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Functional Characterization of the CD300e Leukocyte Receptor Tamara Brckalo TESI DOCTORAL UPF / 2010 DEPARTAMENT DE CIENCIES EXPERIMENTALS I DE LA SALUT DIRECTOR DE LA TESI Dr Miguel López-Botet ii To Filip and Raša iii iv ACKNOWLEDGEMENTS My deepest gratitude is to my thesis advisor Prof. Dr. Miguel LópezBotet for his continuous support, guidance and encouragement he provided in all stages of this thesis. I would also like to thank my colleagues at the UPF: Andrea Saez, Aura Muntasell, Gemma Heredia, Diogo Baia, Neus Romo, Giuliana Magri and Medya Shikhagaie for their help and support during all these years. I owe deep respect and gratitude to Prof. Dr. Marco Cassatella for his time, expertise and everything I had the opportunity to learn under his guidance. I am very grateful to Federica Calzetti for being an excellent teacher, exceptional colleague and a great friend. I am eternally grateful to my parents Rajko and Slobodanka and my brother Miloš, for their unconditional love and infinite encouragement. But above all, I would like to thank my husband Raša Karapandža that has been there for me more than any other person. Thank you for your love, your patience and for believing in me. At the end, I would like to thank my son Filip for giving my life a new meaning and for doing everything possible to make me write this thesis slowly but surely. v vi SUMMARY The focus of this work was to functionally characterize the CD300e receptor expressed in human monocytes and myeloid dendritic cells and investigate the implications that receptor engagement has on their biology. We provide evidence formally supporting that CD300e functions as an activating receptor capable of regulating the innate immune response by triggering various pro-inflammatory functions including intracellular calcium mobilization, superoxide anion production, pro-inflammatory cytokine release and up-regulation of co-stimulatory molecules in myeloid cells. We also report that ligation of CD300e on the surface of monocytes results in their differentiation to functional MΦ2-like macrophages by an autocrine mechanism that involves M-CSF and its receptor (CD115). RESUM L’objectiu d’aquest treball ha estat caracteritzar funcionalment el receptor CD300e expressat en monòcits i cèl·lules dendrítiques mieloides humanes, així com investigar les implicacions que l’activació d’aquest receptor pot tenir en la seva biologia. Demostrem formalment que el receptor CD300e funciona com un receptor activador capaç de regular la resposta immune innata activant diverses funcions proinflamatòries, incloent la mobilització de calci intracel·lular, la producció d’anió superòxid, la secreció de citocines proinflamatòries i la inducció de molècules coestimuladores en cèl·lules mieloides. També descrivim que l’activació del receptor CD300e a la superfície dels monòcits provoca la seva diferenciació cap a macròfags funcionals del tipus MΦ2 gràcies a un mecanisme autocrí que funciona a través del M-CSF i el seu receptor (CD115). vii viii PREFACE The CD300 glycoproteins represent a family of recently identified cell surface molecules with inhibitory and activating functions expressed by cells of the myeloid lineage. Since there are only few characterized reagents available, there is no information about their natural ligands, and because most studies have used transfectants rather than primary cells, our understanding of the biology of this receptor family is still rather limited. On that basis, we have investigated in detail the functional role of the CD300e receptor in human monocytes and myeloid dendritic cells. ix x ABBREVIATIONS BCR BMMC CD CR DAP10 DAP12 DC FcR fMLP G-CSF GM-CSF HCMV HIV IFN Ig IgSF IL ILT IREM ITAM ITIM ITSM KIR LPS mAb M-CSF mDC MHC moDC MΦ NFAT NF-κB NK PBMC PI3K PMN RBL ROS SCF B cell Receptor Bone Marrow-derived Mast Cells Cluster of Differentiation Complement Receptor DNAX Adaptor protein of 10kDa DNAX Adaptor protein of 12kDa Dendritic Cell Receptor for the Constant Region of Immunoglobulins Formyl-Methionyl-Leucyl-Phenylalanine Granulocyte Colony Stimulating Factor Granulocyte-Macrophage Colony Stimulating Factor Human Cytomegalovirus Human Immunodeficiency Virus Interferon Immunoglobulin Immunoglobulin Super Family Interleukin Immunoglobulin-Like Transcript Immune Receptor Expressed by Myeloid Cells Immune Receptor Tyrosine-based Activating Motif Immune Receptor Tyrosine-based Inhibitory Motif Immune Receptor Tyrosine-based Switch Motif Killer Immunoglobulin-Like Receptor Lipopolysaccharide Monoclonal Antibody Macrophage Colony Stimulating Factor Myeloid Dendritic Cell Major Histocompatibility Complex Monocyte-derived Dendritic Cell Macrophage Nuclear Factor of Activated T cells Nuclear Factor - κB Natural Killer Cells Peripheral Blood Mononuclear Cells Phosphatydil Inositol-3 Kinase Polymorphonuclear Neutrophils Rat Basophilic Leukemia Reactive Oxygen Species Stem Cell Factor xi SH-2 SHIP SHP SIGLEC SP-A/D TCR TLR TNF TREM ZAP-70 Src Homology-2 domain SH2 domain containing Inositol Phosphatase SH2 domain containing Protein Tyrosine Phosphatase Sialic Acid Binding Ig-like Lectins Surfactant protein A/D T cell Receptor Toll-like Receptor Tumor Necrosis Factor Triggering Receptor Expressed by Myeloid Cells ξ – chain Associated Protein 70 xii SUMMARY............................................................................... VII PREFACE ..................................................................................IX ABBREVIATIONS ....................................................................XI 1. INTRODUCTION................................................................... 3 1.1 Development of myeloid cells........................................... 3 1.2 Myeloid cells and their effector functions ........................ 6 1.2.1 Monocytes....................................................................................... 6 1.2.2 Macrophages.................................................................................. 8 1.2.3 Myeloid (Conventional) Dendritic cells...............................12 1.2.4 Granulocytes ................................................................................15 1.3 Immune receptor families in myeloid cells .....................19 1.3.1 CD85...............................................................................................19 1.3.2 TREM............................................................................................21 1.3.3 CD172 .............................................................................................23 1.3.4 CD200R .........................................................................................23 1.3.5 SIGLEC .........................................................................................24 1.3.6 CD300.............................................................................................26 1.3.6.1 Human CD300 receptors .....................................................29 1.3.6.2 Mouse CD300 receptors .......................................................33 2. AIMS ........................................................................................41 3. RESULTS ............................................................................... 45 Article 1: ...................................................................................... 47 Functional analysis of the CD300e receptor in human monocytes and myeloid dendritic cells ...................................................................................................49 Article 2: ......................................................................................................77 Engagement of CD300e induces the differentiation of human monocytes to macrophages involving an autocrine M-CSF-dependent pathway........................79 Appendix ...................................................................................107 Functional Characterization of CD300f Inhibitory Receptor in Human Granulocytes...................................................................................107 4. DISCUSSION........................................................................126 5. CONCLUSIONS................................................................... 141 BIBLIOGRAPHY .....................................................................144 xiii xiv xv xvi Introduction 1 2 INTRODUCTION 1. INTRODUCTION Monocytes, granulocytes, macrophages and dendritic cells, collectively called myeloid cells, are differentiated from common progenitors derived from hematopoietic stem cells in the bone marrow. Commitment to either lineage of myeloid cells is controlled by distinct transcription factors, followed by differentiation in response to specific colony-stimulating factors and release into the circulation. Upon pathogen invasion, myeloid cells are rapidly recruited via chemokine receptors into tissues, where they become activated, developing different effector mechanisms that contribute to pathogen elimination and promoting further recruitment of other leukocytes at the site of the infection. Therefore, by serving as a first line of defense myeloid cells play a major role in innate immunity. 1.1 Development of myeloid cells All immune cells develop from hematopoietic stem cells (HSCs) that can be subdivided in long-term HSCs (LT-HSCs), short-term repopulating HSCs (ST-HSCs), and multipotent progenitor (MPP), as defined by combinations of cell surface markers. Progenitors with a more restricted differentiation potential identified in the bone marrow include the common progenitor for lymphoid lineages (CLP) and common myeloid progenitor (CMP) that generates granulocyticmacrophage (GM) and megakaryocytic-erythroid (ME) lineages. Alternatively, MPPs may develop to recently described lymphoidprimed multipotent progenitors (LMPPs) that have lost megakaryocytic-erythroid potential but retain myeloid and lymphoid developmental options [1]. CLPs give rise to pro-B and pro-T cells, uncommitted lymphoid progenitors that will differentiate further into mature B and T cells, and cells of the NK lineage. CMPs in turn generate two more restricted progenitors: granulocyte-macrophage progenitors (GMPs) and megakaryocyte-erythrocyte progenitors (MEPs). The offspring of GMPs includes monocytes, neutrophils, eosinophils, and basophils/mast cells [2]. It is believed that CMPs can also give rise to macrophage-DC progenitors (MDPs) that will give rise to monocytes, macrophages, classical or myeloid DCs (cDCs or mDCs), and plasmacytoid DCs (pDCs). MDPs-derived monocytes can further differentiate into inflammatory DCs. MDPs lie upstream of the common DC 3 INTRODUCTION progenitors (CDPs), which are DC-restricted, giving rise to pDCs and, via pre-DCs, to cDCs (Figure 1)1. Figure 1. Hematopoietic tree for the development of myeloid cells [1]. Macrophage-dendritic progenitors (MDPs) and common DCsprogenitors (CDPs) commitment is dependent on cytokines. MDPs and CDPs express the receptors for Fms-like tyrosine kinase 3 ligand (Flt3L), GM-CSF and M-CSF. MDPs have the potential to differentiate into macrophages, monocytes, and inflammatory DCs, and via CDPs to cDCs and pDCs. Different microenvironments with variations in the combination and concentration of the three cytokines influence the lineage commitment and differentiation of MDPs and CDPs to mature cells (Figure 2). 1 Solid arrows show demonstrated pathways; dotted arrows show suggested pathways that have not been formally proven. 4 INTRODUCTION Figure 2. Cytokine-induced differentiation of macrophage dendritic progenitors (MDP) and common DCs-progenitors CDP progenitors [1]. The development of blood monocytes is dependent on the M-CSF (also known as Csf-1). M-CSF receptor (CD115, Csf-1R) is expressed on monocytes, macrophages, DCs and their precursors [3, 4]. The two known ligands for CD115, M-CSF [5] and the more recently described IL-34 [6], are both important for the development of myeloid lineage. Other cytokines, such as GM-CSF, Flt3, and lymphotoxin α1β2 [7-9], control the development and homeostasis of the macrophage and DC networks but appear to be unnecessary for monocyte development (Figure 2). Myeloid cells develop from hematopoietic stem cells in the bone marrow via several commitment steps and intermediate progenitor stages that pass through the common myeloid progenitor (CMP), the granulocyte/macrophage progenitor (GMP), and the macrophage/DC progenitor (MDP) stages. Each of these differentiation steps involves cell fate decisions that successively restrict developmental potential and many are controlled by the Ets family transcription factor PU.1 [10]. Besides being able to induce myeloid commitment in immature multipotent progenitor cells [11], PU.1 is required for the generation of CMP in early myelopoiesis [12, 13]. It also controls several cell fate decisions along the myelomonocytic pathway by engaging in antagonistic interactions with different transcription factors. Initially, inhibitory interactions with GATA-1 shut down the megakaryocytic/erythroid pathway, and repression of GATA-2 blocks mast cell development [14]. At the later bipotent GMP stage, PU.1 is critical for driving monocytic differentiation, at the expense of granulocytic differentiation [12], by antagonizing C/EBPα [15], a 5 INTRODUCTION transcription factor required for granulocytic development [16]. Two additional transcription factors that can selectively drive monocyte fate in myeloid progenitors are MafB and c-Maf [17, 18]. 1.2 Myeloid cells and their effector functions 1.2.1 Monocytes Monocytes represent 5-10% of leukocytes in human blood, and contribute together with polymorphonuclear (PMN) and natural killer (NK) cells to constitute the innate arm of the immune system. Monocytes originate in the bone marrow from a common myeloid progenitor shared with neutrophils, and are then released into peripheral blood where they circulate for several days before entering tissues. They constitute a systemic reservoir of myeloid precursors that give rise to a variety of tissue resident macrophages, and also to specialized cells such as dendritic cells (DCs) and osteoclasts [19-22]. Thus, circulating monocytes represent accessory cells that are able to link inflammation and the innate defense against pathogens to adaptive immune responses [10]. Blood monocytes also represent a large pool of scavenger and potential effector cells inside blood vessels, in homeostasis and also during inflammatory processes [23]. They are armed with a large array of scavenger receptors that recognize microorganisms but also lipids and dying cells. Upon stimulation, monocytes become activated and produce different effector molecules involved in the defense against pathogens. Stimulated monocytes can produce ROS, complement factors, prostaglandins, nitric oxide (NO) (in mice), cytokines (i.e. TNF-α, IL-1β, CXCL8, IL-6, and IL-10), vascular endothelial growth factor and proteolytic enzymes [10]. Even though antigen presentation has been described as a functional feature of monocytes, they have been found to be far less efficient than DCs [24]. Monocytes have some typical morphological features such as irregular cell shape, oval- or kidney-shaped nucleus, cytoplasmic vesicles, and high cytoplasm-to-nucleus ratio. However, they are still very heterogeneous in size and shape and are difficult to distinguish by morphology from blood DCs, activated lymphocytes, and NK cells [10]. Human blood monocytes can be defined by the expression of the CSF-1 receptor (MCSF-R or CD115) and the chemokine receptor 6 INTRODUCTION CX3CR1. They are distinct from PMNs, NK cells, and lymphoid T and B cells and do not express NKp46, CD3, CD19 or CD15 [10]. Table I summarizes cell surface receptors expressed by monocytes . Antigen CD14+CD16- CD14+CD16+ Antigen CD14+CD16- CD14+CD16+ Chemokine receptors Other receptors CCR1 + CD4 + + CCR2 + CD11a ND ND CCR4 + CD11b ++ ++ CCR5 + CD11c ++ +++ CCR7 + CD14 +++ + CXCR1 + CD31 +++ +++ CXCR2 + CD32 +++ + CXCR4 + ++ CD33 +++ + CX3CR1 + ++ CD43 ND ND CD49b ND ND CD62 ++ CD80 ND ND CD86 + ++ CD115 ++ ++ CD116 ++ ++ CD200R ND ND MHC class II + ++ Table 1. Phenotype of the two best-characterized monocyte subsets in humans [25]. In recent years, investigators have identified three distinct populations of blood monocytes defined by the expression of CD14 and CD16 (CD14+CD16−, CD14+CD16+, and CD14dimCD16+) [26-29]. The CD14+CD16− monocytes which represent the majority of human blood monocytes (80%-90%), express high levels of the chemokine receptor CCR2 and low levels of CX3CR1, and upon LPS stimulation produce IL-10 rather than TNF and IL-1 [21, 30-32]. In contrast to this subset, human CD16+ monocytes express high levels of CX3CR1 and low levels of CCR2 [21, 30, 32] and are responsible for the production of TNF-α in response to LPS. They are found in larger numbers in the blood of patients with acute inflammation [33] and infectious diseases [34, 35]. The CD16+ monocytes, also called proinflammatory monocytes are composed of at least two populations with strikingly distinct functions [27]. Monocytes that co-express CD16 and CD14 (CD14+CD16+) also express other Fc receptors (i.e. CD64 and CD32), have phagocytic activity, and are mainly responsible for the production of TNF-α and IL-1 in response to LPS [36]. In contrast, monocytes that express CD16 but very low levels of CD14 7 INTRODUCTION (CD14dimCD16+) lack the expression of other Fc receptors, are poorly phagocytic and do not produce neither TNF-α nor IL-1 in response to LPS [37]. Even though they may be expanded in the blood of septic patients [34] the function of CD14dimCD16+ monocytes remains thus far elusive. 