The extent to which Tfh and other CD4
+ T cell subsets represent distinct lineages that express lineage-defining master regulators is subject of intense ongoing research (
Murphy and Stockinger, 2010;
O’Shea and Paul, 2010). The present data demonstrate a previously unappreciated degree of phenotypic overlap between Tfh and Th1 cell and illustrate molecular interplay among “master” transcription factors such that dynamically regulated expression of T-bet and Bcl6 affect STAT4-mediated gene expression and ultimately define cellular phenotype.
Previous work has suggested that a species-specific effect of IL-12 inducing IL-21 and other features of Tfh cells in human but not mouse cells (
Ma et al., 2009;
Mehta et al., 2005;
Schmitt et al., 2009;
Suto et al., 2008). However, recent work has shown that murine Th1 cells can express IL-21 (
Eto et al., 2011) and our results also indicate that IL-12 also has the capacity to induce Bcl6 and Tfh cell surface markers. With this regard, temporal considerations, rather than species difference, may provide an explanation for the apparent discrepancy. In previous studies cytokine production was measured in cells polarized for 5–7 days, times at which the Tfh cell-like phenotype of Th1 cells has begun to wane. In addition, we used greater IL-12 concentrations than others; however, we do not believe that our results are due to artificially high amounts of IL-12. Our results were confirmed
in vivo in a model associated with vigorous IL-12 production and intense Th1 cell responses induced by T.
gondii.
The present study also provides the evidence to explain why others have found STAT3 not to be essential for Tfh cell differentiation (
Eddahri et al., 2009;
Schmitt et al., 2009). IL-12 acting via STAT4 can be an early inducer of Tfh phenotype. Consistent with redundant functions of STAT3 and STAT4 is recent work which demonstrates that neither IL-6 nor IL-21 are required for induction of Bcl6
+ Tfh cells
in vivo and
in vitro (
Eto et al., 2011;
Poholek et al., 2010). STAT4 appears to provide an alternative mechanism, as our data argue that STAT3 and STAT4 redundantly serve to induce IL-21, Bcl6 and other Tfh cell molecules; both STAT4 and STAT3 directly bind these genes and promote gene expression (
Durant et al., 2010;
Schmitt et al., 2009;
Wei et al., 2007;
Wei et al., 2010). What differs between STAT3 and STAT4 is the capacity to efficiently induce
Tbx21 gene. It is notable in this regard, that IFN-γ acting via STAT1 is also a potent inducer of T-bet (
Lighvani et al., 2001). However, unlike IL-12-STAT4, IFN-γ-STAT1 inhibits Bcl6 expression.
While Tfh cells are a functionally critical subset of helper T cells, it remains an open question whether Tfh cells are truly a distinct lineage parallel to other subsets or rather represent a temporary “state” of differentiation. As described in this manuscript, during the course of Th1 cell differentiation, we noted the appearance of IL-12-induced IL-21+ IFN-γ+ Bcl6+ T-bet + Tfh-Th1-like cells, which were followed by the generation of fully differentiated IL-21− IFN-γ+ Bcl6− T-bet+ Th1 cells. Our ChIP-seq findings do indicate that T-bet directly binds to Bcl6 locus and multiple other Tfh-related genes. The present data confirm that both STAT4 and T-bet are indispensable positive regulators for full induction of IFN-γ. Although STAT4 can promote Tfh cell-like features, induction of T-bet inhibits Tfh cell genes and tips the balance towards a more Th1 dominant phenotype. Our data indicate that early on following IL-12 stimulation, cells are uncommitted and complete differentiation reflects the counter-regulatory effects of STAT4 and T-bet.
Previous work has shown that Bcl6 functions as a transcriptional repressor for T-bet (
Nurieva et al., 2009;
Yu et al., 2009); however, it also appears that T-bet can limit expression of Bcl6. Our results indicate that expression of T-bet and Bcl6 antagonized each other’s function, as did IFN-γ and IL-21. The action of T-bet to suppress the generation of Tfh cells and humoral responses were confirmed
in vivo dominant Th1 response by
T. gondii. Thus, T-bet-mediated down-regulation of Bcl6 is required to become “
bona fide” Th1 cells. Recent work also shows that Bcl6 and T-bet cooperate and can reduce IFN-γ production during Th1 differentiation (
Oestreich et al., 2011). Our data indicate that T-bet does not counter-regulate IL-21 or Bcl6 during initial phase of Th1 cell differentiation; presumably there are threshold levels of T-bet and Bcl6 expression that needs to be reached, which subsequently dictate the outcome of repression of Tfh or Th1 cell phenotypes. Interestingly, there seems to be a biphasic effect of IFN-γ: early on it promotes IL-21 but later it inhibits. This finding may also be a contributor to the seemingly contradictory effects of Bcl6 and T-bet.
