nondraining lymph nodes) of immune mice undergoing challenge infection before T cell accumulation and expansion in the lungs.
Our studies using FTY720 to inhibit CD4
+ T cell egress from DLN implied that the time frame in which CD4
+ T cells enter the DLN, activate, and then egress from these nodes must be brief (likely occurring over a 24 h period between 24 and 48 h p.i). This is in contrast to the prolonged retention time reported for naive CD4
+ T cells responding in the DLN to respiratory virus infection in the mouse (
9). This narrow window in which FTY720 inhibition occurs likely reflects, first, the time required for virus infection and replication in the respiratory tract to induce APC activation and the subsequent migration of Ag-bearing APC from the respiratory tract to the DLN during the first 24 h p.i. (
33), followed then by the encounter of recirculating (and node-resident) memory CD4
+ T cells with viral Ag in the DLN, and their subsequent activation and egress from the DLN in the ensuing 24 h.
It is of interest that we were unable to detect the accumulation of an expanded population of memory RSV G-specific Vβ14+CD4+ T cells in the DLN of FTY720-treated immune mice undergoing challenge infection. This result could be readily explained if the pool of circulating memory RSV G-specific CD4+ T cells is distributed throughout the blood and secondary lymphoid organs. If FTY720 administration is conducted immediately before challenge RSV infection, the memory T cells would be “trapped” (equally distributed and retained in) the secondary lymphoid organs. As a result, only a small fraction of the memory T cells would be localized to DLN at the time of challenge infection, and the proliferative expansion of the memory T cells in the DLN in response to infection would therefore be limited. This finding could also imply that activated memory CD4+ T cells, which fail to egress from the DLN, undergo accelerated apoptosis in the nodes. Although we are not able to detect preferential or increased apoptosis of the CD4+Vβ14+ T cells in the DLN of infected FTY720-treated recipients (E. L. Wissinger, unpublished observations), we cannot exclude this explanation for our results. To further address the fate of activated memory CD4+ T cells “trapped” in the DLN of FTY720-treated animals, it will be necessary to develop reagents (e.g., RSV-specific MHC class II multimers) capable of identifying and quantifying the potentially small number of activated (and possibly apoptotic) memory CD4+ T cells retained in the DLN of treated animals.
Another potential implication of our findings relates to the potential contribution of recirculating memory CD4
+ T cells to the recall CD4
+ T cell response to Ag exposure at sites other than the respiratory tract, such as contact sensitivity and other forms of peripheral DTH responses. These responses are generally considered to be mediated by tissue-resident effector/effector-memory T cells elicited by Ag contact at the peripheral site (i.e., the skin). Ag-specific responding memory CD4
+ T cells are, in classic contact sensitivity, typically first detected at the site of Ag exposure 24 h after the elicitation of the response by Ag in the skin (
34), with proliferative expansion of responding CD4
+ T cells potentially occurring at this site. Our findings suggest an alternative explanation for the classic DTH response, i.e., that this rapid recall response is largely mediated by memory T cells that encounter Ag in the DLN within hours of Ag exposure, activate, and rapidly migrate from the nodes to the peripheral site over the subsequent 24–48 h. Accordingly, the contribution of long-lived circulating memory CD4
+ T cells to the recall response (in the respiratory tract or other peripheral sites) will be particularly prominent if the time between initial Ag contact (sensitization) and the elicitation of the recall response is prolonged (i.e., weeks to months), because the frequency of cells of the effector memory subset, both in the tissues and the circulation, markedly decreases over time (
35–
37). Consistent with this concept, we have found that the efficiency of FTY720-mediated inhibition of the memory CD4
+ T cell response to challenge RSV infection in the lungs increases with greater time between RSV G-priming and challenge virus infection (E. L. Wissinger and T. J. Braciale, unpublished observations).
Several studies have suggested that, for both CD4
+ and CD8
+ T cells, a relatively brief encounter with processed peptide/MHC complexes (<24–30 h) is sufficient to both activate these cells and render them competent to undergo multiple rounds of programmed division. In this instance, cell division occurs without continued antigenic stimulation (
38–
40). However, in the case of primary CD4
+ T cells, it has also been reported that continued exposure to Ag further increases the extent of proliferation and promotes the viability of activated CD4
+ T cells (
39). For viruses producing localized infection in the respiratory tract, including RSV, the bulk of the viral Ag (in the form of virions and virus-infected cells) is present in the lungs. Thus, for memory CD4
+ T cells, additional exposure of activated CD4
+ T cells to Ag at the site of infection in the periphery may play a more important role in regulating the magnitude of the effector T cell response than has been observed for the induction of the primary response by naive T cells. If, as we believe, memory CD4
+ T cells may reside in the DLN for a limited time (<24 h), then additional contact with Ag at the site of infection could be an essential step in the development of the effector phase of the memory CD4
+ T cell response in the periphery.
A number of groups have demonstrated a correlation between the number of divisions of activated T cells and the acquisition of effector activity for both CD4
+ and CD8
+ T lymphocytes (
9,
41–
44), and our results are consistent with these earlier findings. In this report, we detected minimal effector activity (IFN-γ-secretion) by the CD4
+Vβ14
+ T cells present in the lungs at day 3 p.i., maximum proliferation (as detected by propidium iodide staining) at day 4 p.i., and finally maximum effector T cell activity (i.e., cytokine production) in the lungs at day 5 p.i. (). This finding, and the absence of significant IFN-γ production by the CD4
+Vβ14
+ T cells in the draining PBLN and spleen over this period, suggests that the proliferation of these RSV G-specific T cells in the infected lungs is linked to the development and acquisition of effector activity by these responding CD4
+ T cells. It remains to be determined whether this division-linked effector T cell differentiation is dependent upon antigenic stimulation in the infected lungs or is preprogrammed by T cell/APC interaction in the DLN.
Several lines of evidence suggest that the effector cytokine responses of memory CD4
+ T cells are programmed during the initial Ag encounter of naive CD4
+ T cells (
45–
49). In experimental RSV infection the effector cytokine response of memory CD4
+ T cells directed to RSV G appears not to be fixed by the priming of naive T cell precursors because, upon challenge RSV infection, the balance between Th1 and Th2 effector cytokine production by the memory CD4
+ T cells can be influenced by other cell types (i.e., memory CD8
+ T cells) (
2,
5,
50) and cytokines (
51,
52) elicited in the lungs during challenge infection. This raises the interesting possibility that the environment of the infected lung may influence the differentiation of the memory CD4
+ T cells entering the lung during their conversion to effector cells. Indeed, such plasticity of memory cell phenotype has been suggested previously, notably by Sallusto and colleagues, who found that polarized Th1 or Th2 human memory CD4
+ T cells restimulated in vitro under the converse polarizing conditions could initiate gene expression with the cytokine profile opposite to the one at priming (
53).
If, as our results suggest, CD4
+ T cells complete their differentiation into effector cells at the primary site of infection, then the differentiating T cells responding to RSV may be susceptible to the immunoregulatory effects of viral gene products expressed at high levels at the site of maximum virus replication (i.e., the lungs) (
32). Such a mechanism may, in part, help explain the lack of durable immunologic memory in the respiratory tract associated with RSV infection and the susceptibility to repeated infections with this virus observed in humans (
54).