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Activation of dendritic cells: translating innate into adaptive immunity Caetano Reis e Sousa Innate recognition of infection in vertebrates can lead to the induction of adaptive immune responses through activation of dendritic cells (DCs). DCs are activated directly by conserved pathogen molecules and indirectly by inflammatory mediators produced by other cell types that recognise such molecules. In addition, it is likely that DCs are activated by poorly characterised cellular stress molecules and by disturbances in the internal milieu. The multiplicity of innate pathways for DC activation may have evolved to ensure that any signs of infection are detected early, before overwhelming pathogen replication. Understanding which of these signs are both necessary and sufficient to convert DCs into the immunostimulatory antigen-presenting cells that prime appropriate effector T cells may hold the key to improved strategies for vaccination and immunotherapy. Addresses Immunobiology Laboratory, Cancer Research UK, London Research Institute, Lincoln’s Inn Fields Laboratories, 44 Lincoln’s Inn Fields, London WC2A 3PX, UK e-mail: [email protected] it is not surprising that adaptive immunity takes its cues from the innate immune system. Indeed, as postulated by Janeway [1], it is now abundantly clear that innate signalling precedes, and is essential for, the generation of T-cell and B-cell responses. Central to this process are the dendritic cells (DCs), a heterogeneous family of leukocytes that integrate innate information and convey it to lymphocytes. Innate stimulation of DCs can trigger their differentiation into immunogenic antigen-presenting cells (APCs) capable of priming and sustaining the expansion of naı̈ve T cells. In addition, DCs direct T-cell effector differentiation, thus being responsible for ensuring that the specificity of the innate immune system, which distinguishes between many classes of potential pathogens, is translated into an equally specific class of adaptive immune response. This review focuses on our emerging understanding of the mechanisms involved in innate activation of DCs and how they may impact on immunity. Innate activation of dendritic cells Current Opinion in Immunology 2004, 16:21–25 This review comes from a themed issue on Innate immunity Edited by Bruce Beutler and Jules Hoffmann 0952-7915/$ – see front matter ß 2003 Elsevier Ltd. All rights reserved. DOI 10.1016/j.coi.2003.11.007 Abbreviations APC antigen-presenting cell CpG ODN CpG-containing oligonucleotide DC dendritic cell dsRNA double-stranded RNA IFN interferon IFN-I receptor for type I interferons IL interleukin LPS lipopolysaccharide Mo-DC monocyte-derived DC NK natural killer PAMP pathogen-associated molecular pattern PDC plasmacytoid DC PKR protein kinase R PRR pattern-recognition receptor Th T helper TLR Toll-like receptor TNF tumour necrosis factor Introduction The adaptive immune system, found exclusively in vertebrates, evolved from an ancient innate defence mechanism common to all metazoans. Given this past, www.sciencedirect.com There are several distinct mechanisms leading to innate DC activation, all of which probably share an evolutionary link to infection [2]. In this review, a distinction is made between pattern recognition pathways, which allow direct or indirect detection of conserved molecular signatures of potential pathogens (the so-called ‘pathogenassociated molecular patterns’, or PAMPs; [1]), and PAMP-independent DC activation in response to selfmolecules or alterations in the internal milieu (Figure 1). Although interactions with CD4þ and CD8þ T cells can also induce DC activation [3–6], such ‘adaptive’ signals will not be discussed. PAMP-dependent dendritic cell activation Cells of the innate immune system, including DCs, possess pattern-recognition receptors (PRRs) that recognise PAMPs from viruses, bacteria, fungi and