1.2.2 Macrophages Tissue macrophages are generally considered to be derived from circulating monocytes and show a high degree of heterogeneity [25]. They have a broad role in the maintenance of tissue homeostasis, through the clearance of senescent cells and the re-modeling and repair of tissues after inflammation [38]. The heterogeneity of tissue macrophages reflects the specialization of function that they have adopted in different locations, such as the ability of osteoclasts to remodel bone, or the high expression of pattern recognition receptors and scavenger receptors by alveolar macrophages that are involved in clearance of air-borne microorganisms, and environmental particles in the lungs [25]. Osteoclasts. Osteoclast precursors are found in the granulocyte/macrophage precursor (GMPs) and can be derived from unfractionated, mature monocytes from peripheral blood [39, 40]. Osteoclast precursors express the receptor for macrophage colonystimulating factor (M-CSF R or CD115) and depend on it for their development. Since culture of peripheral-blood monocytes with MCSF and RANKL is sufficient to induce their differentiation into osteoclasts it has been assumed that osteoclast precursors are monocytes, although this has not been formally proven in vivo [25]. Alveolar macrophages. Alveolar macrophages have been reported to be derived both from peripheral blood precursors and from their local proliferation. GM-CSF has a crucial role in the maintenance, maturation and activity of alveolar-macrophage populations. Although it is assumed that a monocyte subset might be the precursor of alveolar macrophages, this has not been directly proven[25]. Macrophages in the central nervous system. The central nervous system (CNS) contains various macrophage subsets, including microglia, perivascular macrophages, meningeal macrophages and choroid-plexus macrophages [25]. Meningeal macrophages are thought 8 INTRODUCTION to be rapidly replaced by cells of bone-marrow origin, whereas the turnover of of perivascular and choroid-plexus macrophages is slower; the basis for the different turnover rate is unknown [41]. It is assumed that monocytes can enter the CNS and differentiate into microglia [25]. Splenic macrophages. Macrophages in the white pulp include tingible-body macrophages. Marginal zone macrophages are found next to the marginal sinus and they express pattern-recognition receptors and scavenger receptors, which aid in the clearance of blood-borne pathogens [42]. Metallophilic macrophages, found nearby the white pulp and marginal sinus, can sample the circulation and are thought to play an important role during infections [25]. Regarding the origin of splenic macrophages, it seems that local proliferation does occur under steady-state conditions in the case of white-pulp macrophages and metallophilic macrophages, but circulating precursors also contribute, even though their nature is uncertain. Kupffer cells. Kupffer cells are an important component of the mononuclear-phagocyte system that is present in the liver. The origin of Kupffer cells has been speculated to involve two mechanisms: replenishment by local proliferation and recruitment of circulating precursors. Both mechanisms are presumably affected by inflammation and other factors [25]. Inflammatory-monocyte-derived macrophages. It has been known for a long while that monocytes are recruited to the inflammatory lesion where they differentiate into macrophages [43]. At the site of the infection macrophages undergo activation depending on local environmental signals, among them microbial products and cytokines [44]. Bacterial products (e.g., LPS) and immune stimuli such as interferon-γ (IFN-γ), promote classic (or M1) macrophage activation which produce abundant reactive nitrogen (RNI) and oxygen intermediates (ROI) and IL-12 [45, 46]. M1-activated macrophages participate in the Th1 responses mediating resistance against intracellular parasites and tumors, associated to tissue disruptive reactions [44]. Alternative (or M2) macrophage activation was originally discovered as a response to IL-4 [45, 46]. M2-activated macrophages may present different forms depending on the stimulating signals, which include IL-4 and IL-13, immune complexes plus signals mediated through receptors that involve downstream 9 INTRODUCTION signaling through MyD88 (i.e., IL-1 or LPS), glucocorticoid hormones, and IL-10. M-CSF–cultured monocytes have a transcriptional profile close to IL-4–activated cells, suggesting that this is a default pathway of differentiation [44]. In general, M2-activated cells share high expression of scavenger and mannose receptors, and have an IL-12low, IL-10high, IL-1decoyRhigh, IL-1rahigh phenotype. They also have a distinct chemokine expression pattern (i.e. CCL17 and CCL22) as shown in Figure 3. Macrophage polarization is also characterized by changes in various metabolic pathways [47] such as iron metabolism. MΦ1 cells are characterized by an increased iron uptake and intracellular retention of the metal whereas MΦ2 cells release iron to the extracellular milieu. The various forms of M2 activation are oriented to the promotion of tissue remodeling and angiogenesis, parasite encapsulation, regulation of immune responses, and have been associated to tumor growth stimulation [44]. Recent results have highlighted the integration of M2polarized macrophages with immunoregulatory pathways since MΦ2 cells were shown to induce the differentiation of regulatory T cells (Treg) [48], which have been reported to reciprocally contribute to the alternative activation of human mononuclear phagocytes [49]. Macrophages that infiltrate tumor tissues have been shown to acquire a polarized M2 phenotype [45], playing a key role in subversion of adaptive immunity and in inflammatory circuits that promote tumor growth and progression. Human peritoneal macrophages (pMΦ) represent another paradigm of MΦ2 cells [50]. 10 INTRODUCTION Figure 3. M1 and M2 macrophages, the extremes of a continuum [45]. Despite these classifications, the degree of macrophage plasticity is still incompletely defined since it is unclear whether macrophage fate is irreversibly determined or remains flexible [25]. Macrophages express a number of receptors that mediate their diverse functions. Since these receptors are located on the surface but also in intracellular compartments, they mediate recognition of both extracellular and intracellular pathogens [51] (Figure 4). Complement and Fc receptors function in phagocytosis and endocytosis of opsonized particles [52, 53]. In addition, Fc receptors via NF-κB regulate the production of pro-inflammatory mediators in macrophages. Another group of phagocytic/endocytic surface receptors are the non-Toll-like receptors (NTLR), which include the family of scavenger receptors and C-type lectins [54]. Non-opsonic surface receptors that do not mediate phagocytosis/endocytosis but are important sensors of bacteria, fungi and viruses are the Toll-like 11 INTRODUCTION receptors (TLR) [55]. Scavenger receptors including CD36, SREC and LOX-1 have been shown to collaborate with TLR to induce NF-κB and may also directly mediate its induction upon interaction with their ligands. Some TLRs are located within vacuoles and play a role in recognition of intracellular pathogens. Cytosolic viruses and bacterial products in macrophages are recognized by the NOD-like receptors (NLR) and RIG-like helicases (RLH). NLR induce NF-kB either directly or in collaboration with TLR. Figure 4. Pattern-recognition receptor system in phagocytes [56] 1.2.3 Myeloid (Conventional) Dendritic cells Dendritic cells (DCs) represent the migratory group of bone-marrowderived leukocytes that are specialized for the uptake, transport, processing and presentation of antigens to T cells [57]. They are found in all tissues including blood and lymphoid organs. In peripheral tissues and in their 'immature' stage of development, DCs act as 12 INTRODUCTION sentinels continuously sampling the antigenic environment [57]. Any encounter with microbial products or tissue damage initiates the migration of the DCs to lymph nodes and their maturation process. Antigens are processed and presented on the DC surface as peptides bound to major histocompatibility complex (MHC) molecules. Concomitantly, DCs up-regulate co-stimulatory molecules that are required for effective interaction with T cells. In lymph nodes, mature DCs efficiently trigger the response of T cells bearing receptors specific for the foreign-peptide–MHC complexes on the DC surface. Besides them, DC can also present glycolipids and glycopeptides to T cells and NKT cells. In the steady state, DCs also migrate at a low rate without undergoing activation and, by presenting self-antigens to lymphocytes in the absence of co-stimulation they contribute to tolerance [58]. There are two main pathways of DC ontogeny from hematopoietic progenitor cells (HPCs), one pathway generates myeloid DCs (mDCs); while another generates plasmacytoid DCs (pDCs). Myeloid (or conventional) DCs are found in three compartments: in peripheral tissue, secondary lymphoid organs and blood. Peripheral blood myeloid dendritic cells (mDCs) differ from the other DC subsets by expression of CD11c and CD123dim, higher levels of MHC class II molecules and lower levels of CD62L. They are also characterized by the presence of CD2 and Fc receptors CD32, CD64 and FcεRI. Some myeloid DCs are also positive for CD14 and CD11b [59]. Peripheral blood myeloid DCs express TLR1, 2, 3, 4, 5, 6, 7, 8 and 10, but not TLR9 [60]. In the skin, two distinct types of mDCs are found in two distinct layers. Langerhans cells (LCs), which express CD1a and Langerin reside in the epidermis, while interstitial DCs (intDCs), which express DC-SIGN and CD14 reside in the dermis [58]. Epidermal Langerhans cells isolated from skin lack the expression of TLR4 and TLR5, while dermal interstitial DCs express many TLRs including TLR2, 4 and 5 [61]. 13 INTRODUCTION Figure 5. The current view of the ways in which the activation states of DCs can determine the nature of T-cell responses [57]. Numerous agents can activate DCs including microbes, dead cells, as well as innate and adaptive immune system components. Pathogenassociated molecular patterns (PAMPs) signal DCs and other cell types through a variety of pattern-recognition receptors (PRR) including Toll-like receptors (TLRs), cell surface C-type lectins receptors (CLRs) and intracytoplasmic NOD-like receptors (NLRs) [58]. Cells undergoing necrosis induce the maturation of DCs, and some components involved may enhance antigen presentation by DCs leading to T cell immunity. These endogenous activating molecules are collectively called damage-associated molecular pattern molecules (DAMPs) [62]. DCs can secrete a diversified panel of chemokines that attract different cell types at different times of the immune response [63]. They also express a unique set of co-stimulatory molecules among them early activation markers CD40, CD80 and CD86 [64] which permit the activation of naïve T cells promoting primary immune responses. Through the cytokines they secrete (e.g. IL-8/CXCL8, IL12, IL-23 or IL-10) as well as the surface molecules they express (e.g. 14 INTRODUCTION OX40-L or ICOS-l) DCs can contribute to polarize naïve T cells into Th1, Th2, Treg or Th17 [58]. 1.2.4 Granulocytes Polymorphonuclear neutrophils (PMNs or neutrophils) are an essential component of the innate immune system. Mature PMNs are incapable of cell division, and their sustained generation by the bone marrow at impressive numbers (1011 cells per day in a normal adult) is the result of a highly controlled process of myelopoiesis. Common myeloid progenitor (CMPs) divide and differentiate from the pluripotent haematopoietic stem cell and generate granulocyticmacrophage (GM) lineage progenitors. Their differentiation proceeds to committed stem cells, which provide granulocyte-restricted progenies. Once activated, neutrophils undergo a complex series of functional responses culminating in the destruction of invading microbes. These functions include chemotaxis to sites of infection, transmigration across capillary endothelium, phagocytosis of opsonized microbes, and killing of the pathogens. During maturation, neutrophils produce multiple enzymes critical to these functional responses, each packaged into primary (azurophil), secondary (specific) or tertiary (gelatinase) granules, lysosomes and secretory vesicles [65]. Azurophil (or primary) granules largely contain proteins and peptides directed toward microbial killing and digestion, whereas specific granules replenish membrane components and help to limit free radical reactions. Azurophil granules are the first to be produced and they contain MPO; three predominant neutral proteinases (i.e. cathepsin G, elastase, and proteinase 3); bactericidal/permeability-increasing protein (BPI); defensins and an abundant matrix composed of strongly negatively charged sulphated proteoglycans [65] that binds almost all the peptides and proteins other than lysozyme, which are strongly cationic. Specific granules contain unsaturated lactoferrin that binds and sequesters iron and copper, transcobalamin II that binds cyanocobalamin, about two thirds of the lysozyme, neutrophil gelatinase-associated lipocalin and a number of membrane proteins also present in the plasma membrane, including flavocytochrome b558 of the NADPH oxidase. Gelatinase or tertiary granules contain gelatinase in the absence of lactoferrin and may represent one end of the spectrum of a single type of granule with the same contents but in 15 INTRODUCTION differing proportions [65]. Acid hydrolases are found it the lysosomes. Endocytic vesicles contain serum albumin and provide a valuable reservoir of membrane components. Their re-association with the plasma membrane replenishes the membrane parts that were consumed during phagocytosis, as well its component proteins like complement receptor and flavocytochrome b558 [65]. In order to effectively eliminate pathogens neutrophils also produce superoxide anions (O2–) that are generated by the reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex. Once generated they are converted into potent microbicidal reactive oxygen species (ROS), such as hydroxyl radical, hydrogen peroxide (H2O2), and hyperchlorous acid [66]. Figure 6. Neutrophils deliver multiple anti-microbial molecules [67]. A variety of surface molecules regulates neutrophil functions[56]. FcR and CR are expressed on both neutrophils and monocytes playing a critical role in phagocytosis through pathways regulating cytoskeletal reorganization [68]. Neutrophils and monocytes express cell-adhesion molecules (selectins and integrins) that regulate their transendothelial migration into tissues [69]. Neutrophils also express different receptors for chemotactic factors that promote their migration. Among others, receptors specific for complement (i.e.C5aR), bacterial N16 INTRODUCTION formyl peptides (fMLP), platelet activating factor (PAF) and leukotriene B-4 (LTB-4) [70]. Besides serving as a first line of defense, they contribute to the recruitment, activation and programming of antigen presenting cells (Figure 7). Neutrophils generate chemotactic signals that attract monocytes and dendritic cells (DCs), and influence whether macrophages differentiate to a predominantly pro- or antiinflammatory type [67]. By proteolytically activating prochemerin to generate chemerin, neutrophils attract both immature DCs and plasmacytoid DCs [71] and by producing tumor-necrosis factor (TNF) and other cytokines they induce DC and macrophage differentiation and activation [72]. Moreover, neutrophils secrete TNF-related ligand B-lymphocyte stimulator (BLyS) [73] that induce B cell proliferation and maturation, and interferon-γ that promotes macrophage activation. Nevertheless, neutrophils can also function as powerful suppressors of T-cell activation by impairing the T-cell receptor (TCR) ζ-chain expression and cytokine production [74]. The ability of neutrophils to control lymphocyte activation is counteracted by the adaptive immune system regulation of the rate of neutrophil production via granulocyte colony-stimulating factor (G-CSF) production (Figure 6). Stromal-cell-derived G-CSF triggers bonemarrow neutrophils to release matrix metallo-proteinase 9 (MMP9) that helps to mobilize progenitor cells. In the same time, G-CSF also acts directly on the progenitors to increase their proliferation and suppresses stromal-cell expression of CXC-chemokine ligand 12 (CXCL12) which helps to retain neutrophils in the bone marrow. In turn, G-CSF production is regulated by interleukin-17 (IL-17), that is produced by a T cell subset. T-cell production of IL-17 is governed by IL-23, which is released from macrophages and is suppressed when macrophages ingest apoptotic neutrophils [67]. 17 INTRODUCTION Figure 7. Neutrophils interact with monocytes, dendritic cells, T cells and B cells in a bidirectional, multi-compartmental manner [67]. 18 INTRODUCTION 1.3 Immune receptor families in myeloid cells The innate immune response is regulated by an array of activating and inhibitory surface receptors [75]. In myeloid cells, recognition of a wide range of endogenous and exogenous ligands regulates cell differentiation, growth and survival, adhesion, migration, phagocytosis, cytotoxicity and cytokine secretion [76]. Biology and function of activating and inhibitory receptors involved in regulating these processes have been extensively explored in the last decade. However, the nature of ligand/s for a great number of them still remains unknown and for that reason the role that they have in the immune response is only partially understood. Immune receptors expressed by myeloid cells are often members of multigenic families that include both inhibitory and activating molecules. It is believed that both receptor types contribute to establish an activation threshold that determines the initiation, amplitude and the duration of the immune response triggered by pathogenic stimuli. Inhibitory and activating members of the same receptor family have similar extracellular regions but different transmembrane and cytoplasmic domains that confer them with distinct signaling properties; most of them can be classified as a C-type lectins or members of the immunoglobulin superfamily (IgSF). Our focus will be on superfamily members that are expressed by myeloid cells. 