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書き出し

Possible involvement of regulatory T cell abnormalities and variational usage of TCR repertoire in children with autoimmune neutropenia

郷田 聡 広島大学

2021.02.22

概要

A
Abstrac
Aut
Autoimm
Autoimmune
neutropenia (AIN) in childhood is characterized by chronic neutropenia and positivity for
ant
antineut
antineutrophil
antibodies, resulting in the excessive destruction of neutrophils. In this study, we investigated the
involvem
nv
involvement
of regulatory T cells (Tregs) in the pathogenesis of AIN in childhood. Tregs have been classified
into thre
three subpopulations based on the expressions of CD45RA and FOXP3: resting Tregs, activated Tregs, and
non
non-sup
non-suppressive
Tregs. ...

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参考文献

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Accepted Article

i e

Table 1.

1 Clinical characteristics of 25 patients with autoimmune neutropenia

Human neutrophil

Pat

Patient

Age at onset

Initial manifestation for the diagnosis of

antigens against

(months)

neutropenia

antineutrophil

Sex*

num

number

antibodies

Pyoderma

1a

10

Acute upper respiratory infection

1a

12

Pyrexia

1a

Lymphadenitis

1a/1b

14

Pyrexia

1a

22

Pyoderma

1a

17

Adeno Virus infection

1a

Pyrexia

1a/1b

22

Acute upper respiratory infection

1a

10

14

Lymphadenitis

1a

11

38

Pyrexia

1a

12

12

Pyrexia

1a

13

Pyrexia

1a/1b

14

Pyoderma

1a/1b

15

Pyrexia

1a/1b

16

Not doing well

1a

17

21

Acute bronchitis

1a/1b

18

10

Pyrexia

1a/1b

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Acute upper respiratory infection

1a

20

11

Pyrexia

1a

21

Acute bronchitis

1a

22

Respiratory syncytial virus infection

1a

23

10

Lymphadenitis

1a

24

31

Acute bronchitis

1a

25

20

Pyrexia

1a

Accepted Article

rticle

19

*M

M, male;

ma F, female

Patient examined for both the frequency of total/activated regulatory T cells and T cell receptor (TCR)-Vβ

Patien

repertoi

rep

repertoire.

Patients 18–25: analysis of frequency of total and activated regulatory T cells.

This article is protected by copyright. All rights reserved

Accepted Article

Table 2.

2 Standard value of TCR-Vβ family usage in CD4⁺⁺ T cells

β fam

family

%Mean

95%CI

SD

%Median

IQR

β1

3.08

2.93, 3.24

0.35

3.09

0.54

β2

10.84

10.1, 11.6

1.66

11.10

2.46

β3

6.75

5.78, 7.72

2.19

7.13

2.79

β4

2.10

2.01, 2.19

0.20

2.08

0.47

Vβ 5.1

4.73

4.10, 5.36

1.43

5.00

1.22

β 5.2

0.98

0.93, 1.03

0.12

0.97

0.20

β 5.3

0.86

0.82, 0.90

0.08

0.88

0.12

β 7.1

2.06

1.88, 2.24

0.40

2.05

0.57

β 7.2

0.40

0.20, 0.59

0.44

0.07

0.75

β8

3.44

3.16, 3.72

0.63

3.46

0.88

β9

3.12

2.94, 3.30

0.41

3.17

0.60

β 11

0.79

0.73, 0.84

0.13

0.79

0.20

β 12

1.78

1.59, 1.96

0.43

1.72

0.67

β 13.1

4.07

3.68, 4.45

0.88

4.13

1.32

β 13.2

1.84

1.46, 2.21

0.84

1.60

1.33

β 13.6

1.78

1.70, 1.86

0.18

1.76

0.25

β 14

2.70

2.53, 2.86

0.37

2.69

0.46

β 16

0.83

0.77, 0.89

0.13

0.84

0.17

β 17

5.20

4.96, 5.45

0.55

5.27

0.86

β 18

2.00

1.87, 2.13

0.29

2.06

0.39

β 20

3.27

2.87, 3.66

0.89

3.34

1.48

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1.54

1.41, 1.66

0.28

1.55

0.33

β 22

3.80

3.57, 4.03

0.52

3.78

0.67

β 23

0.46

0.42, 0.49

0.08

0.43

0.12

Accepted Article

β 21.3

TCR, T cell receptor; 95%CI, 95% confidential interval; SD, standard deviation; IQR, interquartile range (75th–

TC

25th

5t per

percentile).

