High Expression of NKG2A/CD94 and Low Expression of Granzyme B Are Associated with Reduced Cord Blood NK Cell Activity

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Cellular & Molecular Immunology 377 Article High Expression of NKG2A/CD94 and Low Expression of Granzyme B Are Associated with Reduced Cord Blood NK Cell Activity Yanyan Wang 1, 2, Han Xu 1, 2, Xiaodong Zheng 1, Haiming Wei 1, Rui Sun 1 and Zhigang Tian 1, 3 Human umbilical cord blood () has recently been used as a source of stem cells in transplantation. NK cells derived from are the key effector cells involved in graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL). It was reported that the activity of NK cells was lower than that of adult peripheral blood () NK cells. In this study, we analyzed the expression of some NK cell receptors and cytotoxicity-related molecules in and NK cells. The expressions of activating NK receptors, CD16, NKG2D and NKp46, did not show significant difference between and NK cells. But the expression of inhibitory receptor NKG2A/CD94 was significantly higher on NK cells. As to the effector function molecules, granzyme B was expressed significantly lower in NK cells, but the expressions of intracellular perforin, IFN-γ, TNF-α and cell surface FasL and TRAIL did not show difference between and NK cells. The results indicated that the high expression of NKG2A/CD94 and low expression of granzyme B may be related with the reduced activity of NK cells. Cellular & Molecular Immunology. 27;4(5):377-382. Key Words: NK, cord blood, NK cell receptor, NKG2A, granzyme B, cytotoxicity Introduction Natural killer (NK) cells are a population of large granular lymphocytes with a CD56 + /CD3 - phenotype (1, 2). They are distinguishable from B and T lymphocytes by lack of antigen receptors. NK cells kill a variety of tumor cells, virus-infected cells and allogeneic cells in a non-major histocompatibility complex restricted manner and provide the first line of immune defense (3, 4). Although NK cells lack the antigen-specific receptors, they distinguish between normal cells and abnormal cells by their cell surface receptors (5). After binding to potential target cell, NK cell activating and inhibitory receptors interacted with ligands and transmitted signals, and then all 1 Institute of Immunology, Hefei National Laboratory for Physical Materials at Microscale and School of Life Sciences, University of Science and Technology of China, Hefei 2327, China; 2 Yanyan Wang and Han Xu equally contributed to the present study; 3 Corresponding to: Dr. Zhigang Tian, School of Life Sciences, University of Science and Technology of China, 443 Huangshan Road, Hefei, Anhui 2327, China. Tel: +86-551-36-7379, Fax: +86-551-36-6783, E-mail: tzg@ustc.edu.cn Received Jul 1, 27. Accepted Aug 7, 27. Copyright 27 by The Chinese Society of Immunology the signals were integrated to determine whether NK cell stays and responds (6, 7). The effector function of NK cells is regulated by a balance between the inhibitory signals delivered by the MHC class I-specific inhibitory receptors and the activating signals transmitted by activating receptors (2, 8). NK cell effector function is mainly mediated through: 1) releasing cytoplasmic cytotoxic granules (granzyme and perforin) by exocytosis; 2) secreting cytokines (IFN-γ, TNF-α, etc.); and 3) the engagement of death receptors on target cells by their cognate ligands (e.g., FasL and TRAIL) on NK cells (9-12). Human umbilical cord blood () has recently been used as a source of stem cells in partially HLA-mismatched transplantation (13-16). NK cells derived from are the key effector cells involved in graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) (17-19). So much interest was focused on the characteristics of. It was reported that the activity of NK cells was lower than that of adult peripheral blood () NK cells (2-22). Analysis of adhesion molecules on NK cells showed that low expression level of adhesion molecules on CD56 dim NK cells may contribute to the low NK cell activity (21). In this study, we investigated the expressions of some NK cell-related receptors and intracellular cytokines in and NK cells. We sought to determine whether the expression pattern of the NK cell receptors and cytokines between and was related to the low activity of NK cells. The results showed that NK cells expressed high level of Volume 4 Number 5 October 27

