Previous work showed that direct engagement of A
2AAR on T cells inhibited proliferation, as well as Th1 and Th2 responses (
9–
11). A
2AAR also contributes to the generation and function of Tregs (
10,
12–
14,
33). However, T cell activation and differentiation do not occur in isolation but require APCs and a cadre of extracellular factors. Moreover, the accumulation of endogenous adenosine at inflammatory sites does not exclusively target A
2AAR; it stimulates other available AR subtypes. To more faithfully model how adenosine impacts CD4
+ T cell differentiation, we studied the effects of a nonselective adenosine mimetic in cocultures with DCs and highly purified naive CD4
+ T cells. In this study, we found that adenosine preferentially promoted de novo differentiation of CD4
+ T cells that express IL-17 and IL-22 and have a transcriptional profile consistent with Th17 cells (i.e., upregulation of genes encoding for IL-23R and the transcription factor RORγt) (
34). Our data indicated that activation of A
2BAR on DCs stimulated IL-6 production in a cAMP-independent manner, and this IL-6 is an important intermediary that favors the Th17 response. Thus, adenosine represents a biological mediator that can enhance the development of Th17 cells.
In the murine system, TGF-β1 and proinflammatory cytokines, such as IL-6, are critical for Th17 differentiation, whereas a host of other cytokines, such as IL-2 and IFN-γ, are negative regulators (
35). The data reported in this article suggest that adenosine alters the balance of these cytokines in a way that favors Th17 differentiation at the expense of Treg development. For instance, adenosine directly impairs IL-2 and IFN-γ production by Th cells (
9–
11,
14), and we previously showed that an adenosine mimetic impaired IL-12 by DCs (
17). Conversely, adenosine was reported to promote or remain permissive for DC production of TGF-β1 and IL-6 (
29). The importance of specific cytokines in controlling adenosine-mediated Th17 differentiation is evidenced by the fact that A
2BAR stimulates IL-6 and that neutralization of the IL-6–gp130 receptor abrogates the Th17 response. The necessary role for IL-6 in this system implies that Th17 cells are induced in a Stat3-dependent mechanism (
36); however, that has yet to be confirmed. The role of TGF-β1 in this system is less clear, because we did not find direct evidence that A
2BAR stimulation was sufficient to generate TGF-β1. However, the fact that neutralizing Ab to TGF-β1 diminished IL-17 production indicated that adenosine-mediated Th17 differentiation requires the presence of TGF-β1.
Although NECA favors Th17 cells and not Tregs, upon IL-6 neutralization, the opposite result was observed: Th17 expansion was abrogated as was the decrease in cells expressing Foxp3. These data suggested that IL-6 induced by NECA was predominantly, if not solely, responsible for the decrease in Foxp3-producing Th cells and that it is a key intermediate controlling the effects of adenosine on Th17 and Treg development. Stimulation of A
2AAR was implicated in the expansion of Tregs (
14) when T cells were stimulated in the absence of APCs. However, A
2AAR activation did not inhibit Th17 cells when a source of APCs was provided (
14).
The finding that A
2BAR acts on DCs to promote Th17 cell development conflicts with the conclusions of other investigators that adenosine signaling favors a Th2-biasing DC (
37,
38). These groups studied human monocyte-derived DCs and restricted their investigation to Th1 and Th2 markers in MLR, specifically IFN-γ and IL-4 and/or IL-5 (
37,
38). Thus, these investigators studied DCs with characteristics unique from BMDCs and did not assess markers associated with other Th phenotypes, such as IL-17 or IL-22. A potentially important distinction between the studies is the difference in the human and mouse systems. However, in addition to species variation, there are other factors that may be important. In the single study that compared the effects of adenosine, in the presence or absence of LPS, on DC-polarizing capacity, anti-Th1/pro-Th2 skewing was only observed in the group with LPS (
37,
38). In our model system, no LPS was required to achieve the striking upregulation of IL-17 and IL-22.
The data obtained with BMDCs were consistent with observations made using DCs isolated from the intestinal lamina propria, a site rich in Th17 cells. When used in coculture experiments, the CD11c
+CD11b
+ DC subset preferentially increased IL-17 and IL-22 mRNA in the presence of the adenosine mimetic. These findings indicated that ARs modulate CD11c
+CD11b
+ lamina propria DCs and suggested that endogenous adenosine acts via lamina propria DCs to control intestinal Th responses, which agrees with other studies on intestinal DCs (
26). The difference in A
2BAR-mediated effects between these two intestinal APC populations may reflect the fact that resting macrophages express fewer A
2BAR (
17), and this receptor leads to the production of IL-6, whereas the A
2AAR does not. Although we showed that adenosine is one factor that can promote Th17 development, there are clearly redundant pathways that contribute to the in vivo response. For instance, A
2BAR
−/− mice have numbers of Th17 cells in small intestine lamina propria comparable to wild-type controls; moreover, the abundance of Th17 cells in our A
2BAR
−/− mice could be augmented by manipulating commensal flora (data not shown), presumably due to segmented filamentous bacteria (SFB), which persist in some, but not all, mouse facilities (
39). Although ruling out a necessary role for A
2BAR in the SFB-mediated Th17 response, this does not discount the possibility that local accumulation of adenosine can act to promote Th17 cells.
The role of A
2BAR in the promotion of Th17 cells, and possibly inflammation, is somewhat surprising but not entirely unexpected. For example, some studies implicated A
2BAR in pulmonary inflammation (
40). This is at least consistent with other evidence suggesting that intestinal inflammation is reduced in the absence of normal A
2BAR function (
23,
24). However, it is important to note that another group investigating adenosine in the gut found the exact opposite (
41). One interpretation of the conflicting results of A
2BAR regulation on intestinal inflammation is that the microbiome differs in the animal facilities of the respective investigators. Although the A
2BAR-dependent induction of Th17 could be consistent with these receptors promoting inflammation, emerging thought suggests that Th17 cells may confer protective/anti-inflammatory responses. For example, mice harboring SFB have a marked increase in intestinal Th17 cells but no disease (
39). In addition, the coexpression of IL-22 by Th17 cells can be protective (
42). Similarly, IL-17R knockout mice have worse intestinal disease in some models (
43). Because Th1, Th2, and Th17 cells contribute to the protection of the host, which is why they exist, their contribution to the pathogenesis of disease may require the presence of other factors. For example, in Crohn’s disease, Th17 responses are implicated in the pathogenesis but usually are the result of their heightened activation by accessory cytokines, such as IL-23 (
44). Thus, the presence of IL-17–producing cells in the absence of other cues may not be sufficient for inflammation to ensue.
Factors that calibrate the magnitude and quality of CD4
+ T cell responses are critical for host health. Although previous work emphasized an inhibitory role for adenosine in controlling CD4
+ Th cells, the current study suggests that adenosine promotes Th17 cells. Thus, adenosine represents a biological mediator that regulates CD4
+ T cell development and function, albeit in a manner that was not predicted. Adenosine shares its pleiotropic functions with other factors, such as IL-2 and TGF-β1. For example, IL-2 drives the expansion of effector T cells, but it is required for the maintenance of Tregs (
45). Similarly, TGF-β1 is important for the induction of Foxp3 and the accumulation of induced Tregs, and it contributes to Th17 cell development (
46). The relative concentration of a nucleoside, the types of cells that it targets, and the specific ARs available for engagement may be important determinants of the final outcome. The current study is significant because it adds to the regulatory effects of adenosine and expands the current thinking on its role in the control of host responses.