1.3.1 CD85 Members of the CD85/ILT/LIR/MIR family are characterized by either 2 or 4 homologous extracellular C-2 type Ig-like domains and subclassified by the structure of the transmembrane and cytoplasmic regions. They are related to other IgSF receptors whose genes are clustered in human chromosome 19, including human FcαR, LAIR, NKp46 and KIRs. Moreover, they are also homologous to murine gp49B1/B2 antigens and PIR-A and PIR-B receptors. Activating members expressed by myeloid cells CD85h, CD85h-like protein and CD85g have a short cytoplasmic domain that lacks recognizable docking motifs for signaling mediators. In addition, they are characterized by the presence of a single basic arginine residue within the hydrophobic transmembrane region [76, 77]. Activating CD85s associate with the gamma chain of Fc receptors (FcRγ) that contains a 19 INTRODUCTION negatively charged residue in the transmembrane region and which transduces the stimulatory signals by recruiting protein tyrosine kinases through its cytoplasmic ITAMs. CD85h (ILT1) is selectively expressed by myeloid cells and is able to induce intracellular Ca2+ mobilization in monocytes [77]. Human pDCs preferentially express another triggering member, CD85g (ILT7), that can inhibit Toll-like receptor-induced interferon production upon its association with the Fc epsilon RI gamma [78]. CD85g directly binds to and can be activated by bone marrow stromal cell antigen 2 (BST2; CD317) protein. The interaction between CD85g and CD317 functions to assure an appropriate TLR response by pDCs during viral infection and likely participates in pDC-tumor crosstalk [79]. By contrast, CD85a (ILT5), CD85j (ILT2), CD85k (ILT3) and CD85d (ILT4) contain cytoplasmic ITIMs [80-85]. When these receptors are engaged in close proximity to activating receptors, their ITIMs become phosphorylated by protein tyrosine kinases of the Src family. Phosphorylation of these residues creates the docking site for SH-2 domain containing phosphatases such as SHP-1 and SHIP, which deliver inhibitory signals by dephosphorylating ITAM-containing signal transduction molecules. It has been reported that upon ITIM tyrosine phosphorylation CD85j, CD85k and CD84d bind SHP-1 protein tyrosine phosphatase [81, 83, 84]. The mechanism of inhibition so far has been studied for CD85j in T cells, B cells and monocytes. In the CD85j-transfected Jurkat T cell line, receptor was tyrosine phosphorylated when engaged with the TCR by p56Lck kinase. In the same cells, crosslinking of CD85j and TCR reduced the CD3ξ phosphorylation. Similarly, CD85j was tyrosine phosphorylated in B cells when co-ligated with BCR [86]. In monocytes, Ca2+ mobilization and tyrosine phosphorylation triggered via either HLADR, the Fc gamma receptor II (FcγRII or CD32) or FcγRI (CD64) were inhibited when triggering receptors were co-engaged with CD85j or CD85d [83-85]. Peripheral blood monocytes express most CD85 members, while granulocytes express only CD85h and CD85a. Peripheral blood DCs express CD85h and/or CD85k and can be divided into two subsets based on differential expression of these two receptors [87]. The homology with KIRs originally suggested that CD85s might constitute receptors for MHC class I molecules. However, only CD85j 20 INTRODUCTION and CD85d were shown to interact with a broad range of cellular class I molecules, including HLA-A, -B, and -G [83]. In addition, CD85j was shown to bind the human cytomegalovirus (HCMV)-encoded class I molecule UL18. CD85g binds bone marrow stromal cell antigen 2 (BST2 or CD317). Other members of CD85 family are still ligand-orphan. 1.3.2 TREM Triggering receptors expressed by myeloid cells (TREMs) belong to the family that includes both activating and inhibitory isoforms and are encoded by a gene cluster on a human chromosome 6p21 that is linked to the MHC. TREMs have limited homology with other members of the immunoglobulin gene superfamily since their closest relative is NKp44, an activating NK-cell receptor [88]. More distant relatives of TREMs include the CD300 family members [89, 90] and a receptor for a polymeric immunoglobulin (PigR) [91]. The human TREM family contains at least one inhibitory (TREM-like transcript-1, TLT-1) and two activating receptors (TREM-1 and TREM-2) that both signal via DAP12. The activating isoforms are unique in that one receptor, TREM1, controls inflammation, whereas another, TREM-2, regulates the development and function of dendritic cells (DCs), as well as microglia and osteoclasts [91]. Human TREM-1 is expressed by peripheral blood neutrophils and a subset of monocytes/macrophages [92]. In normal tissues, TREM-1 is selectively expressed by alveolar macrophages [93]. Furthermore, TREM-1 is expressed at high levels by neutrophilic infiltrates and epithelial cells in human skin and lymph nodes after sepsis [94]. Coengagement of TREM-1 has been shown to stimulate the production of pro-inflammatory chemokines and cytokines such as IL-8/CXCL8, monocyte chemoattractant protein 1 (MCP1, CCL2), MCP3 (CCL7) and macrophage inflammatory protein 1 (MIP1, CCL3). Triggering of TREM-1 also induces granulocytes to release myeloperoxidase, but does not induce phagocytosis [92, 95]. Crosslinking of TREM-1 on LPS primed human monocytes induces the release of TNF and IL-1α. These findings indicate that TREM-1 acts as an amplifier of inflammatory responses initiated by TLRs [94]. Since LPS and other TLR ligands up-regulate the expression of TREM-1, it is reasonable to 21 INTRODUCTION believe that TREM-1 and TLRs cooperate in order to produce an inflammatory response (Figure 8). Figure 8. Schematic presentation of the role of TREM1 in inflammatory responses [91]. While the main role of TREM-1 is the responses of granulocyte and monocyte/macrophage, TREM-2 mainly controls the function of other myeloid cells, including DCs, osteoclasts and microglia. Ligation of TREM-2 immature monocyte-derived DCs induces their incomplete maturation [96]. Some data indicate that the TREM2– DAP12 pathway directs the differentiation of myeloid precursors towards the formation of mature DCs, osteoclasts, microglia and possibly oligodendrocytes but it is unclear how [91]. Even though TLT-1 displays two ITIMs and is able to recruit SHP-1 [97], some reports have shown that its cross-linking with FcεR induces calcium influx [98] and therefore promotes activation instead of inhibition. Despite the fact that some studies indicate the presence of TREM-1 ligand on human platelets [99] and that TREM-2 ligands could be 22 INTRODUCTION polyanionic bacterial products [100], TREM receptors are still considered to be ligand-orphans. 1.3.3 CD172 Signal regulatory proteins (SIRPs or CD172) comprise a family of transmembrane glycoproteins expressed in myeloid cells, including macrophages, monocytes, granulocytes, and DCs [86]. Structurally, CD172 receptors are characterized by three homologous extracellular Ig-SF domains. CD172a (SIRPα) displays cytoplasmic ITIMs, recruits SHP-2 and SHP-1, and inhibits receptor tyrosine kinase-coupled signaling pathways [101-103]. Interaction with SCAP2 (Src-family Associated Phosphoprotein 2), FYB (Fyn-binding protein) and Grb-2 have also been reported [101]. In the same time CD172a is able to induce early events in integrin signaling and to positively regulate the MAP-kinase signaling cascade in response to insulin when overexpressed in transfected cells [86] which suggest that in some circumstances CD172a may mediate stimulation rather than inhibition. CD172b (SIRPβ) contains a short cytoplasmic domain that lack cytoplasmic sequence motifs and associates with the transmembrane ITAM bearing adapter protein DAP12 [104]. DAP12 is required for cell surface expression of CD172b and it mediates activation in CD172b-transfected cells by promoting Syk and MAPK phosphorylation. CD172b signaling induces neutrophil migration [105] and triggers phagocytosis in macrophages [106]. The ligands for CD172a are shown to be CD47, an integrin-associated protein with multiple functions in immunological and neuronal processes [86] and surfactant proteins A and D [107]. Ligand/s for CD172b are still unknown. 1.3.4 CD200R The CD200 gene cluster is located on human chromosome 3q12-13 and contains CD200R and its ligand CD200 [108, 109]. Expression of the CD200R is restricted to the cells of myeloid lineages including monocytes, macrophages and DC. On the other hand, CD200 has been detected on the surface of thymocytes, B cells, activated T cells, neurons, endothelial cells and macrophages [110]. Both CD200 and its 23 INTRODUCTION receptor have two extracellular Ig domains, essential for their ligandreceptor interaction that was shown to modulate macrophage fusion and differentiation of osteoclasts [111, 112]. That CD200R is an inhibitory receptor that in contrast to other welldescribed myeloid-inhibitory immune receptors does not contain any immunotyrosine-based inhibitory motif (ITIM) and appears to deliver inhibitory signals via a novel myeloid cell inhibitory pathway. The crucial phosphorylation of CD200R is mediated through its tyrosine residue within the NPxY motif. Upon receptor clustering and tyrosine phosphorylation by Src, Dok1 and Dok2 adaptor proteins are recruited and subsequently bound RasGAP and SHIP allowing the downstream inhibition of the Ras MAPK pathways [113]. There is evidence supporting an immunoregulatory role for CD200 [110]. In particular, interaction with CD200R that is constitutively expressed by monocytic myeloid cells such as macrophages and dendritic cells represses their pro-inflammatory activation in vivo [114-118], reduces activation of MAPKs in mononuclear cells, and represses degranulation of human mast cells and basophils [119-121]. It is also probable that CD200 expressed by endothelium has a role in controlling circulating neutrophil degranulation, but this has not been directly tested. CD200R is the only definitively characterized receptor for CD200, and functional ligands for the activating isoforms of the receptor have yet to be found in humans or mice [110]. 1.3.5 SIGLEC The SIGLECs (sialic-acid-binding immunoglobulin-like lectins) are the best characterized immunoglobulin-type lectins belonging to IgSF [122]. They represent the type 1 membrane proteins with aminoterminal V-set immunoglobulin domain that binds sialic acid and variable numbers of C2-set immunoglobulin domains. Human monocytes express a great numbers of inhibitory SIGLEC molecules including Siglec-3 (CD33), Siglec-5 (CD170), Siglec-7 (CD328), Siglec9 (CD329) and Siglec-10 that are all sub-classified as CD33-releated SIGLECs. Siglec-11 is expressed exclusively by macrophages. Human neutrophils and myeloid (conventional) dendritic cells express Siglec-9 (CD329). 24 INTRODUCTION Figure 9. Siglec-family proteins in humans and rodents [122]. B, B cells; Ba, basophils; cDCs, conventional dendritic cells; Eo, eosinophils; GRB2, growthfactor-receptor-bound protein 2; ITIM, immunoreceptor tyrosine-based inhibitory motif; Mac, macrophages; Mo, monocytes; MyP, myeloid progenitors; N, neutrophils; ND, not determined; NK, natural killer cells; OligoD, oligodendrocytes; pDCs, plasmacytoid dendritic cells; Schw, Schwann cells; Troph, trophoblasts. Sialoadhesin (Siglec-1 or CD169), one of the largest memebrs of IgSF with 17 Ig domains in the extracellular part, was discovered as a sialicacid-dependent macrophage adhesion molecule [123]. Contrasting to most SIGLECs, sialoadhesin lacks tyrosine-based signaling motifs and its cytoplasmic tail is poorly conserved, which suggests a primary role as a binding partner in cell–cell interactions, rather than in cell signaling [122]. Sialoadhesin is constitutively expressed on subpopulations of tissue-resident macrophages [124] and is rapidly upregulated on inflammatory macrophages which indicate its contribution in their pro-inflammatory functions. 25 INTRODUCTION The CD33-related SIGLECs are mainly expressed by mature cells of the innate immune system, such as neutrophils, eosinophils, monocytes, macrophages, NK cells, DCs and mast cells (Figure 8). CD33 itself is a marker of myeloid progenitor cells, indicating a potential role for CD33 in the regulation of cellular proliferation and/or differentiation. There are great number of studies showing the important roles of CD33-related SIGLECs in modulating leukocyte behavior, including inhibition of cellular proliferation, induction of apoptosis, inhibition of cellular activation and induction of proinflammatory cytokine secretion [122]. The SIGLECs signaling pathways are poorly understood but in most cases they are assumed to involve ITIM and ITIM-like motifs and recruitment of tyrosine phosphatases [122]. 1.3.6 CD300 CD300 represents a multigenic family of leukocyte surface receptors belonging to the Ig superfamily, originally termed CMRF-35 and Immune Receptor Expressed by Myeloid cells (IREM), that is conserved in different mammalian species [125]. The human CD300 gene cluster is located in chromosome 17 (17q25.1). The molecules are encoded by genes with intron-exon structures that are conserved between human and rodents ,[126] (Figure 10). The locus contains six genes encoding for two inhibitory receptors (CD300a/IRp60 and CD300f/IREM-1), two activating receptors (CD300e/IREM-2 and CD300b/IREM-3), and two receptors with still undefined function (CD300c/CMRF-35 and CD300d/IREM-4). CD300g/Nepmucin is the most distantly related CD300 molecule encoded by a gene that is mapped upstream from the main complex (17q21). It shares similar IgV-like domain but is exclusively expressed by endothelial cells unlike the other family members [127]. In the close proximity to the CD300c/CMRF-35 gene is located a pseudogene (φ) that has a high degree of sequence similarity with CD300c [128]. 26 INTRODUCTION Figure 10. Shematic diagram showing the organization of CD300 gene complexes in (a) human and (b) mouse. Gene orthologues are shaded similarly. [126]. Murine orthologues of CD300 molecules are members of CD300L (CD300-Like) family with a gene custer located in mouse chromosome 11 that is syntenic to human chromosome 17 (25). It contains nine genes encoding for six triggering (CLM-2, -3, -4, -5, -6 and -7) and two inhibitory receptors (CLM-1 and CLM-8). CLM-9 is a counterpart of human CD300g and is also located upstream of the CD300L locus. It is of noteworthy that sequence homology in most cases is not correlated with functional similarity between human and mouse molecules. Only CD300g, CD300a and CD300f have clear orthologs within the murine locus. The CD300 molecules are type I transmembrane glycoproteins (Figure 11) with a single IgV-like extracellular domain and an extended membrane proximal region that is rich in prolines, serines and threonines, which links the Ig and transmembrane domains. The CD300 IgV domain contains a conserved amino acid motif YWCR and two disulfide bonds instead of one that makes them a distant relatives of Fc receptors for polymeric A and M, TREMs and CD336 (NKp46) [126]. The transmembrane domains of CD300b, CD300c, CD300d, and CD300e contain a charged amino acid residue, which enables association with other transmembrane adaptor molecules such as DAP12, whereas the cytoplasmic domains of CD300a and CD300f contain tyrosine-based signalling motifs, particularly immunoreceptor tyrosine-based inhibitory motifs (ITIM). 27 INTRODUCTION Figure 11. Schema of the individual CD300 molecules in (a) human and (b) mouse [126]. Distribution of CD300 molecules has been determined by a combination of mRNA and protein expression analyses when mAbs are available. CD300d and CD300f transcripts are present in high levels in the lung and CD300c in spleen and thymus. Expression of CD300 in peripheral blood (PB) leukocytes follows four patterns. First, CD300a and CD300c have a broad expression on leukocytes including CD34+ hematopoietic stem cells but not B lymphocytes nor a subpopulation of T lymphocytes [90][129-132]. Their surface expression on PB CD4+ T lymphocytes subdivides those cells into two naïve and two memory populations that have distinct functional and survival capabilities [133]. Second, transcripts for all CD300 molecules, except CD300g, are expressed by peripheral blood myeloid and DC lineages, although in vitro-generated monocyte-derived DC (moDC) down-regulate CD300a, CD300c and CD300f. There is still limited information on the cellular distribution of CD300b and CD300d due to the lack of available specific mAbs. Third, CD300e shows a restricted expression, being present only in some mature myeloid populations, monocytes and myeloid dendritic cells, and is also downregulated in in vitro-derived moDC [134, 135]. Finally, CD300g and its 28 INTRODUCTION mouse ortholog CLM-9 mRNA are not expressed by leukocytes but are expressed at high levels in the heart and in placenta [127]. Ligands for the CD300 molecules remain elusive. The data showing that a fusion protein expressing the CLM-1 IgV domain was able to bind to T cells, indicates that endogenous CD300 ligands probably regulate interactions between cells [136]. The high degree of amino acid identity between the CD300a and CD300c Ig domain sequences implies that they might bind similar ligands, eventually with different affinities [126]. CD300a was considered to be a potential NK cell inhibitory molecule, but it does not bind to HLA-class I molecules [129]. Despite the considerable sequence identity between the CD300 Ig domains and the Ig binding domains of the Poly Ig receptor, only CD300g has been shown to bind human Ig [89, 90, 127, 137, 138]. but its physiological relevance is unclear. Some CD300g isoforms can bind L-Selectin that is expressed in lymphocytes and is known to enhance lymphocyte adhesion [139]. 