378 NKG2A/CD94 and Granzyme B Associated with NK Activity NKG2A/CD94, one of NK cell inhibitory receptors; and the expression of cytotoxic granzyme B was significantly lower in NK cells than that in NK cells. So this may suggest that high expression of NKG2A/CD94 and low expression of granzyme B are associated with the reduced NK cell activity. Materials and Methods A CD3 47.4.5 24. CD56 7.6 6.4 11.5 Blood samples samples were collected from the umbilical cords of the placentas of normal, full-term, non-stressed newborns of consenting mothers at the Obstetrics and Gynecology of Anhui Provincial Hospital. Adult samples were obtained from healthy donors at Hefei Blood Bank. All blood samples were collected following approval of the University of Science and Technology of China Institutional Review Board and obtaining informed consent. Cell preparation Blood samples were processed within 8 hours of collection. or adult samples were diluted 1:2 in S. Mononuclear cells were isolated by Ficoll-Hypaque centrifugation using standard procedures. Antibodies Anti-CD16, CD8, CD94, CD158a, IFN-γ, granzyme B conjugated with FITC, anti-cd56, CD161, CD158b, NKG2D, NKp46, TRAIL, perforin conjugated with PE, anti- TNF-α conjugated with Alexa-488, anti-cd56 conjugated with Alexa-647, anti-cd3 conjugated with APC-Cy7 was purchased from BD PharMingen. Anti-FasL conjugated with PE was from ebioscience and anti-nkg2a conjugated with PE was purchased from R&D systems. Cell staining and flow cytometry Mononuclear cells were washed twice and blocked with mouse IgG (1 μg/1 6 cells) for 3 min at 4 C. Then the cells were incubated with saturating concentrations of the appropriate mabs for 3 min at 4 C. Thereafter, cells were washed twice and analyzed by using FACSAria (Becton Dickinson). Intracellular granzyme B and perforin detection Freshly isolated mononuclear cells (5 1 6 /ml) were stained with anti-cd56 and -CD3 antibodies for 3 min at 4 C, followed by fixed and permeabilized using the Fix/Perm cell permeabilization kit (BD Biosciences) for 2 min at room temperature. Then the cells were stained with anti-granzyme B or perforin for 1 hour at room temperature, washed twice with permeabilisation buffer, and analyzed by flow cytometry. Intracellular cytokine detection Freshly isolated mononuclear cells (5 1 6 /ml), cultured with RPMI 164 supplemented with 1% fetal bovine serum (FBS, both from GIBCO), were stimulated with PMA (3 B C Count %MNC 4 3 2 1 * 82.28 NK CD8 ng/ml, Sigma) and ionomycin (1 μg/ml, Sigma). One hour later, monensin (1 μg/ml, Sigma) was added to prevent the secretion of the induced cytokines into the supernatant. After 4 hours of culture at 37 C and 5% CO 2, the cells were harvested and labeled with anti-cd56 and -CD3 antibodies for 3 min at 4 C. Cells were fixed and permeabilized using the Fix/Perm cell permeabilization kit for 2 min at room temperature and stained with anti-ifn-γ or TNF-α for 1 hour at room temperature, washed twice with permeabilisation buffer, and analyzed by flow cytometry. Cytotoxicity assay Cytotoxic activity was assessed by using a 51 Cr release assay as previously described (23). Briefly, 1 6 K562 target cells were labeled with 1 μci of Na 2 51 CrO 4 for 1 h at 37 C. Mononuclear cells were washed twice and resuspended in complete RPMI 164 culture medium. Effector cells were %NK 1 8 6 4 2 ** 44.44 CD8 + NK Figure 1. High percentages of NK cells and CD8 + NK cells in. Freshly isolated MCs or MCs were stained with anti-cd3, CD56 and CD8 mabs, and analyzed by flow cytometry. (A) The relative percentage of CD56 + CD3 - NK cells in MCs or MCs was analyzed. (B) The CD56 + CD3 - cells were gated and the percentage of CD8 + NK cells in NK cells was analyzed. For (A) and (B), one representative example was shown from the 6 independent experiments. (C) The percentage of NK cells in MCs or MCs and CD8 + NK cells in NK cells were calculated. Data were collected from 6 independent experiments and analyzed by Student s t test. *p <.5, **p <.1. Volume 4 Number 5 October 27

