Machteld M. Tiemessen, Tracey J. Mitchell, Lisa Hendry, Sean J

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Lack of Suppressive CD4+CD25+FOXP3+ T Cells in Advanced Stages of Primary Cutaneous T-Cell Lymphoma  Machteld M. Tiemessen, Tracey J. Mitchell, Lisa Hendry, Sean J. Whittaker, Leonie S. Taams, Susan John  Journal of Investigative Dermatology  Volume 126, Issue 10, Pages 2217-2223 (October 2006) DOI: 10.1038/sj.jid.5700371 Copyright © 2006 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 The anergic phenotype of CD4+ T cells from CTCL patients is not owing to an overall increase in CD4+CD25+ T cells. CD4+ T cells were isolated from PBMC of HC and CTCL patients via MACS. (a) CD4+ T cells were stimulated with anti-CD3 mAb (50ng/ml) and APC, and T-cell proliferation was measured by 3H-thymidine incorporation. Data are depicted as mean c.p.m.±SEM, n=10 independent experiments. (b) Representative dot plots of peripheral blood lymphocytes from HC versus a CTCL patient showing the percentage of CD4+CD25+total and CD4+CD25+bright T cells in CD4+ T cells; the square region indicates CD4+CD25bright T cells. (c) The percentages of CD4+CD25+total and CD4+CD25+bright T cells in the CD4+ T-cell fraction are shown for each individual HC and CTCL patient. Journal of Investigative Dermatology 2006 126, 2217-2223DOI: (10.1038/sj.jid.5700371) Copyright © 2006 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Dichotomy in suppressive activity of CD4+CD25+ Tregs from CTCL patients. (a) CD4+CD25+ T cells were isolated from phosphate buffer from HC and CTCL patients by MACS. Representative dot plots show the percentage CD4+CD25+ T cells from HC and CTCL patients before and after purification. (b) The relative mRNA expression of CD25 in purified CD4+CD25− and CD4+CD25+ T-cell subsets from HC and CTCL patients was determined by real-time PCR. Results are shown as the mean±SEM of eight independent experiments. (c) Isolated CD4+CD25− T cells were cultured with anti-CD3 mAb and irradiated autologous PBMC in the absence (black bars, 1:0 ratio) or presence (open bars, 1:1 ratio) of autologous CD4+CD25+ T cells. Results of three representative independent experiments are shown: one CTCL patient with non-suppressive CD4+CD25+ T cells (CTCL3), one CTCL patient with suppressive CD4+CD25+ T cells (CTCL6), and one representative HC (HC9). Journal of Investigative Dermatology 2006 126, 2217-2223DOI: (10.1038/sj.jid.5700371) Copyright © 2006 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 3 Lack of suppressive function in CD4+CD25+ Tregs in CTCL patients is associated with significantly lower Foxp3 mRNA expression. (a) The relative mRNA expression levels of Foxp3, (b) CTLA-4, and (c) T-plastin in CD4+CD25− and CD4+CD25+ T cells were assessed by real-time PCR. The mean±SEM of the mRNA expression is shown for HCs (n=8), suppressive CTCL patients (n=4), and non-suppressive CTCL patients (n=4). Significant differences are indicated in the figures; ND, not detected. Journal of Investigative Dermatology 2006 126, 2217-2223DOI: (10.1038/sj.jid.5700371) Copyright © 2006 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 4 The defect in Treg-mediated regulation lies within the CD4+CD25+ T-cell population. CD4+CD25+ or CD4+CD25− T cells from (a) non-suppressive or (b) suppressive CTCL patients were tested for their capacity to suppress the proliferation of allogeneic T cells derived from HC. CD4+CD25− HC T cells were cultured alone (black bars, 1:0), in the presence of CD4+CD25+ CTCL T cells (white bars, 1:1 ratio) or CD4+CD25− CTCL T cells (hatched bars, 1:1 ratio). (c) CD4+CD25−T-cells from a non-suppressive patient were cultured in the absence (black bar, 1:0) or presence of allogeneic CD4+CD25+ T cells derived from HC (white bar, 1:1 ratio). The suppressive activity is indicated by percentage inhibition in each graph. The intrinsic suppressive activity of the CD4+CD25+T cells in the corresponding autologous system were 0, 89, and 40% for non-suppressive CTCLs, suppressive CTCLs, and HCs, respectively. One of the two independent experiments is shown. Journal of Investigative Dermatology 2006 126, 2217-2223DOI: (10.1038/sj.jid.5700371) Copyright © 2006 The Society for Investigative Dermatology, Inc Terms and Conditions