While Bcl6 has been argued to be the “master regulator” transcription factor for Tfh (
King et al., 2008;
Nurieva et al., 2009), our data put this factor in a somewhat different light. We noted that the
Bcl6 locus is accessible in naïve CD4
+ T cells, a finding that is consistent with our data and the data of others indicating that Bcl6 is readily inducible by TCR stimulation alone and further induced by STAT4 or STAT3 (
Durant et al., 2010;
Lund et al., 2005;
Ma et al., 2009;
Nurieva et al., 2009;
Schmitt et al., 2009). Equally interesting is the fact that the
Bcl6 locus is not repressed in fully polarized Th1 cells. The accessibility, assessed by H3K4me3 modifications of the
Bcl6 locus, implies that this factor can be induced in other lineages (Lu et al., 2011). Collectively these results argue that it may not be appropriate to view Bcl6 simply master regulator of Tfh cell.
During the course of LCMV infection, it was noted that Tfh cells maintained expression of IFN-γ and T-bet; however, the levels were low compared to typical Th1 cells (
Johnston et al., 2009). Other work showed that in chronic LCMV infection the induced Th1 cells “converted” to become Tfh cells later during the immune response (
Fahey et al., 2011). These data, along with ours, suggest a model in which signals associated with chronic antigenic exposure can sustain Bcl6 expression, which over-rides the inhibitory function of T-bet. Over time, limitation of T-bet expression favors transition of nascent Th1 cells to become Tfh cells. Conversely, signals that drive expression of T-bet and limit Bcl-6 expression favor “terminal differentiation” of Th1 cells to become effector cells and limit Tfh cell functionalities. Importantly, T-bet is not the only factor that regulates Bcl6 expression. Previous work has demonstrated that Bcl6 expression is not sustained in effector CD4
+ T cells and that Bcl6 and Blimp-1 antagonize each other’s function (
Johnston et al., 2009). Additionally, ICOS-dependent signals are also important for induction of Bcl6 (
Choi et al., 2011). Thus, it is clear that many factors contribute to regulation of Bcl6 expression and Bcl6, in turn, regulates other T cell transcription factors. Rather than invoking models of master regulators in terminally differentiated cells, it may be more accurate to think of Bcl6, T-bet, Blimp-1 and other factors as extrinsically regulated players that dynamically regulate T cell function.
The finding that IL-12 can generate uncommitted Tfh-Th1 cells may have significance to human disease. For instance, in inflammatory bowel diseases, apparently uncommitted, IL-21
+ IFN-γ
+ cells have been found in the gut and have been suggested to be important for intestinal tissue damage (
Monteleone et al., 2005;
Sarra et al., 2010). These finding are also of interest given the genetic link between polymorphisms of the
Il21, Il2,
Stat4 genes and susceptibility to human autoimmune disease (
Daha et al., 2009;
Remmers et al., 2007). It is possible that alterations to the function of STAT4 might not only affect IFN-γ regulation, but could also influence Tfh cell genes.
Taken together, our findings indicate that the diverse actions of STAT4 and T-bet underlie phenotypic heterogeneity between Tfh and Th1 cells. These findings help to clarify seemingly contradictory findings and argue for a coherent stepwise process of Tfh-Th1 differentiation. Acting through STAT4, IL-12 induces a transitional stage of Tfh-Th1 cells, which express IL-21 and Bcl6. However, STAT4 also promotes T-bet expression, which along with IFN-γ, ultimately limits the Tfh phenotype. It is by no means inconceivable that other subsets also share transitional stages with Tfh cells. Future studies are needed to dissect these intriguing degrees of heterogeneity for Tfh cell differentiation that should offer opportunities for the treatment of autoimmune diseases.