Cellular & Molecular Immunology 379 Cytotoxicity (%) 3 25 2 15 1 5 * * 1 8 6 4 2 1 8 6 4 2 1 8 6 4 2 2:1 1:1 5:1 2.5:1 E:T 1 CD16 1 NKG2D NKp46 p <.1 1 p <.1 Figure 2. Reduced NK cell activity in. The cytotoxic activity of MCs and MCs against K562 cells was evaluated with 4-hour 51 Cr-release assay as described in Materials and Methods. Values represent the mean from 5 independent experiments. Data were analyzed by Student s t test. *, p <.5. 8 6 4 8 6 4 8 6 4 2 2 2 incubated with K562 in triplicate at 96-well round bottom plates for 4 hours at 37 C in 5% CO 2. Supernatants were assessed for 51 Cr release using a γ-counter. Culture medium or 1% Triton X-1 was added to incubate with target cells for calculation of spontaneous or maximum release, respectively. The percentage of specific 51 Cr release was calculated as follows: (cpm experimental release - cpm spontaneous release) / (cpm maximal release - cpm spontaneous release) 1%. Spontaneous release did not exceed 1% of the maximum release. Statistical analysis Results are expressed as mean ± SD. The statistical analysis was performed by the Student s t test or the Mann-Whitney test. p < 5 was considered statistically significant. Results High percentage and low activity of NK cells Freshly isolated cord blood mononuclear cells (MCs) or peripheral blood mononuclear cells (MCs) were stained with CD3 and CD56 antibodies, and analyzed by flow cytometry. The percentage of NK cells in was 22.63 ± 5.95%, higher than that of 1.95 ± 3.99% (p <.5) (Figure 1A). It was reported that CD8 + NK cells showed higher cytotoxicity than that of CD8 - NK cells (24, 25). In other words, the higher percentage of CD8 + NK cells, the higher NK cell cytotoxicity. Our results indicated that the percentage of CD8 + NK cells in NK cells was higher than that in NK cells (72.78 ± 7.27% vs 42.26 ± 3.97%, p <.1) (Figure 1B). However, cytotoxicity assay of NK cells against K562 cells showed that NK cell activity was significantly lower than that of (p <.5) (Figure 2), which was similar with previous report (2-22). NK cell receptor expressions on and NK cells Although the percentage of NK cells in was higher and had more CD8 + NK cells, the cytotoxicity of NK 1 8 6 4 2 CD158a CD158b NKG2A p <.5 CD94 1 8 6 4 2 p <.1 CD161 Figure 3. The expressions of NK cell receptors on and NK cells. Freshly isolated MCs or MCs were stained with anti-cd3, CD56 and indicated antibodies (CD16, NKG2D, NKp46, CD158a, CD158b, NKG2A, CD94 and CD161) and analyzed by flow cytometry. The CD56 + CD3 - cells were gated and the expression percentage of each NK cell receptor on NK cells was shown. The data were analyzed by Mann-Whitney test. cells was low. NK cell recognition through NK cell receptors is necessary for NK cell cytolysis target cells. We presumed that the expressions of NK cell activating or inhibitory receptors in were different from those in, so the expressions of NK cell activating and inhibitory receptors on NK cells were examined. The MCs or MCs were stained with CD3, CD56 and another antibody, CD56 + CD3 - NK cells were gated, and the expressions of NK cell receptors were analyzed. The results showed that CD16 expression on NK cells was similar to NK cells (86.76 ± 1.4% vs 91.31 ± 4.42%, respectively). The expressions of NKG2D on and NK cells were 92.13 ± 7.59% and 96.22 ± 1.72%, and those of NKp46 were 93.26 ± 6.6% and 89.98 ± 6.94%, respectively (Figure 3). The results showed that the expressions of activating receptors, CD16, NKG2D and NKp46 did not show significant difference between and NK cells. Volume 4 Number 5 October 27

