In this study, we examined the effector CD8+ T cell response to influenza virus infection in the respiratory tract and the factors ultimately regulating it. This analysis focused on the kinetics of CD8+ T cell accumulation, the localization of effector CD8+ T cells within the infected lungs, and the localization of CD8+ T cell effector activity within the pulmonary interstitium and airspaces. We observed that proinflammatory cytokine production (e.g., IFN-γ production) by effector CD8+ T cells was detected at maximum levels during the early phase of effector CD8+ T cell recruitment into the infected lungs (i.e., 6–7 dpi). Effector cytokine release decreased with virus clearance. Quantitation of effector CD8+ T cells in the lung interstitium and in the airspaces (identified in collected BAL fluid) indicated that influenza-specific CD8+ T cell numbers in the interstitium far exceeded numbers in the airspaces, implicating interstitial effector CD8+ T cells as the major source of the proinflammatory cytokines liberated into the infected lungs. This concept received additional support from analysis of intracellular cytokine synthesis using the in vivo ICCS assay where, again, interstitial T cells were demonstrated to be the predominant, if not exclusive, proinflammatory cytokine producers. Using BM chimeras, we established that production of the proinflammatory cytokine IFN-γ by the effector CD8+ T cells was dependent on recognition of CD45+ BM-derived cells and did not require MHC class I recognition of the infected respiratory epithelium. Furthermore, depletion of CD11chi cells from the infected lung at the time of effector CD8+ T cell migration into the infected lung markedly decreased proinflammatory cytokine production by effector CD8+ T cells. In addition, the release of proinflammatory cytokines by effector CD8+ T cells was inhibited after blockade of the co-stimulatory ligands CD80 and CD86. Finally, we provide several lines of evidence that suggest that infected respiratory epithelium can be recognized and destroyed by effector CD8+ T cells but that this interaction does not lead to proinflammatory cytokine production by the effector CD8+ T cells.
A hallmark of the host response to influenza virus is the potent proinflammatory cytokine/chemokine response and the attendant inflammation in the respiratory tract elicited by infection. Effector molecules contributed by both innate and adaptive immune cells can contribute to this proinflammatory cytokine response. Although this proinflammatory response in the respiratory tract to influenza infection may aid recovery (
Wiley et al., 2001), there is considerable evidence to suggest that this response may also be a major contributor to the pulmonary injury associated with influenza infection (
Peper and Van Campen, 1995;
Hussell et al., 2001;
La Gruta et al., 2007;
Sun et al., 2009) and may not be essential for virus clearance from the respiratory tract (
Lukacher et al., 1984;
Graham et al., 1993;
Hussell et al., 2001). We found that proinflammatory cytokine production by the influenza-specific effector CD8
+ T cells was dependent solely on the recognition of CD45
+ (BM derived) cells infiltrating the infected lungs (). Several lines of evidence, most notably the in vivo ICCS assay, suggested that this interaction between the effector CD8
+ T cells and the APCs leading to cytokine production was occurring predominantly, if not exclusively, within the pulmonary interstitium (). Cellular ablation analysis suggested that the predominant APCs in the infected lung interstitium express CD11c () and appear in preliminary analyses to be inflammatory mononuclear cells of the DC lineage (not depicted). Of note, the ablation of this cell type in vivo did not affect infectious virus elimination from the infected lungs. Furthermore, although not formally evaluated in this study, we believe that the CD45
+CD11c
hi interstitial APC likely presents processed viral antigen to the effector CD8
+ T cells in vivo both by direct infection (
Hao et al., 2008) and by uptake of viral antigen and presentation via exogenous processing pathways (
Albert et al., 1998).
Respiratory epithelial cells are a critical target of influenza virus as these cells are the major cell type in the lungs that are productively infected by most type A influenza viruses (
La Gruta et al., 2007). Thus, elimination of virus-infected respiratory epithelial cells (along with neutralization of infectious virions) is essential for recovery from infection. Our findings, both in vivo and in vitro, suggest that the encounter between effector CD8
+ T cells and antigen-bearing CD45
− cell types, such as the influenza-infected respiratory epithelium, results in minimal proinflammatory cytokine production; however, early analysis from our laboratory indicated that the interaction of effector CD8
+ T cells with virus influenza-infected cells in the lungs was highly specific (
Lukacher et al., 1984). In reprising and extending an earlier analysis using BM chimeras to evaluate the contribution of cytolytic effector mechanisms in virus clearance (
Topham et al., 1997), we were able to confirm the importance of the perforin and Fas/FasL cytolysis mechanisms in virus clearance and to extend this analysis to formally demonstrate for the first time the dependence on these mechanisms for the elimination of influenza-infected respiratory epithelial cells (). These findings, along with our companion in vitro findings, reinforce the view that the infected respiratory epithelium is indeed recognized by effector CD8
+ T cells, but this interaction selectively triggers only the activation of cytolytic effector machinery. It is noteworthy that the simultaneous elimination of both the perforin- and Fas/FasL-dependent cytolysis machinery serves to delay rather than prevent the elimination of virus-infected cells (). Thus, other cytolysis-dependent mechanisms (i.e., TRAIL–TRAIL-L interactions;
Brincks et al., 2008) likely contribute to the overall cytolytic process used by effector CD8
+ T cells to eliminate virally infected cells.