This article is protected by copyright. All rights reserved

Accepted Article

ic

Table 33. Standard value of TCR-Vβ family usage in CD4⁺⁺CD25− T cells and CD4+CD25+CD127low T cells

Regulatory T cell

Conventional T cells

(CD4+CD25−T cells)

(CD4+CD25+CD127low T cells)

%Mean

95%CI

SD

%Median IQR

%Mean

95%CI

SD

Vβ 1

3.06

2.89, 3.24

0.40

3.11

Vβ 2

10.80

10.0, 11.6

1.70

Vβ 3

6.85

5.86, 7.83

Vβ 4

2.10

Vβ 5.1

%Median IQR

0.62

2.92

2.77, 3.07

0.34

3.01

0.36

10.70

2.74

10.9

10.2, 11.7

1.65

11.10

2.44

2.20

7.28

2.77

5.74

4.87, 6.61

1.97

5.81

2.68

2.01, 2.19

0.04

2.09

0.32

2.00

1.85, 2.15

0.33

1.96

0.50

4.59

3.97, 5.21

1.40

4.92

1.23

6.03

5.21, 6.84

1.84

6.43

1.44

Vβ 5.2

0.97

0.92, 1.03

0.12

0.96

0.18

1.13

1.06, 1.20

0.16

1.12

0.22

Vβ 5.3

0.84

0.80, 0.88

0.08

0.84

0.11

1.03

0.95, 1.11

0.18

1.03

0.22

Vβ 7.1

2.04

1.85, 2.22

0.41

2.07

0.58

1.83

1.67, 1.99

0.35

1.88

0.60

β 7.2

0.40

0.20, 0.59

0.44

0.07

0.76

0.40

0.23, 0.58

0.39

0.23

0.68

Vβ 8

3.47

3.18, 3.75

0.65

3.49

0.85

3.22

2.97, 3.46

0.55

3.25

0.75

Vβ 9

3.14

2.96, 3.32

0.41

3.19

0.64

2.83

2.65, 3.00

0.39

2.78

0.56

Vβ 11

0.78

0.72, 0.84

0.13

0.77

0.19

0.73

0.64, 0.81

0.19

0.76

0.29

Vβ 12

1.74

1.54, 1.94

0.44

1.66

0.63

2.26

2.05, 2.47

0.48

2.41

0.75

Vβ 13.1

4.12

3.73, 4.52

0.90

4.20

1.39

3.72

3.38, 4.06

0.76

3.94

1.05

β 13.2

1.79

1.41, 2.16

0.85

1.51

1.33

1.98

1.59, 2.36

0.87

1.46

1.38

Vβ 13.6

1.75

1.67, 1.82

0.18

1.75

0.25

2.15

2.00, 2.30

0.34

2.16

0.46

Vβ 114

2.70

2.53, 2.87

0.38

2.65

0.52

2.74

2.55, 2.93

0.42

2.70

0.42

β 16

0.83

0.77, 0.89

0.14

0.85

0.14

0.73

0.64, 0.81

0.19

0.73

0.31

family

fami

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5.21

4.96, 5.47

0.58

5.26

0.87

4.86

4.58, 5.12

0.61

4.87

1.21

Vβ 18

1.99

1.86, 2.13

0.30

2.02

0.41

1.99

1.85, 2.11

0.30

2.02

0.39

Vβ 20

3.37

2.95, 3.78

0.93

3.45

1.56

2.61

2.34, 2.89

0.63

2.65

0.80

β 21.3

1.55

1.67, 1.42

0.28

1.57

0.33

1.49

1.38, 1.60

0.25

1.48

0.33

Vβ 22

3.83

3.59, 4.06

0.52

3.81

0.71

3.32

3.03, 3.61

0.65

3.28

1.16

β 23

0.45

0.42, 0.48

0.07

0.43

0.12

0.41

0.35, 0.47

0.14

0.39

0.12

Accepted Article

Vβ 17

TCR,

CR, T cell receptor; 95%CI, 95% confidential interval; SD, standard deviation; IQR, interquartile range (75th–

25t

25th per

percentile).