38 NKG2A/CD94 and Granzyme B Associated with NK Activity 1 p <.1 1 1 1 8 8 8 8 6 6 6 6 4 4 4 4 2 2 2 2 Granzyme B Perforin IFN-γ TNF-α 1 8 6 4 1 8 6 4 Figure 5. The expressions of IFN-γ and TNF-α in and NK cells. Freshly isolated MCs or MCs were stimulated with PMA/ionomycin for 4 hours and stained with anti-cd56 and anti-cd3 mabs. Then cells were fixed, permeabilized, stained with anti-ifn-γ or TNF-α mabs and analyzed by flow cytomerty. The CD56 + CD3 - NK cells were gated and the expression percentage of IFN-γ or TNF-α in NK cells was shown. Data were analyzed by Mann-Whitney test. 2 2 FasL TRAIL Figure 4. The expressions of cytotoxicity-related molecules in and NK cells. Freshly isolated MCs or MCs were stained with anti-cd56 and anti-cd3 mabs, as well as FasL or TRAIL. The CD56 + CD3 - NK cells were gated and the expression percentage of FasL or TRAIL on NK cells was shown. For granzyme B and perforin detection, the cells were stained with anti-cd56 and anti-cd3 mabs, fixed and permeabilized, then stained with granzyme B and perforin and analyzed by flow cytomerty. Data were analyzed by Mann-Whitney test. As to the inhibitory receptors, the expressions of CD158a on and NK cells were 9.57 ± 7.8% and 4.67 ± 16.78%, respectively. Whereas CD158b had a lower expression on NK cells (28.61 ± 6.7%), than that on NK cells (46.1 ± 17.67%), p <.1. NKG2A was expressed on 72.2 ± 12.49% NK cells, but only on 23.82 ± 7.83% NK cells (p <.1) (Figure 3). In addition, the expressions of CD94 and CD161, which were the markers of immature NK cells, were also analyzed by flow cytometry. The expressions of CD94 on and NK cells were 76.9 ± 13.55% and 6.53 ± 12.16%, respectively (p <.5). CD161 was expressed on 84.32 ± 15.15% NK cells and 66. ± 12.83% NK cells (p <.1) (Figure 3). The detection of effector function molecules NK cells performed the cytotoxicity function mainly through producing cytotoxic granules. The expression of granzyme B showed significant difference between and NK cells, 1.52 ± 1.74% vs 62.62 ± 11.16%, p <.1. Perforin was expressed at comparable levels between (39.92 ± 43.74%) and NK cells (42.39 ± 12.92%) (Figure 4). In addition, NK cells induced target cell apoptosis through the interaction of FasL or TRAIL with reciprocal ligand on target cells. The results showed that FasL and TRAIL were expressed at very low levels in resting and NK cells,.79 ±.75% vs.77 ±.72%, 3.82 ± 1.84% vs 2.73 ± 1.9%, respectively, and did not show difference between them (Figure 4). The expressions of IFN-γ and TNF-α in and NK cells Besides cytotoxic granules, cytokines secreted by NK cells also played important role in NK cell cytotoxicity. The expressions of IFN-γ in and NK cells were 4.62 ± 15.62% and 33.7 ± 18.65%, respectively. TNF-α expressions in both kinds of NK cells were very low, 1.83 ± 1.57% vs 1.84 ± 1.65%, and did not show significant difference (Figure 5). Discussion Umbilical has become a valuable alternative source of haematopoietic stem cells for allogeneic transplantation (14-16, 26). NK cells derived from are the key effector cells involved in GVHD and GVL (17-19). had higher NK percentage and more CD8 + NK cells than NK cells. And it was reported that CD8 + NK cells were more cytotoxic than their CD8 - counterparts (24, 25). But in our and others results, NK cells showed reduced cytotoxicity compared with NK cells (2-22). NK cell recognition target cells and response by releasing cytotoxic granules and secreting cytokines were important steps for NK effector functions (2, 6, 12). As to our results, it did not show significant difference for the expressions of activating receptors, NKG2D and NKp46 on and NK cells. However, the expressions of inhibitory receptors CD158b and NKG2A were significantly different between and NK cells. Though CD158b was expressed lower in NK cells, NKG2A was significantly higher in NK cells, in accordance with the high level of CD94 on NK Volume 4 Number 5 October 27

