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Published online before print January 2, 2007
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,1
* Department of Molecular Microbiology and Immunology, Malaria Research Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; and
Department of Human Science, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
2 Correspondence: Department of Molecular Microbiology and Immunology, Malaria Research Institute, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA. E-mail: fzavala{at}jhsph.edu
| ABSTRACT |
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-producing CD8+ T cells. The induction of this broad signaling activity in CD8+ T cells coincides with a transcriptional activity of suppressors of cytokine signaling genes, which are decreased significantly in comparison with CD4+ T cells. To our knowledge, this report constitutes the first comprehensive analysis of the signaling events that shape CD8+ T cell responses to IL-4.
Key Words: cytokine signaling CTL JAK/STAT PI-3K
| INTRODUCTION |
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-chain receptor cytokine family, is considered a crucial mediator of CD4+ Th2 T cell differentiation and suppression of IFN-
-producing CD4+ Th1 cells [1
]. This cytokine also plays a pivotal role in differentiation of B cells, controlling the specificity of IgG class-switching and the development of memory B cells. In addition, several studies indicate that IL-4 helps to sustain the growth and prolongs the survival of CD4+ T and B cells [1
]. To exert these functions, IL-4 binds and signals through a heterodimeric receptor complex formed by the IL-4 receptor (IL-4R)
-chain and an accessory chain,
-common chain (Type I receptor) or IL-13R
1 chain (Type II receptor) [2
, 3
]. IL-4 also modulates important functions of CD8+ T cells, which compared with CD4+ T cells, undergo distinct differentiation pathways and exhibit radically different functional properties. Early in vitro studies described a number of effects of IL-4 on CD8+ T cells, including the induction of IL-4 secretion and enhancement of IL-2-induced proliferation [4 5 6 ]. Other studies suggested a role for IL-4 in the in vitro development of cytotoxic T cells [7 , 8 ], and some studies indicated that IL-4 could decrease cytolytic activity in vitro [9 ]. This cytokine was also shown to be necessary for the in vitro generation of memory CD8+ T cells [10 ]. It is important that in vivo studies using a murine model of mammary and colon carcinoma showed that cytotoxic T lymphocyte-mediated tumor immunity was abrogated or did not develop in the absence of IL-4 [11 ]. More recently, vaccination studies in mice using Leishmania donovani demonstrated that the development of CD8+ T cell-mediated, protective responses against this parasite was fully dependent on IL-4 [12 ]. Our studies with the rodent malaria parasite Plasmodium yoelii, using parasite-specific TCR transgenic CD8+ T cells, revealed a critical role of IL-4 in the generation of memory CD8+ T cell responses against the liver stages of this parasite [13 ]. Using IL-4R/ mice, we demonstrated that IL-4 acts directly on activated, antiparasite CD8+ T cells through the IL-4R and promotes the survival of memory CD8+ T cells belonging to the effector/peripheral subset homing to nonlymphoid organs [14 ]. In these studies, we also found lower levels of the antiapoptotic molecule Bcl-xL in activated IL-4R/ CD8+ T cells compared with wild-type cells, suggesting a role for IL-4 in the induction of intracellular mechanisms that rescue CD8+ T cells from apoptosis.
The intracellular signaling induced by IL-4/IL-4R interactions on CD4+ T cells has been characterized in great detail. The binding of IL-4 to the Type I receptor in CD4+ T cells induces the activation of the nonreceptor tyrosine kinase Jak1, which promotes the phosphorylation of STAT6. In addition, IL-4 activates the insulin receptor substrate-2 (IRS-2) pathway, which subsequently induces the activation of PI-3K. The Jak1/STAT6 and IRS-2/PI-3K pathways mediate IL-4-dependent Th2 differentiation and production of Th2 cytokines [15 , 16 ]. Both pathways are required for the proliferative activity of CD4+ T cells induced by IL-4, but they do not seem to participate in the IL-4-dependent rescue from apoptosis [16 ]. IL-4 can also induce a Jak3-dependent activation of STAT1 and STAT5, but this effect appears to be observed only in differentiated CD4+ Th2 cells [17 18 19 20 ]. Although the effects of IL-4 on CD4+ T cells have been examined extensively, the signaling events induced by IL-4 on CD8+ T cells have not been studied, in spite of increasing evidence indicating an important role for this cytokine in CD8+ T cell function and differentiation.