This article is protected by copyright. All rights reserved

Accepted Article

Figure

1. Flow cytometric analysis of regulatory T cells (Tregs) and Treg subpopulations

CD4+CD

CD

CD25+FOXP3high T cells are counted as total Tregs and CD4+CD25+FOXP3highCD45RA− T cells in CD4+

T cells

((Fraction II in the Treg subpopulations) are counted as activated Tregs (a). Data are presented in

box-plo

box

box-plots which display the minimum value, 25th, 50th, 75th, maximum value, and describe means as X (b). For

of T cell receptor (TCR)-Vβ usage of each T cell subsets by flow cytometry, CD4+CD25− T cells

the evaluation

eval

in

n CD4

C + T cell are classified as conventional T cells (Tcons) and CD4+CD25+CD127low T cells are classified as

Tr

Tregs.

Each T cell subset IS sorted with fluorescein isothiocyanate (FITC) or phycoerythrin (PE)-conjugated

anti-TC

ant

anti-TCR-Vβ family antibodies (c). The data for the percentage of each T cell subset (Tcons in CD4+ T cell,

Tre in CD4+ T cell) are presented as box-plots (d). *p = 0.0123, **p = 0.0123, ***p = 0.0113. n.s; not

Tregs

significa

significant. (Wilcoxon rank-sum test).

Figure 2. The usages of 24 TCR-Vβ families in CD4⁺⁺ T cells

Dat are represented as box-plots. Analysis was performed in the control group (Cnt, n=22) and autoimmune

Data

nneutrop

neutropenia (AIN) group (AIN, n = 17). *Vβ 9, p = 0.0252, **Vβ 17, p = 0.0361 (Wilcoxon rank-sum test).

Figure 3. The usages of 24 TCR- Vβ families in regulatory T cells (Tregs) (CD4+CD25+CD127low T cells)

Fig

an con

and

conventional T cells (Tcons) (CD4+CD25− T cells)

Data are represented as box-plots. Analysis was performed in the control group (Cnt, n = 22) and autoimmune

neutropenia (AIN) group, (AIN, n = 17). Upper clonograph: T cell receptor (TCR) in Tregs. Lower clonograph;

neutrop

neu

TC in Tcons. *Vβ9-Treg; p = 0.0031, **Vβ17-Treg; p = 0.0234, ***Vβ20-Treg; p = 0.0218,

TCR

****Vβ21.3-Treg;

p = 0.0262, *****Vβ17-Tcon; p = 0.0325 (Wilcoxon rank-sum test).

*** β

****V

Figure

4. The increased/decreased usage of T cell receptor (TCR)-Vβ families in CD4+CD25− T cells and

Fig

CD4+CD

CD

CD25+CD127low T cells of patients with autoimmune neutropenia (AIN) and control subjects

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Accepted Article

Means and

a standard deviations (SDs) of TCR-Vβ family usage of conventional T cells (CD4+CD25− T cells) and

regulatory T cells (CD4+CD25+CD127low T cells) were calculated in the control group and used as normal

regulato

reg

val

values.

Heat map classifies the degrees of each usage of TCR-Vβ families using five colors; within normal

range:

an −

−2 SD – +2 SD (white), > +2 SD (pink), > +3 SD (red), < −2 SD (pale green), < −3 SD (green) (a). The

increase

inc

increased and decreased numbers of CD4+CD25− T cell and CD4+CD25+CD127low T cells per person were

compare

com

compared. Data are represented as box-plots (b). *p = 0.0022, **p = 0.0001 (Wilcoxon rank-sum test). n.s; not

sig

significa

significant.

Fig

Figure

5. The different usage of T cell receptor (TCR)-Vβ families in individual conventional T cells

(Tcons) and regulatory T cells (Tregs)

Eac lin

Each

line presents individual usage of TCR-Vβ families in Tcon and Treg. *p < 0.05, **p < 0.01, ***p < 0.001,

****p

* < 0.0001 (Wilcoxon signed-rank test)

Figure 6. Preferential T cell subsets with higher usage of T cell receptor (TCR) Vβ families

Usa oof TCR Vβ families was compared between conventional and regulatory T cells, and the T cell subsets

Usage

wit hig

with

higher usage of TCR Vβ families were defined as preferential T cell subsets. Red color or pink color

indicate

ind

indicates a preferential subset, while blue color or light blue color indicates a decreased subset. White color

indicate

indicates no preference between conventional and regulatory T cells. Con T, conventional T cell; Reg T,

regulatory T cell. Wilcoxon signed-rank test: pink-light blue, p < 0.05; red-blue, p < 0.001.

regulato

reg

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cei_13559_f1.pdf

Accepted

eep ed Article

ept

icle

Figure1.