Cellular & Molecular Immunology 381 cells as previously reported (27). As mentioned above, it is more complex for NK cell recognition than for T lymphocytes, for which T cell receptor triggering is the key event in effector function deployment (28). NK cells have dozens of surface molecules and receptors that are involved in the cell decision (6, 7). The cooperation of activating NK receptors and inhibitory NK receptors regulated NK cell functions. NK cell response was dependent on the amount of activating and inhibitory NK receptors and their counterpart ligands on the target cells, and the signal strength they transmitted. When the strength of activating signals is powerful over the sum of inhibitory signals, NK cells will respond and kill the target cells. Conversely, NK cells detach the target cells (6-8). So the higher expressions of NKG2A/CD94 on NK cells may be an important factor for the low activity of. In addition, the expression level of CD161, a marker of immature NK cells, was also higher on NK cells. This might indicate that NK cells were immature and the ability to respond the foreign antigens is slower and weaker than adult NK cells. Once NK cells decide to respond and clear target cells, they will reorganize and release pre-reserved granzyme, perforin, and transcribe and secrete cytokines, as well as through interaction of FasL and TRAIL with their reciprocal ligand on target cells to perform effector cytolysis (1, 2, 1-12). The expressions of intracellular perforin, IFN-γ (29), TNF-α, and cell surface FasL (29) and TRAIL (29) did not show significant difference between and NK cells. NK cells expressed high levels of granzyme B, whereas almost no granzyme B was expressed in NK cells. Therefore, the deficiency of granzyme B in NK cells was another reason for reduced NK cell activity. Acknowledgements This work was supported by the National Natural Science Foundation of China (#36359, #35287, #357819, #3571695, #35467), Ministry of Science & Technology of China (973 Basic Science Project #2351551; #268654) and Ministry of Education of China (#7529). References 1. Whiteside TL, Herberman RB. The biology of human natural killer cells. Ann Ist Super Sanita. 199;26:335-348. 2. Colucci F, Caligiuri MA, Di Santo JP. What does it take to make a natural killer? Nat Rev Immunol. 23;3:413-425. 3. Trinchieri G. Biology of natural killer cells. Adv Immunol. 1989; 47:187-376. 4. Liao NS, Bix M, Zijlstra M, Jaenisch R, Raulet D. MHC class I deficiency: susceptibility to natural killer (NK) cells and impaired NK activity. Science. 1991;253:199-22. 5. Spits H, Blom B, Jaleco AC, et al. Early stages in the development of human T, natural killer and thymic dendritic cells. Immunol Rev. 1998;165:75-86. 6. Lanier LL. NK cell receptors. Annu Rev Immunol. 1998;16: 359-393. 7. 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Differential oncolytic effect of NKenriched subsets in long-term interleukin-2 cultures. Lymphokine Cytokine Res. 1992;11:271-276. 26. Ohnuma K, Isoyama K, Nishihira H. Cord blood transplantation from HLA-mismatched unrelated donors. Leuk Lymphoma. 22;43:129-134. 27. Sundstrom Y, Nilsson C, Lilja G, Karre K, Troye-Blomberg M, Volume 4 Number 5 October 27

382 NKG2A/CD94 and Granzyme B Associated with NK Activity Berg L. The expression of human natural killer cell receptors in early life. Scand J Immunol. 27;66:335-344. 28. Davis SJ, Ikemizu S, Evans EJ, Fugger L, Bakker TR, van der Merwe PA. The nature of molecular recognition by T cells. Nat Immunol. 23;4:217-224. 29. Dalle JH, Menezes J, Wagner E, et al. Characterization of cord blood natural killer cells: implications for transplantation and neonatal infections. Pediatr Res. 25;57:649-655. Volume 4 Number 5 October 27