In this report, we describe studies aimed at identifying the signaling pathways activated by IL-4 in CD8+ T cells. Similar to CD4+ T cells, IL-4 induced the activation of the IRS-2/PI-3K/protein kinase B (PKB) and Jak1/STAT6 pathways in naïve, activated and differentiated, IFN-
-producing CD8+ T cells. It is surprising that IL-4 also induced Jak3-dependent activation of STAT1, STAT3, and STAT5 in CD8+ T cells, irrespective of their differentiation status. This broad activation of STAT family members coincided with reduced transcriptional levels of intrinsic suppressors of cytokine signaling (SOCS) in CD8+ T cells stimulated with IL-4 when compared with similarly treated CD4+ T cells.
| MATERIALS AND METHODS |
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Adoptive transfer of transgenic cells and immunization
Spleen cells were obtained from SYVPSAEQI-specific TCR transgenic mice, and after purification, 106 tetramer+/CD8+ T cells were used for adoptive transfer experiments. Before transfer, the total number of transgenic cells in the spleen was determined by FACS analysis after staining with anti-CD8 antibodies and SYVPSAEQI tetramers. Immunization with P. yoelii (17X NL strain) sporozoites was done by i.v. injection of
-irradiated parasites.
T cell purification and in vitro activation
Spleen CD8+ T cells were purified through mouse T cell enrichment columns according to the manufacturers instructions (Miltenyi Biotec, Auburn, CA, USA). Briefly, splenocytes were depleted of CD4+ and B220+ cells by negative selection using FITC-labeled anti-CD4 and anti-B220 antibodies (BD PharMingen, San Jose, CA, USA) plus antifluorescein-conjugated magnetic beads (Miltenyi Biotec). The CD8+ T cells were finally purified from the pass-through by positive selection using PE-labeled, anti-CD8 antibody and anti-PE-conjugated magnetic beads (Miltenyi Biotec). Purification of CD4+ T cells was performed using the same protocol but using FITC-labeled, anti-CD8 antibodies in the negative selection and PE-labeled, anti-CD4 antibodies for positive selection (BD PharMingen). The purity of the respective T cell populations was 98% or higher. For the signaling experiments, the purified cells were cultured in vitro for 48 h at 37°C/5% CO2 in DMEM supplemented with 50 µM 2-ME, antibiotics, and 10% FBS in the presence of plate-bound, anti-CD3 (3 µg/ml) and soluble, anti-CD28 (3 µg/ml) antibodies (BD PharMingen) and 2% EL-4 supernatant as a source of IL-2 (30 U/mL). The cells were then divided in two flasks and expanded for 2 additional days. Some experiments were performed using Y26 cells, a memory T cell clone specific for malaria epitope SYVPSAEQI. These cells produce IFN-
but no IL-4. A total of 1 x 106 cells was cocultured with 1 x 106 A20 (B cell melanoma) cells loaded with the SYVPSAEQI peptide and 20 x 106 splenocytes in DMEM supplemented with 10% FCS and 2% EL-4 supernatant as described above.
Immunoprecipitation and Western blotting
Cultured cells were washed twice in DMEM alone and deprived of serum and cytokine for 3 h prior to stimulation with IL-4 (10 ng/ml; BD PharMingen) for different times as indicated. Cells were then harvested and lysed on ice for 20 min in 200 µL lysis buffer (20 mM Tris-HCl, pH 7.3, 50 mM NaCl, 2 mM DTT, 4 mM EGTA, 1% Nonidet-40, 10% glycerol) freshly supplemented with phosphatase and protease inhibitors (10 mM NaF, 1 mM Na3VO4, 10 µg/mL aprotinin, 10 µg/mL leupeptin, 10 µg/mL pepstatin, and 16 mM Pefabloc). Cell lysates were then cleared by centrifugation at 12,000 rpm for 10 min at 4°C, and the protein concentration of the supernatants was determined by using the Bio-Rad protein assay kit (Bio-Rad, Hercules, CA, USA). In immunoprecipitation assays, lysates were incubated with 4 µg anti-IL-4R
antibody (BD PharMingen) overnight at 4°C. Immunocomplexes were precipitated with Protein A/G Plus agarose beads (Santa Cruz Biotechnology, Santa Cruz, CA, USA) for 2 h and eluted by boiling in the presence of 2x SDS-PAGE loading buffer. Proteins were resolved on SDS 7.5% or 10% premade acrylamide gels (Bio-Rad) and transferred onto Immobilon-P membranes (Millipore, Bedford, MA, USA). Membranes were probed with primary, specific antibodies followed by HRP-labeled secondary antibodies (Cell Signaling Technology, Danvers, MA, USA) and visualized with SuperSignal West Pico substrate (Pierce, Rockford, IL, USA). For some experiments, detection sensibility was enhanced with Signal Femto substrate (Pierce). The probed membranes were stripped with Restore and Stripping solution (Pierce) for 20 min at 37°C and reprobed with a second antibody of choice to detect total levels of protein. All antiphospho-specific antibodies, anti-PKB, and anti-STAT1-, anti-STAT3-, and anti-STAT5-specific antibodies were purchased from Cell Signaling Technology. Anti-STAT6 antibody was obtained from BD PharMingen.