protozoa. The best-studied PRRs are the Toll-like receptors (TLRs), discovered a mere six years ago [7]. The role of TLRs in DC biology has been reviewed recently [8] and only the most salient points will be reiterated here. A major dichotomy in TLR expression has been observed in human blood DC subtypes. Thus, human plasmacytoid DCs (PDCs) fail to express TLR4 and do not respond to lipopolysaccharide (LPS), whereas CD11cþ DCs and monocyte-derived DCs (Mo-DCs) are very sensitive to LPS stimulation even if they only express low levels of TLR4 [9–13]. In contrast, human blood PDCs but not CD11cþ DCs or Mo-DCs express TLR9 and make high Current Opinion in Immunology 2004, 16:21–25 22 Innate immunity Figure 1 Pathogen PAMPs Tissue PAMPs MØ, PMN PAMPs Cytokines Cytokines, PAMPs DC Altered self Altered self, PAMPs Cytokines Conserved pathogen Antigens Cytokines, Cell contact Cytokines, Cell contact NK cell γδ T cell NKT cell γδT cell Current Opinion in Immunology Possible signals involved in innate dendritic cell activation. DCs could sense the presence of a potential pathogen via detection of PAMPs (exogenous signals) or infection-induced alterations in self-markers (endogenous signals). Either type of signal may be detected by DCs directly or indirectly. The indirect pathway involves inflammatory cytokines and other mediators produced by various cell types responding to the exogenous or endogenous signals. In addition, DCs may present conserved pathogen antigens to gd or NKT cells bearing invariant T-cell receptors and receive activation signals in return. Pathways are colour-coded according to the source of signal (red for pathogen, pink for tissue, green for NK/gd T cell, brown for NKT/gd T cell, orange for dendritic cell and purple for macrophages (Mfs)/polymorphonucleocytes (PMNs). Receptors are not indicated for the sake of clarity. levels of IFN-a in response to synthetic CpG-containing oligonucleotides (CpG ODNs; [9–11]). Murine PDCs also use TLR9 to respond to CpG ODNs and viral genomes bearing similar motifs [14]. As PDCs are thought to be primarily involved in responses to viral infection [15] it is, therefore, possible that the major physiological role of TLR9 is viral DNA recognition. In rat and mouse, however, TLR9 is also expressed by non-plasmacytoid spleen DCs, which respond to CpG ODNs by producing IL-12 (R Josien, unpublished; [16]). In addition, murine PDCs show a broader TLR repertoire than their human counterparts and express TLR4, as well as most other TLRs [16,17]. Therefore, it would appear that the distinctions in TLR repertoire among DC types are not conserved across species, although it is possible that this simply reflects the tissue origin of the cells, namely blood in the case of humans versus secondary lymphoid tissues in rodents. Nevertheless, in mice, as in humans, particular DC subsets can be identified that lack expression of specific TLRs. Thus, mouse spleen PDCs selectively lack TLR3 and mouse spleen CD8aþ DCs do not express TLR7 [16]. The engagement of TLRs on DCs leads to increased expression of MHC–peptide complexes and co-stimulatory molecules, as well as the production of immunomodulaCurrent Opinion in Immunology 2004, 16:21–25 tory cytokines, all of which have a profound effect on T-cell priming and differentiation [8]. It is important, however, to note that some aspects of this process could be secondary to TLR signalling. Hoshino et al. [18] have reported that CD40 upregulation, commonly used as a marker of DC activation, is markedly diminished in murine DCs deficient for signal transducer and activator of transcription (STAT)-1 or for the receptor for type I interferons (IFN-I) after treatment with TLR4 or TLR9 agonists. This result suggests that full DC activation in response to TLR signals may largely depend on production of IFN-I and establishment of an autocrine or paracrine positive feedback loop. IFN-I injection into mice similarly