(a)

(b)

Total Tregs

CD4+ T cell

**

n.s

***

CD25

SSC

SC

CD25

Lymphcyte

gating

FSC

Foxp3

CD4

CD45RA

CD45RA

CD4+ T cell

III II

Foxp3

CD4

Treg subpopulations

I: Resting Tregs

II: Activated Tregs

III: Non suppressive Tregs

(c)

;ĚͿ

Lymphcyte

gating

CD127

SSC

SSC

CD4+ T cell

CD4

FSC

CD25

CD4+ T cell

Vȕ 7.1

2.50%

PE

Vȕ 5.3

0.75%

Vȕ3

9.06%

FITC

CD4+CD25- T cell

(conventional T cell)

Vȕ 5.3

0.72%

CD4+CD25+CD127low T cell

(regulatory T cell)

Vȕ 5.3

1.08%

Vȕ 7.1

1.70%

PE

PE

Vȕ 7.1

2.50%

Vȕ 3

7.35%

Vȕ3

9.32%

FITC

FITC

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cei_13559_f2.pdf

Accepted Article

Figure2

9ȕ *

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9ȕ

**

cei_13559_f3.pdf

Accepted Article

Figure3

Vȕ9

Vȕ17

**

Vȕ20

***

Vȕ21.3

****

Vȕ17

*****

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cei_13559_f4.pdf

AIN group

AI

up

Control grou

group

Cnt 1

Cnt 2

Cnt 2

Cnt 3

Cnt 3

Cnt 4

Cnt 4

Cnt 5

Cnt 5

Cnt 6

Cnt 6

Cnt 7

Cnt 7

Cnt 8

Cnt 8

Cnt 9

Cnt 9

Cnt 10

Cnt 10

Cnt 11

Cnt 11

Cnt 12

Cnt 12

Cnt 13

Cnt 13

Cnt 14

Cnt 14

Cnt 15

Cnt 15

Cnt 16

Cnt 16

Cnt 17

Cnt 17

Cnt 18

Cnt 18

Cnt 19

Cnt 19

Cnt 20

Cnt 20

Cnt 21

Cnt 21

Cnt 22

Cnt 22

AIN 1

AIN 1

AIN 2

AIN 2

AIN 3

AIN 3

AIN 4

AIN 4

AIN 5

AIN 5

AIN 6

AIN 6

AIN 7

AIN 7

AIN 8

AIN 8

AIN 9

AIN 9

AIN 10

AIN 10

AIN 11

AIN 11

AIN 12

AIN 12

AIN 13

AIN 13

AIN 14

AIN 14

AIN 15

AIN 15

AIN 16

AIN 16

Regulatory T cells

( CD4+CD25+CD127low T cells )

<-3SD <-2SD

-2SD ~ +2SD

Heat map

**

n.s

n.s

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>2SD >3SD

23

22

20

AIN 17

Conventional T cells

( CD4+CD25- T cells )

21.3

18

17

16

14

13.6

13.2

12

13.1

11

7.1

5.3

5.2

5.1

23

22

20

Cnt 1

AIN 17

(b)

21.3

18

17

16

14

TCR-Vȕ family

13.6

12

13.2

13.1

11

7.1

5.3

5.2

5.1

TCR-Vȕ family

7.2

(a

(a)