Isolation of nuclear and cytoplasmic fractions
Nuclear and cytoplasmic extracts from cells were obtained by using NE-PER nuclear and cytoplasmic extraction reagents kit (Pierce) following the manufacturers instructions. Briefly, 200 µl ice-cold CER I reagent, supplemented with inhibitors, as described above, was added to the pellet of 5 x 106 cells. After 10 min of incubation on ice, 11 µL ice-cold CER II reagent was added to each tube and incubated on ice for an additional 1 min. Samples were centrifuged at 15,000 rpm for 5 min at 4°C, and the supernatant containing the cytoplasmic fraction was transferred rapidly to a fresh, prechilled tube. The insoluble pellet was resuspended in 50 µL ice-cold NER reagent, freshly supplemented with the same inhibitors described above. The samples were vortexed vigorously and incubated on ice for 40 min. The nuclear extract was collected by centrifugation at 15,000 rpm for 10 min at 4°C.
Flow cytometry analysis
Annexin V-FITC, in combination with propidium iodide (PI), was used to quantitatively determine the percentage of cells undergoing apoptosis, as described previously [22
]. Resting CD8+ T cells were cultured for different days in DMEM supplemented with 10% FCS in the presence or absence of IL-4 (10 ng/mL). Alternatively, cells were preincubated or not with Jak Inhibitor I (Jak Inh I) or Jak3 Inhibitor I (Jak3 Inh I; Calbiochem, San Diego, CA, USA) or LY294002 (Sigma Chemical Co., St. Louis, MO, USA) for 30 min prior to IL-4 addition. After treatments, 105 cells were resuspended in 1x binding buffer (BD PharMingen) and incubated with Annexin V-FITC for 15 min at room temperature in the dark, followed by PI staining. Cells were analyzed within 1 h in a FACSCalibur flow cytometer, and CELLQuest software (Becton Dickinson, San Diego, CA, USA) was used to analyze the data. Early apoptotic cells were stained with Annexin V alone, whereas late apoptotic cells were stained with Annexin V and PI.
Quantitative real-time PCR analysis
RNA was isolated using TRIzol® reagent (Invitrogen, San Diego, CA, USA), and first-strand cDNA synthesis was performed using RNA (2 µg), RT, and random hexamers, following the manufacturers instructions (Applied Biosystems, Foster City, CA, USA). Quantitative real-time PCR analysis was performed in ABI 7500 (Applied Biosystems) using cDNA as template; TaqMan Assays-on-Demand gene expression assay mix specific for SOCS1, SOCS2, SOCS3, or cytokine-inducible Src homology 2 (SH2) domain-containing protein (CIS); and TaqMan Universal PCR master mix (Applied Biosystems). SOCS copies per cell were calculated by extrapolation from standard curves generated using SOCS plasmid cDNA.
| RESULTS |
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We have extended these studies using an established IFN-
-producing CD8+ T cell clone (Y26) specific for the SYVPSAEQI epitope of the circumsporozoite protein of Plasmodium yoelii and confirmed the prosurvival effect of IL-4 in vitro. As shown in Figure 1A
, Y26 cells supplemented with IL-4 remain alive in culture for a period of several days. In contrast, Y26 cells incubated without IL-4 underwent a progressive loss in viability, detectable at 24 h after cytokine withdrawal and becoming more evident by Day 6, when 98% of the cells were dead (Fig. 1A)
. Flow cytometry analysis for binding of Annexin V to these cells was fully consistent with these results (Fig. 1B)
, and a large number of cells (85%) became Annexin V+, i.e., apoptotic on Day 4 in the absence of IL-4 compared with only 14% when cells were incubated with IL-4. This effect appears to be limited to the survival of cells by preventing apoptosis, as IL-4 has no effect on the proliferation of CD8+ T cells, in sharp contrast to IL-2, which strongly promotes proliferation of these cells (Supplemental Fig. 1A).