1.3.6.1 Human CD300 receptors CD300a The first characterized inhibitory member of CD300 family, CD300a (also termed Inhibitory Receptor protein 60, IRp60) is a type-I transmembrane glycoprotein that contains an extracellular V-type Ig domain, highly homologous to CD300c. Its cytoplasmatic region displays four tyrosine residues out of which three are in the context of ITIMs. Upon tyrosine phosphorylation these ITIMs are able to recruit SHP-1, SHP-2 and SHIP phosphatases [129]. The extracellular region of CD300a is highly N- and O-glycosilated in the membrane proximal region. CD300a is expressed by human NK cells, monocytes, neutrophils and a subset of CD3+ T cells [129, 130]. CD300a might be expressed on all NK clones, but not all NK clones could deliver an inhibitory signal, probably due to the presence of CD300c with whom CD300a shares a high degree of homology [140]. It is also expressed by eosinophils and mast cells [131, 132]. In human neutrophils CD300a is rapidly upregulated upon stimulation with LPS and GM-CSF [130] due to the translocation to the plasma membrane of the pre-synthesized receptor. 29 INTRODUCTION Treatment of cord-blood mast cells with human eosinophil-derived neurotoxin and major basic protein down-regulated the expression of CD300a [131]. In neutrophils, cross-linking of CD300a inhibits ITAM-initiated calcium influx and production of ROS [130]. Moreover, engagement of the receptor is able to inhibit NK cell mediated cytotoxicity upon recruitment of SHP-1 and SHP-2 [129]. In mast cells, CD300a inhibits the release of β-hexosaminidase and IL-4, as well as stem cell factormediated survival and differentiation [131, 132, 141]. In eosinophils, CD300a associates with SHP-1 and is able to inhibit eotaxin-induced transmigration, and secretion of TNF-α, IL-β1, IL-4 and IFN-γ [132]; it also suppresses the anti-apoptotic effects of IL-5 and GM-CSF. CD300b CD300b (also known as IREM-3) is an activating member of the CD300 family. The extracellular region of CD300b displays a single Vtype domain, followed by membrane proximal region, transmembrane domain containing positively charged lysine residue and short cytoplasmatic tail with tyrosine-based motif [142]. In transfected cells, CD300b was able to interact with DAP12 and deliver activating signals through this ITAM-bearing adaptor protein. In addition, a tyrosine-based motif in the cytoplasmatic tail of CD300b is able to recruit growth-factor receptor-bound protein 2 (Grb-2) in a phosphorylation dependent manner [142]. In the absence of specific monoclonal antibodies, information about CD300b expression was obtained using RT-PCR. CD300b transcripts were found abundantly in human monocytes and myelomonocytic cell lines [142], as well as in a wide set of human tissues, including colon, lung, placenta, bone marrow and fetal liver. Cross-linking of CD300b on the surface of a RBL/CD300b transfectant resulted in NFAT/AP-1-dependent transcriptional activity and hexosaminidase release both in the presence and absence of DAP12, suggesting the association with an unknown adaptor in RBL cells that would account for DAP12-independent signaling [142]. 30 INTRODUCTION CD300c Despite being the first cloned member of the CD300 family back in 1992 as a CMRF-35A, precise information about its function and expression pattern is still unclear. None of the recently generated antiCD300c mAbs could discriminate between CD300a and CD300c, since these two molecules show 80% identity at the amino acid level in their Ig domains [140]. RT-PCR analyses indicate the presence of CD300c transcripts in all peripheral blood populations at a different level. A higher expression was found in monocytes, CD34+ cord blood and NK cells. Both CD4+ and CD8+ T cells, together with plasmacytoid and CD11c+ blood DC have lower expression of CD300c [126]. The CD300c transcripts encode for a type-I transmembrane protein with single extracellular V-type Ig domain followed by a membrane proximal region, a transmembrane domain bearing a positively charged glutamic acid and a short cytoplasmatic domain [143]. Very recently it has been shown that CD300c receptor is able to deliver activating signals in transfected RBL-2H3 mast cells and that its signaling was partially mediated by association with FcεRγ [144]. CD300d CD300d is a recently cloned gene that, according to RT-PCR expression analysis, is present at high levels in the lung, monocytes and CD11c+ blood DC [126]. Sequence analysis predicts that CD300d is structurally similar to other triggering CD300 members, having a short cytoplasmatic tail with no signaling motifs and a positively charged lysine residue within its transmembrane domain (Figure 11). At the moment no information about its function and cellular distribution is available. CD300e CD300e was originally termed IREM-2 and according to the sequence analysis and some data obtained with transfected cells, corresponds to a triggering receptor. Like the other CD300 molecules, it consists of a single V-type Ig domain, a transmembrane domain bearing a lysine residue and a short cytoplasmatic tail [134]. CD300e expression is restricted to cells of myeloid origin, and in peripheral blood CD300e can be detected on the surface of monocytes and myeloid DC [134, 135]. On the other hand, monocyte31 INTRODUCTION derived dendritic cells generated in vitro and myeloid cell lines do not express CD300e [134]. CD300e is displayed at a relatively late stage of monocyte differentiation, when precursors have already acquired high levels of CD14 and CD64 [134]. CD300e transcripts were detected in bone marrow, thymus, lungs and spleen [126]. In a CD300e/RBL transfectant engagement of the receptor was able to induce transcriptional activity and it interacted with DAP12 in transiently transfected COS-7 cells [134]. Even though it was shown that CD300e engagement can induce TNF-α secretion in human monocytes information regarding its functional role remained rather limited. CD300f CD300f also known as IREM-1 is another inhibitory member of the family. It is composed of a single V-type Ig domain, a membrane proximal region followed by a transmembrane region and a long cytoplasmatic tail with five tyrosine residues [145]. Two of them are in the context of ITIMs and two provide docking sites for the p85α regulatory subunit of PI3K. CD300f transcripts are present in the spleen and lungs and are found at high levels in monocytes, neutrophils, mast cells, eosinophils, and CD11c+ DC [126]. CD300f has been detected on the surface of monocytes and neutrophils by using specific mAbs [145]. CD300f was able to recruit SHP-1 in a phosphorylation dependent manner and one of the ITIMs was shown to be essential for this interaction [145]. The inhibitory role of CD300f was studied in CD300f transfected RBL cells, where it was shown that its engagement prevents activation induced by signals delivered through the FcεRI [145]. In the same experimental system, CD300f was able to recruit the p85α subunit of PI3K and deliver activating signals when ITIMs and the distal tyrosine-based motif were disabled. Moreover, in myeloid cell lines CD300f can bind both SHP-1 phosphatase and p85α simultaneously consistent with a putative functional duality of the receptor [146]. CD300g The CD300g or nepmucin is a distant member of the CD300 family. The gene encoding for CD300g is mapped at some distance from the 32 INTRODUCTION main gene cluster. CD300g contains a single V-type immunoglobulin (Ig) domain and a mucin-like domain, a transmembrane region and a long cytoplasmatic tail lacking the structural features suggestive of stimulatory or inhibitory potential [127]. Unlike other CD300 members, CD300g is not expressed by leukocytes. Instead its expression is restricted to endothelial cells [139]. CD300g transcripts were identified abundantly in heart and placenta [127]. CD300g was shown to mediate L-selectin-dependent lymphocyte rolling and promotes lymphocyte adhesion [139]. Moreover, it is the only CD300 member shown to bind Ig, inlcuding human IgA2 and IgM but not IgG [127, 138]. 1.3.6.2 Mouse CD300 receptors CLM-1 CLM-1 encoded by CD300LF gene, was the first identified murine CD300 molecule and thus far the best characterized. It the literature it can also be found under the following names: DIgR2, MAIR-Va/b and LMIR32 [136, 147-149]. The CLM-1/LMIR3/MAIRVa and DIgR2/MAIRVb are two alternative slicing variants of the molecules that differ in seven amino acids. CLM-1 is functional and the orthologue of human CD300f. It contains within the cytoplasmatic tail two ITIMs, a potential PI3K docking site and an additional tyrosine residue in the context of a putative SAP (SLAM-associated protein) motif. Through ITIMs, CLM-1 is able to recruit SHP-1 and SHP-2 upon tyrosine phosphorylation but not SHIP [136, 150, 151]. Phosphorylated CLM1 also associates with PI3K Grb-2 and, unexpectedly, with FcRγ in bone-marrow derived mast cells (BMMCs) [151]. The receptor is expressed in myeloid cells such as granulocytes, dendritic and mast cells [126]. CLM-1 expression in granulocytes is up-regulated by TLR4 ligand and G-CSF [149]. 2 CLM - CMRF-35 like molecule; DIgR – Dendritic cell-derived Ig-like Receptor ; MAIR – Myeloid-Associated Ig-like Receptor; LMIR – Leukocyte Mono-Ig-like Receptor; IgSF – Immunglobulin superfamily 33 INTRODUCTION The inhibitory role of the CLM-1 was studied in the myeloid differentiation process and regulation of DC priming. It was shown that receptor engagement inhibits differentiation of myeloid cells to osteoclasts in response to RANKL and TGFβ [150] and prevents dendritic cell-initiated antigen-specific Th1 responses [136]. It was recently reported that CLM-1 cross-linking enhanced cytokine production of BMMCs stimulated with LPS, while suppressing the production stimulated by other TLR agonists and stem cell factor [151]. This data support that CLM-1 has a dual function in mouse BMMCs as proposed for the human CD300f receptor [146]. Inhibitory signals were mediated by SHP-1 and SHP-2 phosphatases, whereas the activating signal was dependent on its association with FcRγ. An additional inhibitory role of CLM-1 was recently identified in the experimental autoimmune encephalomyelitis, a preclinical model of multiple sclerosis, where it was shown that the receptor acts as a negative regulator of myeloid effector cells in demyelination [152]. In several transfected cell types, CLM-1 engagement induced apoptosis through the caspase- and endoplasmic reticulumindependent mechanisms [148]. CLM-5 was identified as an activating counterpart of CLM-1 [137, 138, 149]. Other CLM molecules The CLM-2 (also termed MAIR-VIII and IgSF18) is encoded by CD300E gene and represents a mouse orthologue of human CD300e activating receptor. Thus far, there is no available information regarding its expression or functional role. CLM3 or MAIR-VI is another member of the mouse CD300 family that has not been characterized so far. CLM-4, also known as MAIR-II, DIgR1 and IgSF7 is encoded by CD300LD gene. Even though it is the orthologue of CD300d, structurally it is more similar to CD300b. It is expressed by peritoneal, spleen and bone marrow-derived macrophages and a small subset of B cells in the spleen that upon LPS stimulation up-regulate its expression [153]. CLM-4 transcripts were found in antigen-presenting cells, including DC, monocytes/macrophages and are highly abundant in spleen, granulocytes and NK cells [126, 154]. CLM-4 is able to bind DAP12 in resting and LPS-stimulated B cells isolated from spleen and peritoneum [153, 155]. In peritoneal and bone marrow derived macrophages CLM-4 interacts with another ITAM-bearing adaptor 34 INTRODUCTION FcRγ [155]. CLM-4 engagement in peritoneal and spleen macrophages results in the release of TNF-α, IL-6 and MCP-1[153, 155] . CLM-5 (also termed as MAIR-IV and LMIR-4) is preferentially expressed by peripheral blood neutrophils, bone marrow and spleen. It is also expressed by bone marrow and spleen macrophages and CD11c+ DC [156]. Stimulation of granulocytes with LPS resulted in complete down-regulation of CLM-5 [149]. Upon cross-linking in mast cells, it induces IL-6, TNF-α, histamine secretion and cell survival [149]. CLM-5 was reported to be the activating counterpart of the inhibitory CLM-1 [137, 149]. In mast cells and granulocytes CLM5 synergizes with TLR4 [149] and additionally in mast cells also with FcεR [149]. In transfected cell and peritoneal macrophages CLM-5 was shown to associated with FcRγ [156]. CLM-6 corresponds to the orthologue of human CD300c and is also termed MAIR-III and LMIR2. It is a type I transmembrane protein, with a single extracellular variable Ig domain that shares about 90% amino acid identity with CLM-8. This indicates that CLM-8 and CLM6 represent a pair of molecules that regulate mast cell-mediated inflammatory responses. In COS-1 transfectants CLM-6 is associating with DAP10, DAP12, and FcRγ adaptor proteins [138]. The expression pattern of CLM-6 is still poorly defined. CLM-7 (also termed LMIR5, MAIR-VII, IgSF17, mIREM-3 and CD300Lb) is the orthologue of CD300b. The molecule was detected in the spleen and peritoneal macrophages, granulocytes and spleen DCs. Mast cells and in vitro derived bone-marrow populations also express CLM-7 [157]. Cross-linking of transduced CLM-7 in bone marrow-derived mast cells (BMMCs) triggered activation, promoting cytokine and chemokine production (TNF-α, IL-6 and MCP-1), cell survival, degranulation, and adhesion to the extracellular matrix. In the same cells CLM-7 was shown to associate with both DAP12 and DAP10 [157]. Very recently T cell Ig mucin 1 (TIM1) was identified as a ligand for CLM-7 [158]. CLM-8 is also known as MAIR-I, LMIR1 and CD300La. It has the typical structure of inhibitory receptors with five tyrosine residues in cytoplasmatic tail in the context of ITIMs. Through those residues CLM-8 is able to bind SHP-1, SHP-2 and SHIP phosphatases in transfected cells [138, 159] but only SHIP in BMMCs [138, 153]. 35 INTRODUCTION CLM-8 has a wide expressional pattern. It is present in myeloid cells, including monocytes, neutrophils, eosinophils and basophils, peritoneal and spleen macrophages, spleen DCs, a small subset of B cells isolated from spleen and in bone-marrow-granulocytes and mast cells. It can also be induced on the surface of NK cells in response to IL-12 [153, 160]. The functional role of CLM-8 was broadly studied in mouse models of allergy since it is highly expressed by mast cells and eosinophils. Cross-linking of CLM-8 in the mouse model of asthma resulted in decreased secretion of Th2 cytokines and mast cells mediators including IL-4, IL-5, IL-13, tryptase and eotaxin-2 [141, 160]. Engagement of CLM-8 impaired mast cell degranulation and anaphylactic reactions in the passive cutaneous anaphylaxis model [141, 161]. CLM-8 was also shown to inhibit both IgE-dependent serotonin and hexosaminidase release [153, 159]. Nepmucin or CLM-9 is the Ig domain-containing sialomucin and orthologue to human CD300g receptor. Unlike the other CLM members it is expressed in vascular endothelial cells of various tissues including those of high endothelial venules in lymph nodes [139]. There nepmucin supports L-selectin-dependent lymphocyte rolling through its mucin-like domain and mediates lymphocyte binding through its Ig domain. Nepmucin-expressing endothelial cells also showed enhanced lymphocyte transendothelial migration and it is suggested that endothelial nepmucin promotes this by using multiple adhesion pathways [162]. 36 INTRODUCTION 37 INTRODUCTION 38 Aims 39 40 2. AIMS The present work was originally developed in the context of the project focused on the characterization of CD300e/IREM-2 and CD300f/IREM-1 myeloid cell receptors. The main aims were: 1. To functionally characterize CD300e in human monocytes and myeloid dendritic cells and investigate the implications that its engagement has on cells that naturally express the receptor. 2. To examine the functional role of the inhibitory CD300f receptor in human granulocytes. 41 42 Results 43 44 3. RESULTS 3.1 Article 1: Functional analysis of the CD300e receptor in human monocytes and myeloid dendritic cells Eur J Immunol. 2010 Mar; 40(3):722-32. 3.2 Article 2: Engagement of CD300e induces the differentiation of human monocytes to macrophages involving an autocrine M-CSF-dependent pathway Submitted manuscript 3.3 Appendix I Functional characterization of CD300f inhibitory receptor in human granulocytes Preliminary results 45 46 Article 1: Functional analysis of the CD300e receptor in human monocytes and myeloid dendritic cells Eur J Immunol. 2010 Mar; 40(3):722-32 47 Brckalo T, Calzetti F, Pérez-Cabezas B, Borràs FE, Cassatella MA, López-Botet M. Functional analysis of the CD300e receptor in human monocytes and myeloid dendrictic cells. Eur J Immunol. 2010; 40(3): 722-32. 48 RESULTS: ARTICLE 1 74 RESULTS: ARTICLE 1 75 RESULTS: ARTICLE 1 76 Article 2: Engagement of CD300e induces the differentiation of human monocytes to macrophages involving an autocrine M-CSFdependent pathway Submitted manuscript 77 78 RESULTS: ARTICLE 2 Engagement of CD300e induces the differentiation of human monocytes to macrophages involving an autocrine M-CSF-dependent pathway Tamara Brckalo*, Diogo Baia*, and Miguel Lopez-Bótet*(†) (*) Immunology Unit, Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain; (†)IMIMHospital del Mar, Barcelona, Spain Key words: human, differentiation, M-CSF monocytes, macrophages, CD300, cell Correspondence: Miguel López-Botet, Immunology Unit, Department of Experimental and Health Sciences, University Pompeu Fabra, Dr Aiguader 88, 08003 Barcelona, Spain; fax. +34933160410, email: [email protected] Abbreviations: IREM, Immune receptor expressed by myeloid cells; DAP, DNAX-activating protein; DC, dendritic cells; FADD, Fasassociated death domain ; FLIP-L, FLICE Inhibitory protein L ; OxLDL, oxidized low-density lipoprotein; MΦ, macrophages; CD300e MΦ, macrophages obtained by stimulating monocytes with antiCD300e mAb; MΦ1, classically activated macrophages; MΦ2, alternatively activated macrophages; moDC, monocyte derived dendritic cell; PAK2, p21-activated protein kinase 2; ROS, reactive oxygen species; RIP1, Receptor-Interacting Protein 1; pMΦ, human peritoneal macrophages. 