7.2

Accepted

pted Arti

Article

Figure4

Figure5

0.4

0.4

0.6

0.2

0.5

0.2

Treg

Treg

Tcon

Tcon

Treg

Treg

Tcon

Tcon

Treg

AIN

**

****

1Ϭ͘ϱ

0.5ϭ

Treg

Treg

Treg

Tcon

Treg

Tcon

Treg

Tcon

9ȕ

9ȕ

Cnt

AIN

Ϭ͘ϵ

0.7

0.6

Ϭ͘ϳ

0.5ϯ

Ϭ͘ϱ

0.4

0.3

Ϭ͘ϰ

0.2

0.1

Ϭ͘Ϯ

Ϭ͘ϴ

Ϭ͘ϲ

Ϭ͘ϯ

Ϭ͘ϭ

This article is protected by copyright. All rights reserved

0.9

0.8

Treg

ϭ͘ϱ

Treg

Cnt

Treg

6ϯ͘ϱ

Tcon

ϭ͘Ϯ

Tcon

9ȕ

Cnt

AIN

Tcon

1.5

Tcon

Treg

Ϭ͘Ϯ

Treg

Tcon

0.2

Ϭ͘ϱ

Ϯ͘ϱ

Treg

Tcon

Tcon

Treg

Ϭ͘ϰ

Treg

Treg

Treg

Tcon

ϭ͘ϱ

0.4

2.5

Treg

Treg

Ϭ͘ϲ

1.5

Ϭ͘ϱ

0.5

Ϯ͘ϱ

1 Ϭ͘ϱ

ϯ0

Tcon

Ϭ͘ϴ

0.6

Treg

3.5ϲ

0.8

Ϯ͘ϱ

2ϭ͘ϱ

ϭ͘ϱ

0.5

ϯ͘ϱ

3.5

**

9ȕ

AIN

****

Tcon

45

4.5

Cnt

ϭ͘ϰ

2.5Ϯ

Tcon

ϱ͘ϱ

1.5

ϰ͘ϱ

6 ϯ͘ϱ

2.5

5.5

Tcon

Treg

Tcon

9ȕ

Cnt

AIN

**

ϯ͘ϱ

Treg

1.5

9ȕ

Cnt

AIN

1.2

Tcon

1.4

ϰ͘ϱ

3.5

Ϯ͘ϱ

Tcon

2.5

9ȕ

Cnt

AIN

Tcon

***

****

4.5ϯ͘ϱ

Treg

**

3.5

Treg

Tcon

Tcon

Treg

Tcon

Treg

**

9ȕ

Cnt

AIN

3.5ϲ

ϲ͘ϱ

Treg

9ȕ

Cnt

AIN

Treg

Tcon

***

Tcon

00

0.5ϭ

Treg

6.5

9ȕ

Cnt

AIN

0.6

0 0

Tcon

Treg

Tcon

Tco

1Ϭ͘ϱ

Treg

0.5

0.8

0.6

Ϭ0

0.8

0.2

Tcon

0.21

ϭ͘ϱ

1 1

Treg

1.5

1.2

Ϭ͘ϱ

1.27

9ȕ

Cnt

AIN

0.4

Tcon

0.2

0.4

Ϯ͘ϱ

0.4

16

****

Tcon

9ȕ 

AIN

Treg

2.5

7 6

Cnt

6 5

Treg

***

****

00

Tcon

****

10

1.2

Ϭ͘ϰ

Ϭ͘Ϯ

0.2

9ȕ

Cnt

AIN

****

Ϭ͘ϴ

Ϭ͘ϲ

0.4

Tcon

****

6ϯ͘ϱ

ϭ͘ϱ

Tcon

Treg

9ȕ

Cnt

AIN

AIN

ϭ͘ϰ

ϭ͘Ϯ

0.8

00

Tcon

Treg

Tcon

35

3.5

Ϯ͘ϱ

1.4

Treg

Tcon

1.2

0.6

0.8

1.5

0.6

9ȕ

ϭ͘ϴ

ϭ͘ϲ

Cnt

1.6

1.2

2.5

9ȕ

Cnt

AIN

1.8

1.2

0.8

.8

01

ϯ͘ϱ

**

1.4

0.6

1.5

Tcon

3.5

1.6

1.5

Treg

***

9ȕ

Cnt

AIN

0.8

0.6

0.4

0.2

Treg

00

0.8

Treg

10

24

Treg

9ȕ

AIN

1.6

2.5

***

1.4

38

2.5

****

1.4

1.2

61

1.5

Treg

Treg

Cnt

Tcon

Tcon

Treg

1.5

10

86

1.6

10

10

Tcon

**** ****

3.5

10

Tcon

12

9ȕ

Cnt

AIN

9ȕ

AIN

Cnt

12

3.5

Tcon

14

10

12

3.5

9ȕ

AIN

Cnt

**

Tcon

2.5

*****

14

9ȕ

AIN

****

12

16

10

2.5

1.6

Cnt

Treg

3.5

1.4

9ȕ

AIN

16

4.5

Cnt

Tcon

4.5

AIN

Tcon

9ȕ

Accepted

Acc

Ac

cc p

cc

ptte

pte

ted Ar

Article

rticle

ticle

cle

cl

Cnt

cei_13559_f5.pdf

Accepted Article

cei_13559_f6.pdf

Figure 6

TCR Vb

5.1

5.2

5.3

7.1

7.2

11

12

13.1

13.2

13.6

14

16

17

18

20

21.3

22

23

Control

Con T

Reg T

AIN

Con T

Reg T

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