activates DCs and promotes adaptive immune responses to co-administered antigen [19,20]. As IFN-I can be produced by virtually any cell type in vivo, it is possible that the activation of DCs in response to infection occurs largely indirectly (Figure 1). Indeed, Matzinger and co-workers [20] have argued that ‘alarm’ signals produced by virally infected tissues are sufficient to activate DCs and, consistent with that notion, recent in vitro experiments show that keratinocytes exposed to a mimic of viral double-stranded RNA (dsRNA) produce cytokines that act on DCs to make them competent to prime T helper 1 (Th1) differentiation [21]. Similarly, before TLRs were discovered, the effects of LPS on DC www.sciencedirect.com Activation of dendritic cells Reis e Sousa 23 migration in vivo were attributed to TNF and IL-1 rather than to a direct effect of the PAMP on DCs [22]. But, if inflammation induced by PAMPs is sufficient to activate DCs, why do these cells also express TLRs and, more pointedly, what is the significance of the lack of TLR expression by specific DC subtypes? The answer is unclear at present but it is likely that direct PRR triggering, but not indirect activation, allows DCs to differentiate between classes of pathogen (R Spörri and C Reis e Sousa, unpublished). Thus, the main function of DCexpressed PRRs may not be to activate DCs to become immunogenic APCs, but, rather, to convey information about the nature of the insult, thereby allowing DCs to direct an appropriate class of immune response. DCs can also be activated in response to the engagement of PRRs other than TLRs. Sensing of dsRNA via protein kinase R (PKR) has been recently described as a TLRindependent pathway for DC activation by viruses, illustrating the importance of cytosolic PRRs in innate viral sensing [23]. Cytosolic PAMP detection may not be restricted to viral infections as some members of the Nod family of cytosolic proteins can acts as PRRs for components of bacterial peptidoglycans [24–27]. However, the role of Nod proteins in DC activation has yet to be reported. Other than TLRs, PKR and Nods, another major class of PRRs regulating DC activation may be C-type lectins. DC-SIGN, a C-type lectin, can signal in response to Mycobacterium tuberculosis, synergising with LPS to induce IL-10 production by Mo-DCs [28]. Dectin-1, another C-type lectin that acts as a PRR for bglucan, can transduce some signals independently of TLRs in macrophages [29,30] and could play an important role in DC activation by yeasts. Other C-type lectins expressed in DCs (e.g. blood dendritic cell antigen-2 [BDCA-2], dendritic cell immunoactivating receptor [DCAR]; [31,32]) can also act as signalling receptors, although their role in PAMP recognition has yet to be established. In contrast, and despite some suggestions to the contrary [33], some C-type lectins such as the mannose receptor may act simply as endocytic receptors, concentrating potential pathogens for antigen presentation and recognition by bona fide PRRs. PAMP-independent innate activation of dendritic cells PAMPs and ‘PAMP surrogates’, such as inflammatory cytokines, are major DC stimuli. Other triggers, however, may be PAMP independent. Matzinger [34] proposed that DC activation does not involve recognition of molecules derived from potential pathogens, but rather the recognition of endogenous host-derived molecules released by cells undergoing necrosis. Such endogenous ‘danger’ signals may, in some cases, mimic PAMPs and act as ligands for PRRs, a possibility given most credence by a recent report demonstrating the involvement of a putative TLR in skin graft rejection in mice [35]. Similarly, hyaluran degradation products, fibronectin A, www.sciencedirect.com fibrinogen, heat shock proteins and b-defensins have all been put forward as putative endogenous TLR ligands, although the possibility that they contain traces of microbial contaminants has not been rigorously