79 RESULTS: ARTICLE 2 ABSTRACT Human monocytes may alternatively differentiate to dendritic cells or macrophages depending on the nature of the environmental signals. In vitro monocytes stimulated with M-CSF or GM-CSF yield the socalled alternatively (MΦ2) or classically activated macrophages (MΦ1), respectively. Cross-linking of the CD300e receptor restricted to the monocytic lineage was reported to promote cell activation and survival. We provide evidence supporting that CD300e engagement led to monocyte differentiation to macrophages displaying a CD14brightCD16+CD163low/negCD1a-CD11bbrightCD209phenotype. Upon stimulation with LPS these cells exhibited a low respiratory burst but high phagocytic activity, and mainly produced IL-10, thus resembling type 2 macrophages (MΦ2). Monocyte differentiation induced by CD300e was inhibited by anti-M-CSF and anti-CD115 (CSF-1R or M-CSF R) mAbs. CD300e engagement did not upregulate CD115 surface expression but rather enhanced its internalization associated to M-CSF production. Detection of caspase3 active fragments in monocytes activated via CD300e further indirectly supported M-CSF/CD115 involvement in the differentiation process. Overall, our data indicate that CD300e regulates monocyte differentiation to functional MΦ2 macrophages by a mechanism that entails an autocrine production and consumption of M-CSF. 80 RESULTS: ARTICLE 2 INTRODUCTION Differentiation of monocytes to macrophages (MΦ) or dendritic cells (DC) depends on environmental factors encountered during migration to peripheral tissues [172, 184-186]. A number of in vitro conditions have been reported to induce different patterns of monocyte differentiation. Monocytes differentiate to immature dendritic cells in the presence of serum from systemic lupus erythematosus patients that contains IFN-α [187], in response to IL-4 plus GM-CSF produced by mast cells [162-164] and also upon transendothelial trafficking [188]. Culturing monocytes in the presence of GM-CSF together with either LPS, TNF-α or calcium ionophore leads to their differentiation to mature dendritic-like cells [189, 190]. DCs that have features of Langerhans cells can be obtained in culture with TGF-β or GM-CSF plus IL-15 [191]. On the other hand, monocyte differentiation to macrophages is efficiently induced in the presence of either macrophage colony-stimulating factor (M-CSF or CSF-1) [192, 193] or granulocyte/macrophage colony-stimulating factor (GM-CSF or CSF-2) [194] . In addition, , interleukin 32 (IL-32) [195], human cytomegalovirus (HCMV) infection [196] and oxidized low-density lipoprotein (Ox-LDL) [197] can also induce differentiation of monocyte to macrophage-like cells. Some cytokines such as IL-10 [198], IL-6 [199] and IFN-γ [200] are able to switch monocyte differentiation from dendritic cells to macrophages either inducing MCSF secretion or up-regulating surface expression of the M-CSF receptor (CD115 or CSF-1R). Recently, Toll-like receptor (TLR) activation of human monocytes has been reported to induce differentiation to macrophages and dendritic cells, by up-regulating IL-15 and IL-15-R and GM-CSF and CD114 (GM-CSF-R), respectively [201]. M-CSF is the main regulator of survival, proliferation and differentiation of mononuclear phagocytes, which include monocytes, macrophages, osteoclasts, and their precursors [202, 203]. M-CSF is detected in the circulation under steady-state conditions and may be produced in vitro by several cell types including fibroblasts, endothelial cells, stromal cells, macrophages, smooth muscle cells and osteoblasts [204]. The M-CSF receptor, encoded by the protooncogene Csf1r [205] is a tyrosine kinase exclusively expressed on mononuclear phagocytes. Binding of M-CSF to CD115 induces receptor dimerization, autophosporylation of cytoplasmatic tyrosine residues and phosphorylation of signaling proteins (e.g. SHP-1, Src 81 RESULTS: ARTICLE 2 kinases, PLC-γ, PI(3)K, Akt and Erk) [206]. The M-CSF/CD115 complex undergoes internalization and further degradation by lysosomes. CD115 signaling was shown to be essential for cell survival [207] and their entry into the S phase of cell cycle [208]. CD300e is an activating receptor selectively expressed by mononuclear cells (i.e.) that has been shown to trigger various inflammatory responses in peripheral blood monocytes and mDCs, including intracellular calcium mobilization, respiratory burst activity, upregulation of surface markers and cytokine production [209]. CD300e is expressed at a relatively late stage of the monocyte maturation process, when their precursors have already acquired high levels of CD14 [134], and has been used as a specific monocyte marker [135]. We recently reported that cross-linking of CD300e promoted monocyte survival by a still unknown mechanism [209]. In the present study, we addressed whether prolonged survival of monocytes was eventually associated to their differentiation. Our results indicate that CD300e ligation leads to differentiation of monocytes to macrophages that show an anti-inflammatory or alternatively activated (MΦ2) profile, according to the expression of specific surface markers, cytokine secretion and phagocytic activity. Moreover, CD300einduced monocyte differentiation appeared mediated by an autocrine effect of M-CSF associated with caspase-3 activation. Our results support that activation through a monocyte-specific receptor results in their differentiation into functional macrophages. 82 RESULTS: ARTICLE 2 MATERIALS AND METHODS Isolation and differentiation of monocytes Human peripheral blood samples were obtained from healthy donors according to guidelines approved by the Clinical Research Ethical Committee (CEIC-IMAS). Peripheral blood mononuclear cells (PBMCs) were isolated under the endotoxin-free conditions from fresh blood by Ficoll-Paque PLUS centrifugation (GE Healthcare BioSciences AB, Uppsala, Sweden) and extensively washed with PBS for platelet removal. Monocytes were isolated from total PBMC by negative selection using the EasySep™ Human Monocytes Enrichment Kit without CD16 Depletion (StemCell Technologies, Seattle, WA, USA) following the manufacturer’s guidelines. Purity of cell preparation was assessed by FACS using the CD14 as a monocyte marker. 80-95% cells were CD14+ and viability was greater than 98% according to Trypan blue exclusion staining (Sigma Aldrich, Sent Lois, MO, USA). Monocytes were cultured at 1 x 106 cells/ml in RPMI1640/Glutamax source medium (Invitrogen Life Technologies, Paisley, UK) supplemented with 10% (v/v) heat-inactivated fetal calf serum with low endotoxin level (Greiner Bio-One GmbH, Frickenhausen, Germany) at 37OC in 5% CO2 atmosphere and endotoxin-free conditions. Differentiation of monocytes into alternatively activated macrophages (MΦ2) or classically activated macrophages (MΦ1) was performed in the presence of M-CSF (100 ng/ml, ImmunoTools GmbH, Friesoythe, Germany) or GM-CSF (50 ng/ml, R&D Systems, Minneapolis, MN, USA), respectively. In order to differentiate monocyte to dendritic cells GM-CSF plus IL-4 (bouth from R&D Systems, Minneapolis, MN, USA) were used at 50 ng/ml and 25 ng/ml, respectively. In vitro stimulation of monocytes with anti-CD300e mAb For cell activation through the CD300e receptor, an agonistic antiCD300e mAb (clone UP-H2, IgG1) was used [134]. Flat-bottom 24 well plates (Greiner Bio-One, GmbH, Frickenhausen, Germany) were coated with 10 μg/ml of anti-CD300e or isotype-matched control mAb MOPC-21 (mouse IgG1, from Sigma Aldrich, Sent Luis, MO, USA) for 3-4 hours at 37oC. Freshly isolated monocytes were added to the wells at a concentration of 1 x 106/ml and cultured for 6 days. MCSF and IL-6 neutralizing antibodies (both from R&D Systems, Minneapolis, MN, USA) were used as previously described [199]. 83 RESULTS: ARTICLE 2 Briefly, anti-M-CSF mAb was added to the cultures at 0.5 µg/ml at days 0 and 3; neutralizing anti-IL-6 mAb was used at daily doses of 2.5 µg/ml. Neutralizing anti-CD115 mAb was also used at 0.5 µg/ml at days 0 and 3 (Santa Cruz Biotechnology, San Diego, CA, USA). Flow cytometry analysis Cells were incubated on ice in 15% human serum to block Fc receptors in a round bottom 96-well culture plate (Corning Incorporated, Corning, NY, USA). The following murine monoclonal antibodies were used: PE-conjugated anti-CD1a, anti-CD14, antiCD16 (BD Biosciences, San Jose, CA, USA), anti-CD163 (BioLegend, San Diego, CA, USA). For indirect staining, cells were incubated with either anti-CD11b (mouse IgG1, clone BEAR-1), anti-CD209 (clone MAB161, IgG2b), anti-cleaved caspase-3 mAb (clone 5A1E, Cell Signaling Technology, Danvers, MA, USA) or anti-CD115 (clone 24A5, Santa Cruz Biotechnology, San Diego, CA, USA) followed by either PE-conjugated rabbit anti-mouse IgG (DakoCytomation Denmark A/S, Glostrup, Denmark), FITC-conjugated goat anti-rat IgG1/2 (BD Pharmingen, San Diego, CA, USA) or PE-conjugated goat anti-rabbit IgG (Sigma Aldrich, Sent Lois, MO, USA). For each staining the appropriate PE-, or FITC- isotype controls were included (ImmunoTools GmbH, Friesoythe, Germany) and cells were analyzed by flow cytometry (FACSCalibur, Becton Dickinson, San Jose, CA, USA) . For each staining at least 10 000 events were collected and data analysis was performed using the FlowJo software (Three Star, Ashland, OR, USA). To compare the staining intensity of different samples we calculated the ratios between the geometric mean fluorescence intensity (geo MFI) of samples and isotype-matched controls (MFI=geo MFIsample/geo MFIisotype control). The number of cells (Y axis) was normalized for the different overlaid samples and represented as “% of Max” using the FlowJo software. Intracellular staining In order to detect the active fragment of caspase-3 we performed the intracellular staining with anti-cleaved caspase-3 mAb (clone 5A1E, Cell Signaling Technology, Danvers, MA, USA) according to manufacturer’s instructions. Briefly, monocytes incubated for 72h with either anti-CD300e, M-CSF or GM-CSF plus IL-4 were collected and fixed with 4% formaldehyde. Cells were then permeabilized with 90% methanol and incubated on ice for 30 minutes. After blocking with 84 RESULTS: ARTICLE 2 0.5% BSA in PBS, cells were incubated with anti-cleaved caspase-3 mAb followed by conjugated secondary antibody and analyzed by flow cytometry. Production of reactive oxygen intermediates Production of superoxide anion (O2_) was assayed by detection of reduced Cytochrome c as previously described [209]. PMA at the concentration of 4 µg/ml was used to trigger the respiratory burst in macrophages. Cytokine detection Cytokines were detected in cell free culture supernatants using commercial ELISA kits for IL-6, IL-10, TNF-α (all from ImmunoTools GmbH, Friesoythe, Germany), IL-12p70 (Bioscience, San Diego, CA, USA) and M-CSF (R&D Systems, Minneapolis, MN, USA). Detection of phagocytosis Phagocytic activity was evaluated by the internalization of PE-labeled polystyrene microspheres (FluoresbriteR Polychromatic red microspheres 1μm, Polysciences, Warrington, PA, USA) as described elsewhere [210]. At the end of the culture cells were harvested, incubated with PE-labeled polystyrene microspheres (E:T ratio 1:25) for 60 and 120 minutes at 37OC and then transferred to ice. Samples were washed twice with ice cold PBS, fixed with 1% paraformaldehyde in PBS and analyzed by FACS. Phagocytic activity was quantified as the percentage of PE-positive events detected by flow cytometry (FACScan, Becton Dickinson, San Jose, CA, USA). Data analysis was carried out using the FlowJo software (Three Star, Ashland, OR, USA). 85 RESULTS: ARTICLE 2 RESULTS Engagement of CD300e in monocytes promotes their differentiation to M2-like macrophages We have recently reported that activation via CD300e triggers the prolonged survival of monocytes in culture [209]. Monocytes cultured for 6 days in anti-CD300e mAb-coated plates displayed morphological changes suggestive of an ongoing differentiation process and were firmly attached to the wells (Figure 1A, magnification x200). By contrast, a marked loss of viability (<1%) was observed in monocytes cultured over the control IgG1 mAb (MOPC-21), thus indicating that survival and differentiation could not be attributed to FcR engagement (data not shown). Flow cytometry analysis of cells recovered after CD300e engagement revealed that they displayed a CD14brightCD11bbright CD16+ phenotype; moreover, they were negative for CD1a and CD209 (DC-SIGN), but expressed CD163, an MΦ2 specific marker (Fig 1B and data not shown). As compared to MΦ1 and MΦ2 differentiated in parallel with GM-CSF and M-CSF, respectively, CD300e MΦ clearly resembled anti-inflammatory macrophages (MΦ2). These cells are characterized by a high IL-10 production, associated to low secretion of pro-inflammatory cytokines such as IL-6, IL-12 and TNF-α [194, 211]. The pattern of cytokine production by CD300e MΦ was assessed measuring IL-10, IL-6, IL-12p70 and TNF-α secretion upon stimulation with LPS. Though cytokine production levels were lower than those detected in MΦ2 generated with M-CSF, CD300e MΦ produced higher amounts of IL-10 as compared to IL-6 or TNF-α, whereas no IL-12p70 was detected (Fig 2A and data not shown). Thus, according to their cellular phenotype and cytokine secretion pattern, CD300e derived macrophages resembled antiinflammatory macrophages. Phagocytosis and respiratory burst activity of CD300e M An important functional characteristic of MΦ2, as compared to MΦ1 and moDC, is their higher capacity for antigen uptake, in particular that of early apoptotic cells [211]. We assessed the capacity of CD300e derived MΦ for uptaking polystyrene-PE labeled microspheres (1μm) by FACS, and quantified phagocytic activity as the percentage of PEpositive events (Fig 2B). Similarly to MΦ2, CD300e MΦ exhibited a higher uptake of microspheres as compared to MΦ1 at 1h (CD300e 86 RESULTS: ARTICLE 2 MΦ 56.9 ± 2.2 %; MΦ2 43.9 ± 1.1%; MΦ1 23.4 ± 1.1% ) and 2h of incubation (CD300e MΦ 82.2 ± 1.1%; MΦ2 81.3 ± 1.3%; MΦ1 46.4 ± 2.3%) suggesting that CD300e MΦ share phagocytic properties with MΦ2. The production of ROS by activated macrophages is known to play a key microbicidal role contributing also to inflammation [212, 213]. Thus, we tested the ability of CD300e MΦ to generate ROS in response to PMA, as compared to MΦ1 and MΦ2. As shown in Fig 2C, superoxide anion production was detected in all three types of macrophages, being considerably higher in both MΦ1 (332.8 ± 80.2 nmol/106 cells) and MΦ2 (366.6 ± 92.4 nmol/106 cells) as compared to CD300e MΦ (162.3 ± 3.2 nmol/106 cells). It is of note that basal respiratory burst was virtually undetectable in CD300e MΦ (1.5 ± 2.2 nmol/106 cells) whereas it was relatively high in MΦ2 and MΦ1 (46.9 ± 2.1 and 84.1 ± 6.6 nmol/106 cells, respectively) which might be a consequence of M-CSF and GM-CSF priming of differentiated macrophages. Expression of co-stimulatory molecules An effective antigen presentation by activated macrophages to T cells involves the CD80 and CD86 co-stimulatory molecules [214]. Thus, we examined their expression upon stimulation of the the three different MΦ populations with LPS. It is of note that basal expression levels of CD80 were different, being higher in M1Φ and lower in CD300e MΦ; by contrast CD86 expression was comparable (Fig 3). Beyond the differences in their basal levels of CD80, both CD300e MΦ and M2Φ increased its expression in response to LPS, downregulating CD86, as reported for M2Φ [50]. By contrast, activation of M1Φ with LPS resulted in a marked up-regulation of both costimulatory molecules. These results support that CD300e MΦ may display a reduced T cell-stimulatory capacity upon LPS exposure, further supporting their functional resemblance with M2Φ. Autocrine M-CSF and CD115 play a central role in monocyte-tomacrophage differentiation induced by CD300e engagement M2Φ are generated in vitro in the presence of exogenous M-CSF, the most potent macrophage differentiation factor described [172]. Taking into account the resemblance of M2Φ to CD300e MΦ [172], we addressed the putative autocrine contribution of M-CSF and its receptor (CD115). We considered the possibility that CD300e stimulation might induce M-CSF secretion and/or CD115 expression. 