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IL-4 induces phosphorylation of the IL-4R
chain and activates the IRS-2/PI-3K/PKB pathway in CD8+ T cells
To characterize the initial signaling events involved in the response of CD8+ T cells to IL-4, we first studied the phosphorylation status of IL-4R after incubation with IL-4. Western blot analysis of immunoprecipitated IL-4R probed with antiphosphotyrosine antibodies confirmed that IL-4 induces tyrosine phosphorylation of the IL-4R
chain in CD8+ T cells (Fig. 2A
). Thus, similar to what has been reported in other cell types, IL-4 induces IL-4R activation in CD8+ T cells, a step necessary to recruit signaling molecules that bind directly to the activated complex.
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followed by immunoblotting using anti-IRS-2 antibodies. As shown in Figure 2A
, addition of IL-4 to CD8+ T cell cultures results in increased association between IRS-2 and IL-4R
, indicating that IL-4 activates the IRS-2/PI-3K/PKB pathway in these cells.
IL-4 induces the activation of PKB in CD8+ T cells via the phosphorylation of PKB residues Ser473 and Thr308
Recruitment of IRS-2 to the IL-4R provides additional docking sites for downstream signaling intermediates such as the regulatory subunit of PI-3K, which leads to the activation of the PI-3K/PKB pathway. To determine whether PKB is activated by IL-4 in CD8+ T cells, we used mAb that recognize phosphorylated residues Ser473 and Thr308, which are a hallmark of PKB activation. As shown in Figure 2B
, incubation of naïve, activated CD8+ T cells with IL-4 results in the phosphorylation of Ser473 and Thr308 residues of PKB. The phosphorylation of both residues shows a temporal increase reaching maximal levels at approximately 5 min after cytokine addition, suggesting that the activation of PKB in CD8+ T cells is an early event in the response to IL-4. Similar results were observed with the differentiated CD8+ T cell line Y26 (Supplemental Fig. 2).
PI-3K activation is reported to be an upstream event in PKB phosphorylation because of its ability to induce rapid and transient formation of phosphoinositides phosphorylated in Position 3, which serve as docking sites for pleckstrin homology domain proteins, such as PKB, in the plasma membrane [1 ]. To determine whether IL-4-induced PKB phosphorylation in CD8+ T cells is dependent on PI-3K activity, we used two selective, chemically unrelated inhibitors of PI-3K (LY294002 and Wortmannin) to block PI-3K function [25 ]. CD8+ T cells were pretreated for 30 min with LY294002 or Wortmannin prior to incubation with IL-4 for 5 min, and activation of PKB was assessed by immunoblot using the anti-pSer473 and -pThr308 phospho-specific antibodies. Under these conditions, both inhibitors completely abolished the IL-4-induced phosphorylation of PKB residues Ser473 and Thr308, indicating that these events are indeed PI-3K-dependent (Fig. 2B) . Taken together, these results indicate that exposure of CD8+ T cells to IL-4 leads to the activation of the IRS-2/PI-3K/PKB pathway.
Induction of the Jak/STAT pathway by IL-4 in CD8+ T cells
As Jak1 associates with IL-4R in CD4+ T cells [26
], we analyzed the time course of Jak1 activation in CD8+ T cells after incubation with IL-4. As shown in Figure 3
, the phosphorylated form of Jak1, i.e., activated Jak1, was detected in cell lysates as early as 5 min after IL-4 incubation, and levels of phosphorylation declined after 15 min.