excluded (reviewed in [36]). Other putative ‘danger’ signals may not mimic PAMPs at all. These include ATP, acting via purinergic receptors [37], and bradykinins, which can activate murine DCs via bradykinin receptors, leading to the production of IL-12 and the priming of Th1 responses [38]. The significance of such ‘danger’ signals during infection remains to be established (see also Update). In addition to ‘danger’ signals and inflammatory cytokines, other alterations of the endogenous milieu may also be sensed by DCs (Figure 1). For example, NKG2D recognises stress-induced ligands often found in tumour cells [39]. NKG2D signalling promotes the activation of natural killer (NK) cells and gd T cells and it is, therefore, conceivable that it could perform a similar function for DCs. In the same way, other C-type lectins shared between NK cells, gd T cells and DCs may monitor the expression of stress molecules on neighbouring cells. In a further analogy with NK cells, DCs might also be able to sense loss or alteration of self-markers normally expressed by healthy cells. Siglecs, a family of sialic acid recognition molecules, could potentially serve such a function [40]. Virtually nothing is known about the innate suppression of DC activation, although the fact that DCs isolated from tissues undergo ‘spontaneous’ ex vivo activation could be interpreted to mean that they are no longer subject to inhibitory signals from neighbouring cells or extracellular matrix, rather than the more prevalent view that they have received a positive activation signal. Just as in the case of PAMPs, one should consider that any mechanisms for sensing endogenous ‘danger’ signals or alterations of self-markers may act on DCs only indirectly. For example, changes in self-markers can trigger NK-cell activation, which, in turn, can promote the activation of DCs and lead to the priming of Th1 responses [41–44]. Similarly, DC presentation of an appropriate antigen to NKT cells leads to feedback signals that can fully activate DCs independent of previous TLR signalling [45]. These data strongly suggest that the surveillance of infection by other innate effector cells can translate into DC activation and initiation of adaptive immunity (Figure 1). Conclusions Microbial components and inflammatory cytokines have long been known to profoundly affect DC phenotype and function. However, the pathways involved in infection sensing by DCs still remain elusive. Recent advances in our understanding of innate immunity, including the molecular identification of PRRs (e.g. TLRs) and sensors of altered self (e.g. NKG2D), and an increased awareness of the role of inflammatory cytokines in promoting acquired immunity (e.g. IFN-I), have opened the door Current Opinion in Immunology 2004, 16:21–25 24 Innate immunity to molecular studies of DC activation. At the same time, it is becoming increasingly clear that DC activation is a flexible process that can result in distinct types of ‘effector DC’ that can direct multiple forms of immunity and may, in some cases, even lead to T-cell tolerance. The challenge at present is to establish how DCs interpret and integrate multiple innate activation and inhibitory signals and how they convey the result to the adaptive immune system. Targeting the translation of innate into adaptive information by DCs offers new perspectives for manipulating the immune system for clinical benefit. Update Recent work has demonstrated that uric acid released from dying cells may act as a ‘danger’ signal that promotes cross-priming [46]. Acknowledgements I am grateful to members of the Immunobiology Laboratory, Cancer Research UK, for discussions and critical review of the manuscript. References and recommended reading Papers of particular interest, published within the annual period of review, have been highlighted as: of special interest of outstanding interest express different toll-like receptors and respond to different microbial antigens. J Exp Med 2001, 194:863-870. 