87 RESULTS: ARTICLE 2 As shown in Fig 4, a neutralizing anti M-CSF mAb markedly decreased the number of differentiated macrophages recovered (antiCD300e: 360 ± 19 x103 cells; anti-CD300e plus anti-M-CSF 166 ± 6 x103 cells). Similar results were obtained when CD300e stimulation was carried out in the presence of an antagonistc anti-CD115 (M-CSF R) mAb (anti-CD300e: 431 ± 44 x103 cells; anti-CD300e plus antiCD115 281 ± 6 x103 cells) (Fig 4D). To assess M-CSF production by CD300e activated monocytes, cells were cultured in anti-CD300e mAb coated plates and supernatants collected at different time points were assayed by ELISA. As shown in Fig 4C, samples from all tested donors secreted M-CSF upon CD300e engagement. At day 3, the M-CSF concentrations reached maximal levels decreasing by the end of the culture period (day 6). Altogether, these results support an autocrine contribution of M-CSF to the observed effects upon CD300e stimulation. IL-6 is known to upregulate the surface expression of M-CSF receptor (CD115) in human monocytes [199]. In order to test whether IL-6 production triggered by CD300e ligation may up-regulate CD115, cultures were carried out in the presence of a neutralizing anti-IL-6 mAb. Under these experimental settings no changes in the total number of differentiated macrophages recovered were noticed (anti-CD300e: 431 ± 44 x103 cells; anti-CD300e plus anti-IL-6 506 ± 27 x103 cells) (Fig 4D), indirectly ruling out an involvement of IL-6 in the differentiation process promoted by CD300e activation. Taken together these results indicate that monocyte-to-macrophage differentiation initiated by CD300e ligation is dependent on M-CSF and that the M-CSF receptor (CD115) plays an essential role in the process. Surface expression of CD115 is down-regulated in CD300e M Since consumption of M-CSF is associated with internalization of MCSF receptor [215] we evaluated whether CD300e cross-linking modulated CD115 expression. Freshly isolated human monocytes were cultured for various days in the presence of plate-bound antiCD300e mAb and subsequently assessed for CD115 expression. As monocytes cultured in GM-CSF plus IL-4 (moDC) express CD115 stably during the differentiation process [199, 216] we used them as a control. As shown in Fig 5, CD300e derived M had a reduced surface expression of CD115 at all time points as compared moDC. Analysis of permeabilized cells showed similar levels of CD115 in both cell types (data not shown) thereby suggesting an internalization 88 RESULTS: ARTICLE 2 of CD115 by CD300e M as indicated elsewhere [200]. These results suggest that the up-regulation of M-CSF production by monocytes triggered by CD300e engagement leads to an autocrine M-CSF consumption. CD300e induced differentiation of monocytes to macrophages is associated with caspase-3 activation The differentiation of human peripheral blood monocytes to macrophages in response to M-CSF is associated with activation of caspases, in particular, caspase-3 and caspase-9 [217, 218]. Since the neutralizing anti-M-CSF antibody reduced monocyte differentiation upon CD300e cross-linking, indicating the involvement of the cytokine in the differentiation process, we tested activation of caspase3 in these cells. Cleaved caspase-3 fragments were detectable in monocytes undergoing differentiation to M2 as early as 24h, reaching a peak at 72-96h [217]. By contrast, differentiation of monocytes to moDC (in the presence of GM-CSF plus IL-4) did not involve caspase-3 activation. In line with these observations, active caspase-3 fragments were detected by intracellular staining at 72h in both CD300e M and M2 (Fig 5), being undetectable in moDC generated in parallel from the same donor. These results further support the participation of M-CSF/CD115 signaling cascade in the CD300e induced differentiation process. 89 RESULTS: ARTICLE 2 DISCUSSION The CD300e surface molecule, originally termed Immune Receptor Expressed by Myeloid cells-2 (IREM-2), is an activating receptor restricted to mature monocytes and myeloid dendritic cells. We have recently reported that CD300e ligation besides triggering a proinflammatory response in both cell types, also leads to their prolonged survival in culture. Here we report that survival of monocytes induced by CD300e ligation involves M-CSF release and its autocrine consumption by CD115, being associated to their differentiation to MΦ2-like macrophages. M-CSF is the primary regulator of survival, proliferation, differentiation and function of monocytes and macrophages [202, 203]. Besides having a significant homeostatic contribution to macrophage-lineage development and maintenance of macrophage numbers [181, [219], M-CSF enhances cytotoxicity, superoxide production, phagocytosis, chemotaxis and cytokine production in monocytes and macrophages [220, 221]. It also enhances in monocytes the expression of cell surface molecules such as CD11b, CD14, CD16, CD23, HLA-I and HLA-II [222]. On the other hand, stimulation of monocytes and macrophages with M-CSF downregulates the expression of different TLRs, including TLR1, TLR2, TLR6 and TLR9 [223]. By contrast, the P2X7 extracellular ATP receptor that regulates DCs and macrophage inflammatory functions is up-regulated on human monocytes in response to M-CSF [224]. M-CSF exists in three isoforms including a membrane-spanning cellsurface glycoprotein as well as a secreted glycoprotein and a secreted proteoglycan that are released to the circulation under steady state conditions. The circulating isoforms are synthesized by endothelial cells and have an endocrine action, whereas the cell-surface isoform mediates cell-contact dependent regulatory effects [225]. M-CSF levels increase at sites of inflammation, forming a part of a cytokine network involved in communication between myeloid cells and neighboring cells during the inflammatory reaction [226]. Different stimuli have been shown to induce M-CSF secretion by human monocytes in vitro including GM-CSF [227, 228], interleukin-2 (IL-2) [229], HIV infection [230-232], tumor necrosis factor alpha (TNF-α) [233] and stimulation via CD44, CD45 and LFA-3 [234]. PMA, LPS, cycloheximide and IL-3 are all able to induce M-CSF transcription but not protein secretion [209]. 90 RESULTS: ARTICLE 2 We recently showed that CD300e ligation activates human monocytes promoting their survival in culture. Our results indicate that monocytesurvival and their differentiation to macrophages depends on an autocrine M-CSF production upon CD300e cross-linking, since the effect was partially inhibited by neutralizing M-CSF and blocking CD115. The mechanism by which CD300e signaling triggers M-CSF secretion in vitro thus far remains elusive. Since activation of monocytes and their adherence to plastic are not sufficient to induce M-CSF production in culture [235] we hypothesized that this might occur as a result of the initial cytokine secretion triggered upon CD300e cross-linking. Indeed, TNF-α [209] was identified as a powerful inducer of M-CSF secretion by human monocytes [233]. It is noteworthy that other surface molecules CD44, CD45 and LFA-3 reported to induce M-CSF upon cross-linking also trigger TNF-α production in monocytes [236]. M-CSF binding stabilizes the noncovalent dimerization of CD115, inducing its kinase activation and tyrosine autophosphorylation. This is followed by a covalent dimerization of the receptor leading to subsequent events that include a second wave of tyrosine phosphorylation, serine phosphorylation, receptor ubiquitination and internalization of the receptor-ligand complex for lysosomal degradation [225]. The second wave of tyrosine phosphorylation triggers CD115 interaction with down-stream signaling molecules such as PI3K, Grb2, Cbl, Lyn, Mona, PLCγ2, Socs1 and Src. The Src/Pyk2 and PI3K signaling pathways were identified as important regulators of cell adhesion, polarization, spreading, motility and monocyte differentiation [225]. Even though signaling pathways that connect M-CSF receptor with direct effectors of these processes have not been precisely dissected, it has recently been reported that signaling through CD115 induces the stabilization and nuclear translocation of βcatenin, which among other functions anchors the actin cytoskeleton [206]. An important step forward was the discovery of caspase involvement in M-SCF induced monocyte–to-macrophage differentiation. Caspase-8 is activated in response to M-CSF and it induces the formation of a multimolecular platform comprised of FADD, FLIP-L and RIP1 that contributes with its cleaved fragment to the down-regulation of NF-kB [237]. Caspase-3 that is activated downstream of caspase-8, cleaves other target proteins such as PAK2 and nucleophosmin [217, 238], that contribute to cytoskeleton rearrangements required for macrophage motility [218]. We have shown that CD300e cross-linking in monocytes results in CD115 91 RESULTS: ARTICLE 2 internalization and activation of caspase-3, processes that are associated to their differentiation to macrophages. Cells belonging to the monocytic lineage are quite heterogeneous. In the case of macrophages such heterogeneity probably reflects their plasticity and versatility in the response to microenvironmental signals (i.e. cytokines and microbial products) [45]. In order to define macrophage phenotypes and activation states, macrophage polarization to the so-called classically activated (MΦ1) or alternatively activated (MΦ2) macrophage states have been proposed, based in part on their cytokine profile [45]. The adherent cell populations that result by culturing monocytes with GM-CSF or M-CSF have been related to MΦ1- and MΦ2- polarized macrophages, respectively [193, 194] which differ in terms of receptor expression and effector functions [45]. Culture with GM-CSF leads to cells that produce proinflammatory cytokines, (i.e. TNF, IL-6, IL-12p70 and IL-23) following LPS stimulation, whereas after culture with M-CSF cells tend to produce predominantly IL-10 and CC-chemokine ligand 2 (CCL2 or MCP1) [226]. MΦ2 express Scavenger receptor-A, -B, CD163 and mannose receptor which are absent in MΦ1 [45]. Classically activated M1 macrophages are potent effector cells capable of killing microorganisms and tumor cells and produce high levels of pro-inflammatory cytokines. In contrast, M2 cells promote angiogenesis, tissue remodeling and repair [45]. Activation of monocytes via CD300e results in their differentiation toward MΦ2 macrophages. Yet, though their phenotypic and functional properties correspond to alternatively activated macrophages they appear less efficient than cells differentiated in parallel in response to exogenous M-CSF. Recently macrophages with distinct functional properties have been termed as classically activated (microbicidal activity), wound-healing (tissue repair) and regulatory (anti-inflammatory activity) MΦ [239]. The latter, correspond to human MΦ2 and are characterized by high production of IL-10 and low secretion of inflammatory cytokines, but they require two stimuli to fully induce their anti-inflammatory activity. A first signal (i.e. immune complexes, prostaglandins, adenosine or apoptotic cells), generally has little or no stimulatory function on its own [239]. However when combined with a second stimulus, such as a TLR ligand, these two signals re-program macrophages to produce IL-10 [214] and down-regulate IL-12 production [240]. Thus, the low IL-10 production of CD300e MΦ in response to LPS, may simply reflect the 92 RESULTS: ARTICLE 2 absence of an additional signal to fully induce their anti-inflammatory potential. According to the ‘M-CSF resistance’ model, monocyte-derived macrophages tend to initially acquire the properties of a polarized MΦ2 population [204]. Depending on the exposure to proinflammatory cytokines they may convert to a MΦ1 state when proinflammatory stimuli, such as GM-CSF, IFN-γ and LPS, overcome MCSF-driven polarization interfering with M-CSF signaling. CD300einduced monocyte differentiation in the absence of pro-inflammatory signals is consistent with this model. Moreover, monocyte differentiation triggered by other cell surface receptors in the absence of pro-inflammatory stimuli is expected to follow a similar pattern. In this line with this prediction, we have observed that signaling via hOSCAR, another triggering receptor capable of inducing monocyte survival [29] also led to differentiation of monocytes to MΦ2-like cells (data not shown). It has been shown that human peritoneal macrophages (pMΦ) freshly isolated from patients on peritoneal dialysis have phenotypical features of MΦ2 and are likely involved in maintenance of anti-inflammatory conditions in peritoneal cavity [50]. It is of note that the M-CSF level in human peritoneal fluid is 2.5-fold higher as compared to plasma, and it has been shown also that M-CSF levels correlate to the numbers of pMΦ [241]. The available information indicate that macrophages that infiltrate tumors (tumor-asociated macrophages, TAMs) also acquire the properties of a polarized MΦ2 population [45]. A model is proposed (Figure 7) to interpret how activation via CD300e activation may induce monocyte differentiation towards inflammatory MΦ2-like cells. Upon interaction with its still unknown ligand, CD300e triggers cellular activation and the secretion of proinflammatory cytokines including TNF-α. Subsequently, TNF-αinduced M-CSF binds to CD115 promoting its dimerization, activation and initiation of the signaling cascade that via caspase-3 activates downstream proteins leading to differentiation. After receiving appropriate signals in the tissue, macrophages induce their anti-inflammatory activity and take part in either immune responses or homeostasis. 93 RESULTS: ARTICLE 2 ACKNOWLEDGEMENTS This work was supported by a grant from Plan Nacional de I+D (SAF2007-61814) and Red Heracles, Ministerio de Ciencia e Innovación (MICINN). TB and DB are supported by fellowships from MICINN. We thank Dr. Oscar Fornas (University Pompeu Fabra, Barcelona, Spain) for advice in flow cytometry analysis and blood donors for their contribution. CONFLICT OF INTEREST The authors declare no financial or commercial conflict of interest. 94 RESULTS: ARTICLE 2 FIGURES Figure 1. CD300e activation induces monocyte differentiation into macrophages. (A) Monocytes were cultured for six days over the plate coated anti-CD300e mAb with no added cytokines (magnification x 200). (B) At the end of the culture cells were harvested and analyzed for surface expression of CD14, CD11b, CD16 (FcγRIII) and CD163 molecules. MΦ1 and MΦ2 were generated in parallel from the same donor. Open histograms represent matched isotype controls. Data are representative of at least five independent experiments performed with different donors. 95 RESULTS: ARTICLE 2 Figure 2. Functional analysis of CD300e derived MΦ. (A) Cytokine production by CD300e MΦ, M2Φ and M2Φ following the LPS stimulation. Cell that were generated by culturing monocytes for six days over the anti-CD300e mAb or in the presence of M-CSF 96 RESULTS: ARTICLE 2 (M2Φ) and GM-CSF (M1Φ), were stimulated with LPS for 24h. After the incubation, supernatants were harvested and analyzed for IL-10 and IL-6 release by ELISA. (B) Phagocytic activity of CD300eMΦ, MΦ1 and MΦ2 was assessed by the uptake of fluorescent polystyrene microspheres at 37OC at different time points and analyzed by FACS. (C) All three types of macrophages (CD300eMΦ, MΦ1 and MΦ2) were stimulated or not with PMA and production of superoxide anion (O2-) was measured by detection of reduced Cytochrome c at 6h. (BC) Data (mean ± SD of triplicate samples) correspond to a representative experiment out of three performed with different donors. CD300eMΦ, MΦ1 and MΦ2 were generated in parallel from the same donor. 97 RESULTS: ARTICLE 2 Figure 3. CD300e MΦ up-regulate expression of CD80 upon activation with LPS. CD300e MΦ, MΦ2 and MΦ1, all generated from a same donor, were stimulated or not with LPS and analyzed by FACS for the expression of co-stimulatory molecules after 24h. Data are representative of four independent experiments performed with different donors. 98 RESULTS: ARTICLE 2 99 RESULTS: ARTICLE 2 Figure 4. CD300e mediated monocyte differentiation to macrophages is M-CSF and CD115 dependent. Monocytes were cultured for six days over the plate-coated anti-CD300e mAb with or without neutralizing anti-M-CSF mAb (A-B), anti-CD115 (anti-MCSF R) or anti-IL-6 mAbs (D). At the end of the culture, cells were photographed (magnification x 200) and viable cells were counted. Data (mean ± SD of duplicate samples) correspond to a representative experiment out of three performed with different donors. (C) M-SCF production by CD300e MΦ at day 3 and day 6. Data represent mean ± SD of duplicate samples for four independent donors. 100 RESULTS: ARTICLE 2 Figure 5. Surface expression of CD115 is down-regulated in CD300e macrophages. Monocytes were cultured over the platecoated anti-CD300e mAb or in the presence of GM-CSF plus IL-4 (moDC) for various days and analyzed by flow cytometry for the surface expression of CD115. Open histograms correspond to binding of an isotype-matched control mAb and numbers in the corners correspond to the MFI. One representative experiment is shown out of two performed with different donors. 101 RESULTS: ARTICLE 2 Figure 6. Differentiation of monocytes to macrophages induced by CD300e is associated with capsase-3 activation. Monocytes were cultured for 72h over the plate-coated anti-CD300e mAb, in the presence of M-CSF (100ng/ml) or GM-CSF (100ng/ml) and IL-4 (25ng/ml) when they were harvested and analyzed by flow cytometry for the presence of caspase-3 active fragments. Open histograms represent matched isotype control. One representative experiment out of three performed with different donors. 102 RESULTS: ARTICLE 2 Figure 7. CD300e is able to trigger differentiation of monocytes to macrophages by inducing the M-CSF release and its consumption. Cross-linking of CD300e on the surface of monocytes triggers the M-CSF release. CD115 (M-CSF R) binds and consumes autocrine M-CSF, inducing the cascade of events that lead to differentiation of monocytes to macrophages. 103 RESULTS: ARTICLE 2 104 RESULTS: ARTICLE 2 105 RESULTS: ARTICLE 2 106 RESULT: APPENDIX Appendix Functional Characterization of CD300f Inhibitory Receptor in Human Granulocytes Preliminary results 107 RESULT: APPENDIX 108 RESULT: APPENDIX INTRODUCTION The Immune receptor expressed by myeloid cell 1 (CD300f or IREM1) is a monomeric type I transmembrane protein that displays five cytoplasmatic tyrosine residues (Y205, Y236, Y249, Y263 and Y284), among which Y205 and Y249 are located in ITIM, whereas Y236 and Y263 constitute putative binding sites for PI3 kinase [145, 146]. Biochemical analysis revealed that CD300f is capable of recruiting Src homology region 2 domain-containing phosphatase-1 (SHP-1) in a phosphorylation dependent manner and that the main docking site for this interaction is Y205. In addition crosslinking of the receptor in transfected RBL cells inhibited FcRε-induced activation [145] and degranulation [144]. A loss of inhibitory function and the ability to interact with SHP-1, was observed when Y205, Y249 and Y284 were mutated to phenylalanine [144]. Remarkably, engagement of the Y205, 249,284F CD300f mutant was able to induce RBL cell degranulation. This effect was shown to be dependent on PI3K recruitment via both Y236 and Y263 residues [144]. The putative involvement of PI3K raised the question as to whether CD300f may be able to deliver activating signals in cells that constitutively express it Human monocytes and granulocytes (mainly polymorphonuclear neutrophils, PMNs) are the only peripheral blood cells expressing surface CD300f [144]. Because of their capacity to release proteases, together with great amounts of reactive oxygen species and bactericidal proteins, PMNs play a crucial role in host defense [242]. In addition to their classical pro-inflammatory functions, upon appropriate stimulation they are able to produce different cytokines and chemokines [243]. PMN express a variety of surface receptors that regulate their functions. Among them, FcR -I, -II and –III are critical for facilitating phagocytosis whereas C5aR, C3bR, chemotactic receptors for PAF, LTB-4 and fMLP, Toll-like receptors and also GM-CSF R and G-CSF R regulate their migration [56]. Human neutrophils express various ITIM-bearing inhibitory receptors including: CD305, CLECSF6, CD31 (or PECAM-1), CD66a (or CEACAM1 or BGPa), SIRPα, p75/AIRM1, CD33, CD300a [129][129] and CD300f [143]. Recently it was shown that CD300a can inhibit CD32a (FcγRIIa) mediated reactive oxygen species production in human PMN by inhibiting Ca2+ flux, [129]. The receptor was rapidly translocated from an intracellular pool to the cell surface in response to pro-inflammatory stimuli, suggesting an important role of CD300a in the modulation of PMN function [129]. 