The requirement for co-stimulation in the activation of naive T cells (both CD4
+ and CD8
+ T cells) and in the differentiation of activated T cells into various types of effector cells has been well established from many model systems (
Locksley et al., 2001;
Sharpe and Freeman, 2002), including studies on the role of the co-stimulatory ligands in the induction of influenza-specific CD8
+ T cell responses (
Bertram et al., 2002;
Humphreys et al., 2003;
Vidric et al., 2005). In this study, we examined the impact of blockade of CD80 and CD86 on proinflammatory cytokine production by effector CD8
+ T cells in the infected lungs, that is, after the influenza-specific CD8
+ T cells had undergone activation, proliferation, and differentiation in the draining LNs (
Lawrence and Braciale, 2004) and subsequently begun their migration to the site of infection (i.e., the infected lungs). We found that in vivo blockade of CD80 and CD86 resulted in markedly diminished proinflammatory cytokine production (i.e., IFN-γ) 24 h after co-stimulatory ligand blockade, both in BAL fluid IFN-γ and via the in vivo ICCS assay (). Importantly, this inhibition of co-stimulation of effector T cells had no effect on infectious virus titer in the infected lungs. Because the interstitial CD45
+ cells (including CD11c
hi inflammatory mononuclear cells) express high levels of CD80 and CD86, whereas respiratory epithelial cells do not (), our results suggest that inhibition of co-stimulation through co-stimulatory ligand blockade acts to suppress proinflammatory cytokine production with minimal effect on the elimination of virus-infected respiratory epithelium. More importantly, our results as well as the findings of
Humphreys et al. (2003) altering the host response to influenza infection by inhibiting OX-40–OX40-L interactions raised the possibility that we may be able to suppress excess proinflammatory cytokine responses and associated pulmonary injury without affecting virus clearance.
Our observation that CD45
− cells, including respiratory epithelial cells, could trigger CD8
+ T cell–mediated cytolysis but not proinflammatory cytokine production was initially unexpected but, in retrospect, not surprising. Studies over the past one to two decades have amply demonstrated a hierarchy of responses of T cells to antigen receptor engagement and co-stimulation based on strength of stimulus, with cell-mediated cytotoxicity representing one of the easiest effector responses to elicit, whereas responses like antigen-dependent T cell cytokine production require a stronger stimulus (
Valitutti et al., 1996;
Hemmer et al., 1998). Accordingly, influenza-infected CD45
− respiratory epithelial cells, which express the requisite viral peptide–MHC complexes but do not express the relevant co-stimulatory ligands, would only stimulate the activation of perforin/FasL cytolytic machinery after TCR engagement on effector CD8
+ T cells. Of note, because respiratory epithelial cells are reported to express molecules that can negatively regulate host immune/inflammatory responses (
Stanciu et al., 2006;
Mayer et al., 2008), we cannot exclude the possibility that, in vivo at least, negative signals delivered by infected respiratory epithelium can also act to limit the range of effector activities available to the CD8
+ T cells entering the airspaces after TCR engagement.
In conclusion, in this study, we demonstrate that effector CD8+ T cell–mediated cytolysis-dependent elimination of virally infected cells (and associated virus clearance) and proinflammatory cytokine production by the T cells are differentially regulated in vivo. Cytolytic machinery can be activated by both antigen-bearing CD45+ and CD45− APCs (target cells). In contrast, in the influenza-infected lungs, only CD45+ (predominately CD11chi inflammatory mononuclear) APCs (target cells) can trigger proinflammatory cytokine production by effector CD8+ T cells. T cell–mediated proinflammatory cytokine production is, in part at least, dependent on co-stimulatory interactions mediated by CD80 and CD86. Blockade of CD80 and CD86 has no effect on virus elimination. These findings open up the possibility of therapeutic intervention in severe influenza infection by selectively inhibiting within the infected respiratory tract signaling events between effector T cells and APCs/target cells (i.e., CD45+ inflammatory mononuclear cells), which induce excess proinflammatory cytokine/chemokine responses without affecting T cell/target cell encounters resulting in virus elimination.