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and TNF-
and traces of IL-2 and do not secret IL-4. Their phenotype is typical of memory cells, including CD44high CD62Llow CD122high CCR7high. These cells produce perforin, are strongly cytotoxic in vitro, and exhibit a strong, antiparasite activity in vivo when transferred into mice challenged with parasites. In hematopoietic cells, Jak proteins that associate with the Type I IL-4R include not only Jak1, but also Jak3. To determine whether Jak3 was involved in IL-4-dependent STAT activation in CD8+ T cells, we analyzed the phosphorylation of various STATs in the presence of two potent inhibitors of Jak proteins, Jak Inh I, a broad specificity inhibitor that blocks Jak1 and Jak3 activation [27 ], and Jak3 Inh I, which is specific for Jak3 [28 ]. As shown in Figure 4C , the phosphorylation of all STATs was blocked by Jak Inh I, as expected, in view of its broad specificity. However, treatment of cells with Jak3 Inh I abolished only the activation of STAT1, STAT3, and STAT5 but did not prevent STAT6 phosphorylation. These results strongly suggest that IL-4 induces the activation of Jak1 and Jak3 in CD8+ T cells, the latter being responsible for the activation of STAT1, -3, and -5 but not STAT6, which seems to be Jak1-dependent. Attempts to demonstrate phosphorylation of Jak3 by Western blot analysis proved to be technically challenging. The results using commercially available anti-Jak3 antibodies were inconclusive, as it was not possible to differentiate IL-4-induced Jak3 phosphorylation consistently from background levels.
As different signaling intermediates downstream of the IL-4R complex are activated in CD8+ T cells in response to IL-4, we investigated their respective roles in the antiapoptotic effect of IL-4 following the approach described in previous other studies using signaling inhibitors [29 ]. We found that 24 and 48 h after incubation of CD8+ T cells with the nonspecific Jak Inh I (100 nM), the specific Jak3 Inh I (100 µM), or the PI-3K inhibitor LY294002 (25 µM), the antiapoptotic effect of IL-4 was partially blocked (Supplemental Fig. 4). These data raise the possibility that the effect of IL-4 in sustaining the survival of activated CD8+ T cells may require the activation of the IRS-2/PI-3K/PKB and the Jak/STAT pathways. Studies in other cell types also suggest that Jak/STAT as well as IRS-2/PI-3K pathways mediate the generation of signals involved in growth and cell survival [30 31 32 33 ].
Low-level transcription of SOCS genes in CD8+ T cells
In view of our findings indicating that IL-4 induces the simultaneous activation of several STAT proteins in CD8+ T cells, we examined the transcriptional status of SOCS genes in these cells. The SOCS family of intracellular proteins, particularly CIS, SOCS1, SOCS2, and SOCS3, modulates IL-4 signaling in CD4+ T cells, and it is believed that they suppress cytokine-induced signaling pathways by inhibiting Jak activity or STAT phosphorylation directly [34
, 35
]. Using a quantitative real-time RT-PCR assay, we compared SOCS transcription levels in CD8+ and CD4+ T cells in the absence or presence of IL-4 and found that under the same experimental conditions, CD8+ T cells displayed a greatly diminished induction of CIS, SOCS1, -2, and -3 gene transcription in comparison with CD4+ T cells (Fig. 5
). These results raise the possibility that the differences in signaling that appear to exist between CD8+ and CD4+ T cells may be in part a result of a decreased inhibitory activity of SOCS in CD8+ T cells. Thus, CD8+ T cells may not be subject to the same strong pressure for the development of cell subsets that is seen in CD4+ T cells.
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| DISCUSSION |
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Our results show that IL-4-induced signaling in CD8+ T cells involves tyrosine phosphorylation of the IL-4R and subsequent binding of IRS-2 to the activated receptor complex, which can, in turn, act as a cytosolic docking site for downstream SH2 domain-containing signaling molecules [36 ], such as PI-3K. Indeed, IL-4 induces PI-3K activity, as shown by Western blotting analysis, demonstrating the specific phosphorylation of PKB, a downstream substrate of PI-3K, at residues Ser473 and Thr308. This notion received further support by the results of experiments indicating that PKB phosphorylation was inhibited by Wortmannin and LY294002, two independent PI-3K inhibitors.