109 RESULT: APPENDIX So far, the role of CD300f in cells that constitutively express the receptor, including human neutrophils is uncertain. In this regard, we investigated the functional effects of CD300f ligation in freshly isolated human PMN by using an agonistic anti-CD300f monoclonal antibody to mimic its still unknown ligand. 110 RESULT: APPENDIX MATERIALS AND METHODS Cell purification and culture Granulocytes (neutrophils >96.5%, eosinophils <3%) were isolated under endotoxin-free conditions from buffy coats of healthy donors [244] and cultured in RPMI-1640/Glutamax medium (Invitrogen Life Technologies) supplemented with 10% low endotoxin FBS (Greiner Bio-One GmbH) for various times at 37OC in 5% CO2 atmosphere. After incubation, neutrophils were collected and centrifuged at 300 x g for 5 min Supernatants wereharvested and stored at -80OC whereas cells were either used for immunofluorescencet staining, mRNA extraction or lysed for protein analysis. Ex vivo stimulation of cells To study cell activation through the CD300f receptor, an agonistic anti-CD300f mAb (clone UP-D2, IgG1) was used [143]. The antiCD161 (clone HP-3G10, mouse IgG1), anti-TREM-1 (clone 21C7, mouse IgG1, kindly provided by Dr. Marco Colonna, University of Washington, Saint Louis, MO) and anti-ILT2 (clone HP-F1, mouse IgG1) mAbs were used as isotype-matched controls. Ex vivo stimulation of cells was performed as previously described [209]. Flow cytometry Surface expression of CD300f, CD11b, CD62L and CD66b was tested by immunofluorescence and flow cytometry analysis using the FACScan or FACSCalibur (Becton Dickinson) as described previously [209]. Cells were stained with UP-D2 mAb (anti-CD300f) or isotype matched control mAb followed by secondary PE-conjugated goat rabbit anti-mouse Ab (DakoCytomation Denmark A/S). For direct immunofluorescence the following murine mAb were used: PEconjugated anti-CD11b, anti-CD66b, FITC-conjugated CD62L (all from BD Pharmingen) in combination with their isotype-matched controls (BioLegend). Production of reactive oxygen intermediates The production of superoxide anion (O2-) was assayed by detection of reduced Cytochrome c by freshly isolated PMN as previously described [209]. 111 RESULT: APPENDIX Soluble mediator release assays Concentrations of mediators in cell-free supernatants were measured by specific human ELISA kits for IL-8/CXCL8 (ImmunoTools GmbH), albumin and lactoferrin (Bethyl Laboratories, INC) according to manufacturer’s instructions. Real time RT-PCR Real time RT-PCR has been performed as previously described [245, 246]. Data were calculated using the Q-Gene software (BioTechniques) and expressed as mean normalized expression (MNE) units after GAPDH normalization. Survival assay Estimation of apoptotic and necrotic neutrophils was determined using the Annexin-V-FLUOS Staining Kit (Roche Applied Sciences) following the manufacturer’s guidelines in combination with propidium iodide labeling, followed by by flow cytometry analysis. Immunoprecipitation and western blot analysis After incubation with 1mM sodium pervanadate for 15min at 37OC purified, PMN were biotinylated using EZ-Link Sulfo-NHS-Biotin (Pierce) following manufacturer’s instructions, lysed and immunoprecipitated as described [144]. Samples were resolved by SDS-PAGE in a 10% acrilamide gel and transferred onto polyvinyl difluoride membranes (Millipore). Membranes were blocked for 1h with 3% BSA in TTBS and then probed with HRP-conjugated antiphosphotyrosine mAb mixture (PY-7E1, PY-1B2 and PY20) (Zymed Laboratories). After stripping with Restore Western Blot Stripping Buffer (Pierce) membranes were re-probed with HRP-conjugated Streptavidine (Roche) and, after an additional stripping step, with antip85 (Upstate Biotechnology) followed by HRP-conjugated secondary Ab. 112 RESULT: APPENDIX RESULTS AND DISCUSSION Inflammatory stimuli up-regulate the expression of CD300f in human neutrophils We first investigated whether basal expression of CD300f in freshly isolated neutrophils (Fig.1) varied in response to various proinflammatory agents [67]. As shown in Fig. 2, GM-CSF or a combination of LPS and IFN-γ induced a significant increase in CD300f surface expression levels; by contrast, neither G-CSF, IL-4, LPS nor IFN-γ alone had any effect. The increase in the CD300f expression occurred rapidly, becoming detectable one hour after stimulation with GM-CSF or with LPS and IFN-γ (data not shown). Further studies are required to assess whether this results from the translocation of an existing intracellular receptor pool. This expression pattern was similar to that reported for CD300a, which was also rapidly up-regulated upon neutrophil stimulation with GM-CSF and LPS [130]. Moreover, the mouse homolog of CD300f, known as CD300Lf/CLM-1/LMIR3/DIgR2/MAIR-Va/b was also shown to be up-regulated in murine neutrophils upon stimulation with LPS and G-CSF both in vitro and in vivo [149]. Because the expression of these receptors is up-regulated by inflammatory stimuli in human neutrophils they may play an important role in controlling inflammation. Engagement of the CD300f receptor triggers a respiratory burst in PMN Experiments were designed to explore whether CD300f inhibited the respiratory burst in neutrophils. Yet, unexpectedly, upon engagement of CD300f in neutrophils, stimulation of superoxide anion (O-2) production was detected. ROS production over control (medium or isotype control mAb) was detectable within 10 minutes after incubation with anti CD300f mAb and linearly increased for 140 min (Fig. 3); anti-TREM-1 and fMLP were used in the assay as positive controls. Further studies are needed in order to test wheter CD300f induced respiratory burst in PMN is results from its association to PI3K. CD300f cross-linking on freshly isolated neutrophils leads to phenotypic changes To further investigate the functional role of CD300f, PMN were stimulated for 18h with plate-coated mAb and analyzed for the 113 RESULT: APPENDIX expression of surface molecules known to be modulated upon activation. Neutrophils treated with anti-CD300f mAb significantly cleaved surface CD62L that mediates leukocyte rolling on activated endothelium in inflamed tissues. On the other hand, CD300f engagement had no effect on CD11b and CD66b surface expression (data not shown) indirectly supporting that neutrophils do not degranulate upon CD300f ligation. Engagement of CD300f enhances proinflammatory responses induced by TLR4 ligand in neutrophils Since our results have shown that CD300f is able to activate the respiratory burst, we further explored its putative role as an activating receptor. Cross-linking of CD300f strongly enhanced IL-8/CXCL8 production in human neutrophils stimulated by LPS and fMLP (Fig. 5A). Real-time PCR confirmed the up-regulation of IL-8/CXCL8 expression when CD300f was ligated together with TLR4 (Fig. 5B). By contrast, the synergistic effect of CD300f and LPS was not observed for TNFα production. In the same line, CD300f engagement did not enhance the degranulation of neutrophils triggered by fMLP (Fig. 5A), measured by albumin and lactoferrin release, markers of secretory vesicles and secondary granules, respectively. A recent study in mice is in line with these observations, since crosslinking of the endogenous CD300f homolog (CD300Lf/CLM1/LMIR3) significantly enhanced IL-6 production in BMMCs stimulated with LPS [149]. Interestingly, receptor engagement impaired cytokine production of CLM-1 transduced BMMCs stimulated with ligands for TLR2, TLR3 and TLR9 or SCF. These observations suggest that CD300Lf has a dual function in BMMCs, co-stimulating TLR4 signalling, but repressing the response to other TLR agonists or SCF. Our results confirm that CD300f may induce activating signals in human neutrophils but further studies are needed to test whether it also exerts an inhibitory function. CD300f ligation has no effect on neutrophil life span in culture We tested next whether CD300f can modify the ex vivo life span of neutrophils cultured in the absence of survival factors for 18h. As shown in Fig. 5, neither control mAb nor anti-CD300f decreased the proportion of apoptotic and necrotic neutrophils, whereas rhGM-CSF promoted neutrophil survival. This is in contrast with the observation that the murine CD300Lf/CLM-1/MAIR-V/DIgR1 induced cell death in myeloid cells by caspase and endoplasmatic reticulum stress114 RESULT: APPENDIX independent mechanism [146]. CD300Lf-mediated cell death was dependent on the cytoplasmatic region, but it did not require ITIM nor ITSM. CD300f is not tyrosine phosphorylated in human neutrophils Biochemical analysis performed in CD300f transfectants and the U937 cell line, that does constitutively express the receptor, revealed that CD300f is displayed as a monomeric molecule. Its migration in SDSPAGE as a smear between 50 and 99 kDa suggests the existence of different isoforms, together with different degrees of glycosylation. Upon cellular treatment with sodium pervanadate, CD300f was tyrosine phosphorylated [143, 144]. When similar studies were performed in human neutrophils treated with sodium pervanadate and surface-labeled with biotin, no evidence for CD300f phosphorylation was obtained (Fig. 7A), despite that the receptor was efficiently immunoprecipitated as confirmed by re-blotting the membrane with Streptavidin (Fig. 7B). In the same experiments, we were unable to detect any association of CD300f with the p85α subunit of PI3K. A recent study performed with the mouse homolog CLM-1/LMIR3 showed that this inhibitory receptor associates with the ITAM bearing adaptor protein FcRγ [149]. Whether the human receptor is also capable of coupling to FcRγ in neutrophils remains to be determined. 115 RESULT: APPENDIX FIGURES Figure 1. Expression of CD300f (IREM-1) receptor by peripheral blood neutrophils. Freshly isolated PMN were stained with antiCD300f (UP-D2) mAb followed by anti-mouse IgG1-FITC and analyzed by flow cytometry for the surface expression of CD300f. A representative experiment out of 10 performed with samples from different donors is shown. Figure 2. CD300f is up-regulated on human neutrophils in response to pro-inflammatory agents. Surface expression of CD300f on human neutrophils after overnight treatment with rhGMCSF (10ng/ml), rhG-CSF (103U/ml), rhIL-4 (25ng/ml), rhIFN-γ (100U/ml) or LPS (100ng/ml). Results are representative of five independent experiments performed with different donors. 116 RESULT: APPENDIX Figure 3. Cross-linking of CD300f triggers the release of reactive oxygen intermediates in PMN. (A) Freshly-isolated PMN were stimulated during 2.5h with plate-coated mAb, as indicated, and the production of superoxide anion (O2-) was analyzed by detection of reduced Cytochrome c at ten minute intervals. (B) Superoxide anion production after 140 minutes of stimulation with plate-coated mAbs. Data (mean ± SD of triplicate samples) in (A-B) correspond to a representative experiment out of five performed with samples from different donors. 117 RESULT: APPENDIX Figure 4. Neutrophils down-regulate CD62L upon CD300f crosslinking. PMN were incubated overnight with plate-coated control IgG1 (HP-3G10), anti-CD300f (UP-D2), medium or with 100ng/ml LPS and analyzed by flow cytometry for the expression of CD62L. One representative experiment out three performed with similar results. 118 RESULT: APPENDIX Figure 5. CD300f ligation synergistically up-regulates IL8/CXCL8 release by neutrophils upon LPS and fMLP stimulation. (A) PMN were incubated for 18h with plate-coated control IgG1 (HP-3G10) or anti-CD300f (UP-D2) mAbs and in the presence or absence of 100ng/ml LPS and 10nM fMLP. 10mM Cytochalasin B was used as a positive control. Culture supernatants were tested by ELISA for IL-8/CXCL8, lactoferrin and albumin release. Data are mean ± SD of duplicate samples from one representative experiment out of five performed with various donors. (B) Neutrophils were cultured for the indicated times with antiCD300f, 100 ng/ml LPS or both. Total RNA was extracted and analyzed for IL-8/CXCL8, TNF- and GAPDH mRNA expression by real-time PCR. A representative experiment is shown. Gene expression is depicted as MNE units after GAPDH mRNA normalization of triplicate reactions for each sample. 119 RESULT: APPENDIX Figure 6. Engagement of CD300f has no effect on survival of neutrophils. PMN were incubated with plate-coated mAb (control IgG1, anti-ILT2, HP-F1; anti-CD300f, UP-D2), medium alone or 10 ng/ml rhGM-CSF, as indicated. After 18h, cells were harvested and analyzed for Annexin V and propidium iodine binding (viable cells: AnnexinV-PI-, apoptotic cells: AnnexinV+PI-, necrotic cells: AnnexinV+PI+). Data show mean ± SD of three independent experiments performed with different donors. Figure 7. CD300f is not tyrosine phosphorylated in neutrophils. PMN were surface labeled with biotin, treated with sodium pervanadate, lysed and immunoprecipitated with anti-CD300f, antiCEACAM-1 (positive control) or isotype negative control mAbs. 120 RESULT: APPENDIX Western blots were conducted with anti-phosphotyrosine mAb mixture (A) and Streptavidine (B). 121 RESULT: APPENDIX 122 RESULT: APPENDIX 123 Discussion 124 DISCUSSION 125 DISCUSSION 4. DISCUSSION The human CD300 family of immune receptors is expressed by myeloid cells. The first member (CD300c or CMRF-35A) was identified by expressional cloning back in 1992 [89] and its gene was mapped to human chromosome 17q22-25. During the last decade, five more genes with a related Ig domain were subsequently mapped to the same region; encoding for paired triggering and inhibitory surface glycoproteins of the immunoglobulin superfamily. Despite the time elapsed our understanding of the biological role of CD300 receptors is still quite limited mainly due to the lack of information regarding the nature of their ligands and the unavailability of specific reagents for all of them. Moreover, most data come from studies in transfectants rather than in primary cells. Our goal was was to pursue the functional characterization of CD300e and CD300f in peripheral blood cells constitutively expressing them. CD300e was originally identified as a result of an Ensembl genome data base search for homologues of CD300c (CMRF-35) and CD300f (IREM-1) and was termed Immune Receptor Expressed by Myeloid cells-2 (IREM-2). The cloned nucleotide sequence contained an open reading frame of 618 nucleotides encoding for a polypeptide of 205 amino acids with a predicted molecular mass of 23kDa [134]. According to the amino acid sequence analysis, CD300e is a type I membrane protein with a 12 amino acid (aa) long signal peptide. The extracellular region contains a single Ig variable domain and a 44-aa linker with a potential N-glycosylation site. The transmembrane domain displays a lysine residue followed by a short cytoplasmatic tail of 10-aa. The extracellular Ig domain of CD300e has a high degree of homology with other myeloid receptors including CD300a (71%), and CD300c (73%) from a same family, but also with TREM-1 (49%) and TREM-2 (58%) [134]. CD300e was shown to be selectively expressed by both subsets of peripheral blood monocytes, CD14+CD16- and CD14+CD16+, and by myeloid dendritic cells [134]. Analysis of CD300e in bone marrow samples showed that all hematopoietic precursors tested (erythroid, myeloid and B cells precursors) were negative and that the receptor was detected only at relatively late stages of monocyte differentiation, when their precursors have already acquired high levels of CD14 and 126 DISCUSSION CD64 [134]. It is of note that none of the leukemic cell lines tested, including those belonging to the myeloid lineage (THP-1, U937, HL60, K562 nor MonoMac6) [134] expressed CD300e. In vitro differentiation of monocytes to immature dendritic cells (iDC) or classically activated macrophages (MΦ1) resulted in the complete loss of CD300e expression [134]. In our hands, (Figure 12) monocytes down-regulated CD300e as early as 24 hours upon in vitro culture and similar results were obtained in the presence of IL-4. By contrast, GM-CSF maintained partially CD300e expression, which was fully preserved by M-CSF stimulated cells at levels comparable to those of fresh monocytes. Neither LPS, TNF-α nor IL-10 were able to significantly alter cell surface expression of CD300e at 24h post culture (data not shown). Figure 12. CD300e expression is modulated upon monocyte culture and treatment with cytokines. Purified monocytes were cultured for 24h with 10ng/ml M-CSF, 50ng/ml GM-CSF, 25ng/ml IL-4 or medium alone when the viable cells were analyzed by flow cytometry for CD300e expression. Data are expressed as mean fluorescence intensity (MFI) ± SD of three experiments performed with different donors. Grey bar: freshly isolated monocytes; black bars: monocytes cultured for 24h. Anti-inflammatory macrophages (MΦ2) derived from monocytes in the presence of M-CSF expressed CD300e that was lost in proinflammatory MΦ1 and DC (data not shown). Identification of the CD300e ligand should provide clues to understand the biological implications for its selective expression along monocyte differentiation. 