12. Kadowaki N, Antonenko S, Liu YJ: Distinct CpG DNA and polyinosinic-polycytidylic acid double-stranded RNA, respectively, stimulate CD11cS type 2 dendritic cell precursors and CD11cR dendritic cells to produce type I IFN. J Immunol 2001, 166:2291-2295. 13. Hornung V, Rothenfusser S, Britsch S, Krug A, Jahrsdorfer B, Giese T, Endres S, Hartmann G: Quantitative expression of toll-like receptor 1-10 mRNA in cellular subsets of human peripheral blood mononuclear cells and sensitivity to CpG oligodeoxynucleotides. J Immunol 2002, 168:4531-4537. 14. Lund J, Sato A, Akira S, Medzhitov R, Iwasaki A: Toll-like receptor 9-mediated recognition of herpes simplex virus-2 by plasmacytoid dendritic cells. J Exp Med 2003, 198:1-9. The authors show that the herpes simplex virus-2 (HSV-2) triggers IFN-I production by murine PDCs via TLR9, an activity attributable to CpG motifs in the viral genome. Sensitivity to lysosomotropic drugs suggests that recognition occurs in an endocytic compartment after internalisation and uncoating of viral particles. 15. Colonna M, Krug A, Cella M: Interferon-producing cells: on the front line in immune responses against pathogens. Curr Opin Immunol 2002, 14:373-379. 16. Edwards AD, Diebold SS, Slack EMC, Tomizawa H, Hemmi H, Kaisho T, Akira S, Reis e Sousa C: Toll-like receptor expression in murine DC subsets: lack of TLR7 expression by CD8aR DC correlates with unresponsiveness to imidazoquinolines. Eur J Immunol 2003, 33:827-833. 17. Okada T, Lian ZX, Naiki M, Ansari AA, Ikehara S, Gershwin ME: Murine thymic plasmacytoid dendritic cells. Eur J Immunol 2003, 33:1012-1019. 18. Hoshino K, Kaisho T, Iwabe T, Takeuchi O, Akira S: Differential involvement of IFN-beta in Toll-like receptor-stimulated dendritic cell activation. Int Immunol 2002, 14:1225-1231. An important paper showing that TLR4 and TLR9 signalling may lead to some aspects of DC activation indirectly, through the induction of IFN-I. 1. Janeway CA Jr: Approaching the asymptote? Evolution and revolution in immunology. Cold Spring Harb Symp Quant Biol 1989, 54:1-13. 2. Reis e Sousa C: Dendritic cells as sensors of infection. Immunity 2001, 14:495-498. 3. Ruedl C, Kopf M, Bachmann MF: CD8(R) T cells mediate CD40-independent maturation of dendritic cells in vivo. J Exp Med 1999, 189:1875-1884. 19. Le Bon A, Schiavoni G, D’Agostino G, Gresser I, Belardelli F, Tough DF: Type i interferons potently enhance humoral immunity and can promote isotype switching by stimulating dendritic cells in vivo. Immunity 2001, 14:461-470. 4. Manickasingham S, Reis e Sousa C: Microbial and T cell-derived stimuli regulate antigen presentation by dendritic cells in vivo. J Immunol 2000, 165:5027-5034. 20. Gallucci S, Lolkema M, Matzinger P: Natural adjuvants: endogenous activators of dendritic cells. Nat Med 1999, 5:1249-1255. 5. Muraille E, De Trez C, Pajak B, Brait M, Urbain J, Leo O: T cell-dependent maturation of dendritic cells in response to bacterial superantigens. J Immunol 2002, 168:4352-4360. 6. Mailliard RB, Egawa S, Cai Q, Kalinska A, Bykovskaya SN, Lotze MT, Kapsenberg ML, Storkus WJ, Kalinski P: Complementary dendritic cell-activating function of CD8R and CD4R T cells: helper role of CD8R T cells in the development of T helper type 1 responses. J Exp Med 2002, 195:473-483. 21. Lebre MC, Antons JC, Kalinski P, Schuitemaker JH, van Capel TM, Kapsenberg ML, De Jong EC: Double-stranded RNA-exposed human keratinocytes promote Th1 responses by inducing a Type-1 polarized phenotype in dendritic cells: role of keratinocyte-derived tumor necrosis factor alpha, type I interferons, and interleukin-18. J Invest Dermatol 2003, 120:990-997. 7. Akira S: Mammalian Toll-like receptors. Curr Opin Immunol 2003, 15:5-11. 