IL-4 also activates the Jak/STAT pathway in CD8+ T cells, which is perhaps the best-characterized IL-4-driven signaling cascade in CD4+ T cells. In CD8+ T cells, IL-4 signaling results in the activation of STAT6 [37 , 38 ], following a distinct pattern of tyrosine phosphorylation and nuclear migration. Jak1, not Jak3, seems to be the primary kinase mediating this process, as Jak3 inhibition does not affect STAT6 phosphorylation. A most surprising finding is that STAT1, STAT3, and STAT5 are also activated in naïve, activated and differentiated CD8+ T cells in response to IL-4, as demonstrated by Western blot analysis using antiphospho-specific antibodies for each STAT protein. Unlike STAT6 phosphorylation, the activation of STAT1, STAT3, and STAT5 is blocked by Jak3 inhibition. It is important that the extensive STAT activation induced by IL-4 is abolished completely after neutralization of this cytokine with anti-IL-4 mAb, demonstrating that the observed effects are mediated strictly by IL-4.
The IL-4-induced activation of STATs other than STAT6, although unexpected, is not entirely without precedent, as this effect of IL-4 has been reported in other cell types including differentiated Th2 CD4+ T cells. IL-4 was found to be a potent inducer of STAT6 and STAT1 activation in Th2 but not in Th1 CD4+ T cells [17
]. In a different study, IL-4-induced STAT5 was shown to be necessary for the expansion of Th2 CD4+ T cells [20
]. Therefore, IL-4 appears to induce the activation of STAT6 alone in naïve-activated CD4+ T cells, and the activation of STAT1 and STAT5 is clearly detectable only in differentiated CD4+ T cells of the Th2 subtype. The activation by IL-4 of other STAT proteins, such as STAT5a and STAT5b, has also been observed in a pro-B cell line (Ba/F3), where they acquire specific DNA-binding properties by a mechanism dependent on the
c chain [19
]. Other studies describe an IL-4-dependent, antiapoptotic role for the STAT3 transcription factor in human B cells [39
], malignant glioma cells [40
], and normal and tumor lung fibroblasts [41
], although no such role for STAT3 has been defined in CD4+ T cells.
It is intriguing that CD8+ T cells respond to IL-4 stimulation with extensive and simultaneous activation of different STAT pathways, although the effect of IL-4 appears to be more restricted in CD4+ T cells. Cytokine-induced signal transduction is regulated by different classes of intracellular inhibitors, among which the SOCS gene family features prominently in response to IL-4, controlling the Jak/STAT pathway [34 , 35 ]. CIS, SOCS1, SOCS2, and SOCS3 are constitutively expressed in naïve CD4+ T cells, and their gene transcription is differentially regulated by IL-4 [17 ]. Th2-polarized cells stimulated with IL-4 respond with a strong activation of STAT1, SOCS1, and SOCS3, suggesting a tight control of signaling activity [17 ]. Our study indicates that CD8+ T cells, compared with CD4+ T cells, have lower basal, transcriptional levels of SOCS, which do not increase appreciably after IL-4 stimulation, indirectly suggesting a diminished, inhibitory activity on intracellular signaling by SOCS molecules in these cells.
The physiological consequence of the IL-4-mediated, wide-spectrum signaling in CD8+ T cells has yet to be fully elucidated. This is a rather complex and challenging task, as indicated by studies performed during decades on CD4+ T cells in which the functional roles of the different signaling pathways induced by IL-4 still remain controversial and are yet to be clarified. The results of previous in vivo and in vitro studies describing multiple effects of IL-4 on CD8+ T cells suggest that this cytokine may play a number of yet unsuspected roles in the development of CD8+ T cell responses. A role for IL-4 in ensuring the survival of memory CD8+ T cells may be particularly crucial, as CD8+ T cells undergo an intense post-priming proliferation phase, which is followed immediately by an abrupt contraction phase, in which most activated cells die, presumably as a result of apoptosis. Wide-spectrum signaling pathways, which translate in the generation of antiapoptotic mediators, would be an efficient, physiological mechanism to ensure an efficient development of memory populations. Alternatively, IL-4 might direct discrete specializations within activated CD8+ T cell populations to enable effective memory differentiation. Further studies are required to fully unravel the overarching impact of IL-4 on the activity of CD8+ T cells in different animal systems.
| ACKNOWLEDGEMENTS |
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| FOOTNOTES |
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Received September 21, 2006; revised November 3, 2006; accepted December 7, 2006.
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}2 Cancer Res. 65,2956-2963
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