127 DISCUSSION The structure of CD300e indicated a potential triggering role in myeloid cells and its initial characterization in transfected cells confirmed this hypothesis [134]. In the first part of this work, we investigated the functional role of CD300e in peripheral blood monocytes and myeloid dendritic cells (mDC) using an agonistic mAb to mimic its ligand. Our data formally support that CD300e functions as an activating receptor that is capable of regulating the innate immune response in myelomonocytic cells. Upon engagement by an agonistic mAb, CD300e triggered an intracellular calcium mobilization and superoxide anion production in monocytes. Activation via CD300e provided survival signals that prevented monocyte and mDC apoptosis, triggered the production of pro-inflammatory cytokines (including IL-8/CXCL8, TNF- α, IL-6) and up-regulated the expression of cell surface co-stimulatory molecules CD83 and CD86 in both cell types. In addition, CD300e activation of myeloid dendritic cells enhanced the alloreactive response of naïve T cells. Beyond their function as a reservoir of precursors that give rise to tissue resident macrophages, dendritic cells (DCs) and osteoclasts, circulating monocytes represent accessory cells that link inflammation and innate defense to adaptive immune responses, and may also function as scavenger and effector cells in homeostasis [23]. These cells are armed with scavenger receptors that recognize microorganisms but also lipids and dying cells. Upon pathogen recognition, monocytes become activated and produce a wide array of effector molecules that are involved in the defense including among others: ROS, complement factors, eicosanoids, cytokines (i.e. TNF-α, IL-1β, IL-8/CXCL8, IL-6, and IL-10), vascular endothelial growth factor, and proteolytic enzymes [10]. To some extent, monocytes are able to present antigens and provide co-stimulatory signals to T cells. Myeloid DCs are professional antigen presenting cells that are specialized for the uptake, transport, processing and presentation of antigens to naïve T cells [57]. Upon the encounter with microbial products or tissue damage, mDCs become activated and besides migrating to lymph nodes, they may contribute to the elimination of pathogens. The production of chemokines and pro-inflammatory cytokines (IL-8/CXCL8, IL-12, IL-23 or IL-10) together with upregulation of co-stimulatory (e.g. CD40, CD80, CD86, OX40-L and ICOS-l) contribute to the activation of naïve T cells. 128 DISCUSSION Engagement of CD300e resulted in activation of effector functions in both monocytes and mDC including the production of molecules involved in the defense against pathogens (i.e. reactive oxygen species, cytokines, and chemokines) and in the activation of the adaptive immune response. Yet, unlike other well-characterized triggering receptors that belong to the same subset (e.g. TREM-1), the signaling pathways initiated by CD300e remain elusive. The presence of a lysine residue in the transmembrane domain suggested that CD300e might associate with an ITAM-containing adaptor molecule bearing a negatively charged amino acid residue in its trasmembrane region and, in fact, CD300e was shown to associate with DAP12 in COS-7 transfected cells [134]. Yet, we failed to prove that this association is taking place in human monocytes. In fact, we were unable to coimmunoprecipitate any phosphorylated molecule together with CD300e (data not shown). Beyond putative technical reasons limiting the sensitivity of these assays, it is conceivable that CD300e may not be constitutively associated with its adaptor on the surface of monocytes. The possibility that the receptor might couple to an adaptor different from DAP12, is uncertain since tyrosinephosphorylated molecules were not co-immunoprecipitated. Additional experiments are required in order to define the molecular basis for CD300e signalling in monocytes. We recently reported that CD300e ligation besides triggering various pro-inflammatory responses in myeloid cells, also leads to their prolonged survival in culture by a mechanism independent of caspase3 [187]. In the present study, we observed that CD300e ligation led to differentiation of monocytes to alternatively activated macrophages (MΦ2) displaying an anti-inflammatory functional profile according to their surface phenotype, cytokine secretion and phagocytic activity. Cells obtained as a result of CD300e activation of monocytes displayed phenotypic and functional characteristics closer to MΦ2 alternatively activated macrophages. MΦ2-like cells have been found in human peritoneal cavity [50] and infiltrated in tumors [45], for that reason they have been designated human peritoneal macrophages (pMΦ) and tumor-associated macrophages (TAMs), respectively. Alternatively activated macrophages preferentially produce IL-10 and CCL2 in response to LPS, contrary to classically activated MΦ that under same conditions favor the secretion of pro-inflammatory cytokines such as TNF, IL-6, IL-12p70 and IL-23. Hamilton, J. has 129 DISCUSSION recently formulated a so-called ‘M-SCF resistance’ model for macrophage-dependent inflammation (Figure 15) [226]. He proposed that macrophage populations in various tissues are normally exposed to sufficient levels of tissue-derived M-CSF to maintain them in an 'MΦ2-like' polarized state [45, 193], with a relatively compromised ability to produce pro-inflammatory mediators. During inflammation, autoimmunity and/or infection, exposure of macrophages to increasing concentrations of pro-inflammatory stimuli, such as GMCSF, IFN-γ and LPS, overcomes this M-CSF-driven polarization by interfering with M-CSF signaling leading to a pro-inflammatory ('MΦ1-like') state [45, 193]. This polarization would be dependent on the degree of exposure to M-CSF. In other words, at least at the level of the macrophage lineage, inflammation can be viewed as a state of 'M-CSF resistance' or compromised M-CSF-receptor signaling. This hypothesis also proposes that when the levels of pro-inflammatory stimuli diminish, M-CSF at the reaction site will assist in the resolution of the lesion by favoring the MΦ2-like macrophage phenotype. Figure 15. Macrophage-driven inflammation: a state of ‘M-CSF resistance’ or compromised M-CSF receptor signaling [204]. According to the ‘M-CSF resistance’ model all monocyte-derived macrophages acquire at the beginning the properties of a polarized MΦ2 population. Depending on the exposure to pro-inflammatory cytokines during the processes of inflammation, autoimmunity and/or infection, they may later convert to a pro-inflammatory ‘MΦ1’ state. The CD300e induced differentiation pattern in the absence of proinflamatory signals is consistent with this model. In the same line, signaling via hOSCAR, another triggering receptor capable of inducing 130 DISCUSSION monocyte survival [175] also led to differentiation of monocytes to MΦ2-like cells (data not shown). Our results indicate that prolonged survival of monocytes and their differentiation to macrophages depends on an autocrine effect of MCSF that is released upon CD300e cross-linking. By neutralizing MCSF and blocking its receptor, CD115, the effect was only partially inhibited probably due to the continuous secretion of M-CSF by CD300e activated monocytes that was detected in all donors tested. On the other hand, the mechanism by which CD300e signaling triggers M-CSF secretion in vitro remains elusive. Activation of monocytes and their adherence to plastic are not sufficient to induce M-CSF release [235] and we have postulated that this may occur as a consequence of initial cytokine secretion induced by CD300e engagement. Various stimuli are shown to induce M-CSF in vitro: GM-CSF [227, 228], IL-2 [229], HIV infection [230-232], TNF-α [233] and stimulation via surface molecules CD44, CD45 and LFA-3 [234]. Among the mentioned cytokines, TNF-α was a clear candidate as it was reported to be a powerful inducer of M-CSF secretion by human monocytes [233].Further studies are needed in order to confirm this hypothesis. It is noteworthy that surface molecules CD44, CD45 and LFA-3 which are reported to induce M-CSF are also known to trigger TNF-α release by human monocytes [236]. Besides identifying M-CSF as a key player in the CD300e derived monocyte-to-macrophage differentiation, we provided evidence supporting an involvement of the M-CSF signaling pathway in the process. M-CSF binding to CD115 results in dimerization of the receptor, autophosporylation of cytoplasmatic tyrosine residues and phosphorylation of various substrates including SHP-1, Src kinases, PLC-γ, PI(3)K, Akt and Erk. The second wave of phosphorylation activates numerous down-stream signaling molecules including Grb2, Cbl, Lyn, Mona, PLCγ2, Socs1 and Src [206]. Once formed, the MCSF/CD115 complex gets internalized and later degraded by lysosomes. The Src/Pyk2 and PI3K signaling pathways were identified as important regulators of cell adhesion, polarization, spreading, motility and monocyte differentiation [225]. The CD115 signaling pathway is connected to the ‘caspase network’ shown to be essential for macrophage differentiation. Caspase-8 is activated in response to M-CSF and induces the formation of a multimolecular platform comprised of FADD, FLIP-L and RIP1 that contributes with its 131 DISCUSSION cleaved fragment to the down-regulation of NF-κB [237]. Caspase-3 which is activated downstream of caspase-8 cleaves other target proteins such as PAK2 and nucleophosmin [217, 238], that play role in cytoskeleton rearrangements required for the macrophage to acquire motility [218]. We were able to show that CD300e cross-linking on the surface of monocytes results in both CD115 internalization and activation of caspase-3, two processes that are associated to monocyte-to-macrophage differentiation. A key issue for understanding the biological role of CD300e is the identification of its putative ligand/s. Even though the function of myeloid activating receptors has been extensively studied in the past, their ligand specificity remains often ill defined. Some of these molecules recognize exogenous pathogen-related ligands like polyanionic bacterial products recognized by TREM-2 [99]. Others bind endogenous ligands – CD85g binds CD317 [78], CD172a both CD47 [85] and soluble pattern recognition receptors SP-A and SP-D [106]. On that basis, CD300e may function as a pathogen-associated molecular pattern receptor (PRR) or, alternatively, could contribute to sensing self stress-inducible molecules. Further studies are required to identify the CD300e ligand. Part of our work was focused on CD300f, another ligand-orphan inhibitory receptor. CD300f receptor that was originally termed IREM-1, is composed of a single V-type extracelluar Ig domain, a membrane proximal region that is followed by transmembrane domain and a long cytoplasmatic tail with five tyrosine residues [145]. Two of these tyrosines are in the context of ITIMs and other two constitute binding sites for the PI3K regulatory subunit p85α. CD300f has been detected on the surface of human monocytes and neutrophils. As expected for an ITIM bearing surface protein, CD300f was able to recruit SHP-1 phosphatase in a phosphorylation dependent manner [145]. Its inhibitory role was studied in transfected RBL cells, where it was shown that CD300f engagement prevents gene transcription induced by signals delivered through the activating FcεRI [145]. In the same experimental system, CD300f was able to recruit the p85α subunit of PI3K and deliver activating signals when ITIMs and the distal tyrosine-based motif were disabled. In the U937 myeloid leukemia cell line CD300f binds SHP-1 phosphatase and p85α simultaneously, thus suggesting its putative functional duality [146]. 132 DISCUSSION Preliminary data on the functional role of CD300f in human granulocytes, indicated that its engagement triggered the production of reactive oxygen species, resulted in the decreased expression of CD62L that is a characteristic of activated neutrophils and showed a synergistic effect with TLR4. We were however unable to confirm that these functional effects result of preferential signaling via PI3K in human granulocytes, even though we observed that CD300f was not recruiting SHP-1 in these cells, presumably due to the lack of tyrosine phosphorylation essential for this interaction. Warning on the possibility that granulocyte activation by anti-CD300f mAb might be due to its potential cross-reactivity with another triggering molecule of the same family (CD300d) should be also considered. Yet, interestingly similar results have been obtained recently on the functional characterization of the murine orthologue receptor CLM1/LMIR3. In fact CLM-1 cross-linking enhanced cytokine production of BMMCs in response to TLR4 ligand, while suppressing the production stimulated by other TLR agonist and stem cell factor [151]. Inhibition involved SHP-1 and SHP-2, whereas the activating signal appeared mainly mediated by its association to FcRγ. Further studies are required to understand the physiological role of CD300f and, in particular, the identification of its endogenous ligand/s becomes an essential step. In that regard we have tested a panel of human cells for the binding of CD300f/IgG2a fusion protein and were able to conclude that it reproducibly stained the Jurkat T cell leukemia and HeLa cell lines (Figure 16). Since Jurkat cells are CD4+ T lymphocytes, we analyzed the expression of CD300f putative ligand/s in CD3+ T lymphocytes and the CD4+ subset, using both fresh and PHA-activated T cells. The CD300f/IgG2a supernatant marginally stained CD3+ lymphocytes, particularly the CD4+ subset among PHA-activated T cells, whereas no binding was seen with resting T cells. No staining of CD8+ T, NK, B cells and monocytes was detected. 133 DISCUSSION Figure 16. Staining of Jurkat and HeLa cells with CD300f/IgG2a fusion protein. Anti-myc was used as a isotype control. The staining pattern was reproduced in three experiments. As an additional strategy to seek for CD300f ligand/s we designed a reporter assays in murine T cell line BW36 that were stably transfected with CD300f/CD3ξ chimeric receptor. The CD3ξ cytoplasmic domain of the chimeric CD300f receptor contains three immunoreceptor tyrosine-based activation motifs (ITAM) which upon receptor engagement should recruit the ZAP-70 and Syk tyrosine kinases, resulting in the activation of a signaling cascade that includes the activation of NFAT transcription factors and, ultimately, the production of interleukin 2 (IL-2) by the BW T cell line. To confirm the results of binding studies with CD300f/IgG2a, the BW CD300f/CD3ξ reporter cells were co-cultured with Jurkat and HeLa for 24h and the cell supernatant was tested for IL-2 production. Even though the chimeric receptor was functional in BW cell upon crosslinking with agonistic anti-CD300f (UP-D2) antibody, no response was obtained upon interaction with the stimulatory cells, despite the fact that, as mentioned above, both cell types interacted with the soluble fusion protein (Figure 17). Similar results were obtained using the RBL CD300f/CD3ξ as a reporter system indicating that the sensitivity of the system is presumably insufficient to detect weak receptor-ligand interactions. It is also conceivable that some accessory molecules required to optimize signaling may be missing in the heterologous BW-Jurkat interaction. As stressed in the introduction, a substantial number of leukocyte receptors in different families still remain “ligand-orphan”, despite the long time elapsed since they were cloned, presumably reflecting common technological limitations. As a main open issue for understanding the biological role of CD300e and CD300f is the 134 DISCUSSION identification of their ligands, our laboratory has currently established a collaboration (Dr. Claudia Cantoni and Carola Prato, University of Genova) in a joint effort to design novel strategies allowing to overcome a number of technical difficulties to progress thus far encountered 135 DISSCUSION 136 137 138 Conclusions 139 140 CONCLUSIONS 5. CONCLUSIONS 1. Upon engagement by an agonistic mAb, CD300e triggers intracellular calcium mobilization and superoxide anion production in human monocytes. 2. Activation via CD300e provides survival signals that prevent monocyte and mDC apoptosis by a mechanism independent of TNF-mediated inhibition of caspase-3. 3. CD300e cross-linking on the surface of monocytes and myeloid dendritic cells induces the production of pro-inflammatory cytokines (TNF-α and IL-8/CXCL8) and up-regulates the expression of CD83 and CD86 . 4. In myeloid dendritic cells, stimulation via CD300e enhanced the alloreactive response of naïve T cells. 5. CD300e engagement promotes the differentiation of monocytes to macrophages that display a CD14bright CD16+ CD163low/neg CD1aCD11bbright CD209- phenotype, exhibit a low respiratory burst but high phagocytic activity and mainly produce IL-10 upon stimulation with LPS, thus resembling anti-inflammatory type 2 macrophages (MΦ2). 6. Monocyte-to-macrophage differentiation induced by CD300e appears dependent on the production of M-CSF and autocrine stimulation via its receptor (CD115). 7. Overall, our data support that CD300e functions as an activating receptor capable of regulating the innate immune response of cells of the monocytic lineage and promotes their differentiation to MΦ2-like macrophages . 141 CONCLUSIONS 142 CONCLUSIONS 143 BIBLIOGRAPHY 1. Schmid, M.A., et al., Instructive cytokine signals in dendritic cell lineage commitment. Immunol Rev, 2010. 234(1): p. 32-44. 2. 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