8. Reis e Sousa C: Toll-Like receptors and dendritic cells: for whom the bug tolls. Semin Immunol 2004, in press. A recent review of Toll-like receptors and DCs, which expands on several of the topics discussed here. 9. Krug A, Towarowski A, Britsch S, Rothenfusser S, Hornung V, Bals R, Giese T, Engelmann H, Endres S, Krieg AM et al.: Toll-like receptor expression reveals CpG DNA as a unique microbial stimulus for plasmacytoid dendritic cells which synergizes with CD40 ligand to induce high amounts of IL-12. Eur J Immunol 2001, 31:3026-3037. 22. Roake JA, Rao AS, Morris PJ, Larsen CP, Hankins DF, Austyn JM: Dendritic cell loss from nonlymphoid tissues after systemic administration of lipopolysaccharide, tumor necrosis factor, and interleukin 1. J Exp Med 1995, 181:2237-2247. 23. Diebold SS, Montoya M, Unger H, Alexopoulou L, Roy P, Haswell L, Al-Shamkhani A, Flavell R, Borrow P, Reis e Sousa C: Viral infection switches non-plasmacytoid dendritic cells into high interferon producers. Nature 2003, 424:324-328. A demonstration of TLR-independent activation of DCs by viral dsRNA via cytosolic PRRs, including PKR. 24. Girardin SE, Boneca IG, Viala J, Chamaillard M, Labigne A, Thomas G, Philpott DJ, Sansonetti PJ: Nod2 is a general sensor of peptidoglycan through muramyl dipeptide (MDP) detection. J Biol Chem 2003, 278:8869-8872. 10. Jarrossay D, Napolitani G, Colonna M, Sallusto F, Lanzavecchia A: Specialization and complementarity in microbial molecule recognition by human myeloid and plasmacytoid dendritic cells. Eur J Immunol 2001, 31:3388-3393. 25. Inohara N, Ogura Y, Fontalba A, Gutierrez O, Pons F, Crespo J, Fukase K, Inamura S, Kusumoto S, Hashimoto M et al.: Host recognition of bacterial muramyl dipeptide mediated through NOD2. Implications for Crohn’s disease. J Biol Chem 2003, 278:5509-5512. 11. Kadowaki N, Ho S, Antonenko S, de Waal Malefyt R, Kastelein RA, Bazan F, Liu YJ: Subsets of human dendritic cell precursors 26. Chamaillard M, Hashimoto M, Horie Y, Masumoto J, Qiu S, Saab L, Ogura Y, Kawasaki A, Fukase K, Kusumoto S et al.: Current Opinion in Immunology 2004, 16:21–25 www.sciencedirect.com Activation of dendritic cells Reis e Sousa 25 An essential role for NOD1 in host recognition of bacterial peptidoglycan containing diaminopimelic acid. Nat Immunol 2003, 4:702-707. 27. Girardin SE, Boneca IG, Carneiro LA, Antignac A, Jehanno M, Viala J, Tedin K, Taha MK, Labigne A, Zathringer U et al.: Nod1 detects a unique muropeptide from gram-negative bacterial peptidoglycan. Science 2003, 300:1584-1587. 28. Geijtenbeek TB, Van Vliet SJ, Koppel EA, Sanchez-Hernandez M, Vandenbroucke-Grauls CM, Appelmelk B, Van Kooyk Y: Mycobacteria target DC-SIGN to suppress dendritic cell function. J Exp Med 2003, 197:7-17. Mannosylated lipoarabinomannan from Mycobacterium tuberculosis is shown to bind to human DC-SIGN rather than the mannose receptor, as had been suggested in [33]. Binding suppresses the ability of DCs to produce IL-12 in response to LPS and augments production of IL-10. This is possibly the first demonstration that a C-type lectin can act as a signalling PAMP receptor on DCs, with the caveat that the authors have not excluded the possibility that the signal is mediated via a TLR. The latter is critical in the light of the data in [29,30] suggesting that another C-type lectin, Dectin-1, collaborates with TLR2. 29. Brown GD, Herre J, Williams DL, Willment JA, Marshall AS, Gordon S: Dectin-1 mediates the biological effects of betaglucans. J Exp Med 2003, 197:1119-1124. 30. Gantner BN, Simmons RM, Canavera SJ, Akira S, Underhill DM: Collaborative induction of inflammatory responses by Dectin-1 and Toll-like receptor 2. J Exp Med 2003, 197:1107-1117. 31. Dzionek A, Sohma Y, Nagafune J, Cella M, Colonna M, Facchetti F, Gunther G, Johnston I, Lanzavecchia A, Nagasaka T et al.: BDCA-2, a novel plasmacytoid dendritic cell-specific type II C-type lectin, mediates antigen capture and is a potent inhibitor of interferon alpha/beta induction. J Exp Med 2001, 194:1823-1834. 32. Kanazawa N, Tashiro K, Inaba K, Miyachi Y: Dendritic cell immunoactivating receptor, a novel C-type Lectin immunoreceptor, acts as an activating receptor through association with Fc receptor c chain. J Biol Chem 2003, 278:32645-32652. 33. Nigou J, Zelle-Rieser C, Gilleron M, Thurnher M, Puzo G: Mannosylated lipoarabinomannans inhibit IL-12 production by human dendritic cells: evidence for a negative signal delivered through the mannose receptor. J Immunol 2001, 166:7477-7485. 37. Schnurr M, Then F, Galambos P, Scholz C, Siegmund B, Endres S, Eigler A: Extracellular ATP and TNF-alpha synergize in the activation and maturation of human dendritic cells. J Immunol 2000, 165:4704-4709. 38. Aliberti J, Viola JP, Vieira-de-Abreu A, Bozza PT, Sher A, Scharfstein J: Cutting edge: Bradykinin induces IL-12 production by dendritic cells: a danger signal that drives Th1 polarization. J Immunol 2003, 170:5349-5353. 39. Diefenbach A, Raulet DH: The innate immune response to tumors and its role in the induction of T-cell immunity. Immunol Rev 2002, 188:9-21. 40. Crocker PR: Siglecs: sialic-acid-binding immunoglobulin-like lectins in cell-cell interactions and signalling. Curr Opin Struct Biol 2002, 12:609-615. 41. Ferlazzo G, Tsang ML, Moretta L, Melioli G, Steinman RM, Munz C: Human dendritic cells activate resting natural killer (NK) cells and are recognized via the NKp30 receptor by activated NK cells. J Exp Med 2002, 195:343-351. See annotation to [44]. 42. Piccioli D, Sbrana S, Melandri E, Valiante NM: Contact-dependent stimulation and inhibition of dendritic cells by natural killer cells. J Exp Med 2002, 195:335-341. See annotation to [44]. 43. Gerosa F, Baldani-Guerra B, Nisii C, Marchesini V, Carra G, Trinchieri G: Reciprocal activating interaction between natural killer cells and dendritic cells. J Exp Med 2002, 195:327-333. See annotation to [44]. 44. Mailliard RB, Son YI, Redlinger R, Coates PT, Giermasz A, Morel PA, Storkus WJ, Kalinski P: Dendritic cells mediate NK cell help for Th1 and CTL responses: two-signal requirement for the induction of NK cell helper function. J Immunol 2003, 171:2366-2373. References [41–43] demonstrate that interactions between DCs and NK cells can lead to the reciprocal activation of both cell types. Reference [44] suggests that activation by NK cells allows DCs to prime Th1 responses. Together, these studies underscore the possible importance of PAMP-independent indirect activation of DCs in response to infection or other stresses. 35. Goldstein DR, Tesar BM, Akira S, Lakkis FG: Critical role of the Toll-like receptor signal adaptor protein MyD88 in acute allograft rejection. J Clin Invest 2003, 111:1571-1578. An intriguing study, suggesting that allograft rejection involves innate activation via a putative TLR. 45. Fujii S, Shimizu K, Smith C, Bonifaz L, Steinman RM: Activation of natural killer T cells by alpha-galactosylceramide rapidly induces the full maturation of dendritic cells in vivo and thereby acts as an adjuvant for combined CD4 and CD8 T cell immunity to a coadministered protein. J Exp Med 2003, 198:267-279. This paper shows that NKT cells can recognise a-galactosyl-ceramide presented by CD1d on DCs. NKT-cell activation via the T-cell receptor results in the delivery of feedback signals to the DCs that, in turn, promote their activation. This is an interesting example of PAMP-independent indirect DC activation, which could operate during infection in response to DC presentation of conserved pathogen antigens recognised by NKT cells and, possibly, gd T cells. 36. Beg AA: Endogenous ligands of Toll-like receptors: implications for regulating inflammatory and immune responses. Trends Immunol 2002, 23:509-512. 46. Shi Y, Evans JE, Rock KL: Molecular identification of a danger signal that alerts the immune system to dying cells. Nature 2003, 425:516-521. 34. Matzinger P: Tolerance, danger, and the extended family. Annu Rev Immunol 1994, 12:991-1045. www.sciencedirect.com Current Opinion in Immunology 2004, 16:21–25