@phdthesis{Wiese2022,
  author    = {Wiese, Teresa},
  title     = {Pharmacological targeting of acid sphingomyelinase increases CD4\(^+\) Foxp3\(^+\) regulatory T cell subsets in patients with major depression},
  doi       = {10.25972/OPUS-23347},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233471},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Lack of acid sphingomyelinase (ASM) activity, either through genetic deficiency or through pharmacological inhibition, is linked with increased activity and frequency of Foxp3+ regulatory T cells (Treg) among cluster of differentiation (CD) 4+ T cells in mice in vivo and in vitro1. Thus, pharmacological blockade of ASM activity, which catalyzes the cleavage of sphingomyelin to ceramide and phosphocholine, might be used as a new therapeutic mechanism to correct numeric and/ or functional Treg de-ficiencies in diseases like multiple sclerosis or major depression. In the present study, the effect of pharmacological inhibition of ASM in humans, in vitro and in vivo, was analyzed. In the in vitro experiments, peripheral blood mono-nuclear cells (PBMC) of healthy human blood donors were treated with two widely prescribed antidepressants with high (sertraline, Ser) or low (citalopram, Cit) capaci-ty to inhibit ASM activity. Similar to the findings in mice an increase in the frequency of Treg among human CD4+ T cells upon inhibition of ASM activity was observed. For the analysis in vivo, a prospective study of the composition of the CD4+ T cell com-partment of patients treated for major depression was done. The data show that pharmacological inhibition of ASM activity was superior to antidepressants with little or no ASM-inhibitory activity in increasing CD45RA- CD25high effector Treg (efTreg) frequencies among CD4+ T cells to normal levels. Independently of ASM inhibition, correlating the data with the clinical response, i.e. improvement of the Hamilton rat-ing scale for depression (HAMD) by at least 50 per cent (\%) after four weeks of treatment, it was found that an increase in efTreg frequencies among CD4+ cells dur-ing the first week of treatment identified patients with a clinical response. Regarding the underlying mechanism, it could be found that the positive effect of ASM inhibition on Treg required CD28 co-stimulation suggesting that enhanced CD28 co-stimulation was the driver of the observed increase in the frequency of Treg among human CD4+ T cells. Inhibition of ASM activity was further associated with changes in the expression and shuttling of CTLA-4, a key inhibitory molecule ex-pressed by Treg, between cellular compartments but the suppressive activity of CTLA-4 through its transendocytosis activity was unaffected by the inhibition of ASM activity. In summary, the frequency of (effector) Treg among CD4+ T cells in mice and in hu-mans is increased after inhibition of ASM activity suggesting that ASM blockade might beneficially modulate autoimmune diseases and depression-promoting in-flammation.},
  subject      = {Treg},
  language  = {en}
}
@phdthesis{Haack2021,
  author    = {Haack, Stephanie},
  title     = {A novel mouse model for systemic cytokine release upon treatment with a superagonistic anti-CD28 antibody},
  doi       = {10.25972/OPUS-23775},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237757},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {The adaptive immune system is known to provide highly specific and effective immunity against a broad variety of pathogens due to different effector cells. The most prominent are CD4+ T-cells which differentiate after activation into distinct subsets of effector and memory cells, amongst others T helper 1 (Th1) cells. We have recently shown that mouse as well as human Th1 cells depend on T cell receptor (TCR) signals concomitant with CD28 costimulation in order to secrete interferon  (IFN) which is considered as their main effector function. Moreover, there is a class of anti-CD28 monoclonal antibodies that is able to induce T cell (re-)activation without concomitant TCR ligation. These so-called CD28-superagonists (CD28-SA) have been shown to preferentially activate and expand CD4+ Foxp3+ regulatory T (Treg) cells and thereby efficaciously conferring protection e.g. against autoimmune responses in rodents and non-human primates. Considering this beneficial effect, CD28-SA were thought to be of great impact for immunotherapeutic approaches and a humanized CD28-SA was subjected to clinical testing starting with a first-in-man trial in London in 2006. Unexpectedly, the volunteers experienced life-threatening side effects due to a cytokine release syndrome (CRS) that was unpredicted by the preclinical studies prior to the trial. Retrospectively, CD4+ memory T cells within the tissues were identified as source of pro-inflammatory cytokines released upon CD28-SA administration. This was not predicted by the preclinical testing indicating a need for more reliable and predictive animal models. Whether mouse CD4+ T cells are generally irresponsive to CD28-SA stimulation or rather the lack of a bona fide memory T cell compartment in cleanly housed specific-pathogen-free (SPF) mice is the reason why the rodent models failed to predict the risk for a CRS remained unclear. To provide SPF mice with a true pool of memory/effector T cells, we transferred in vitro differentiated TCR-transgenic OT-II Th1 cells into untreated recipient mice. Given that Treg cells suppress T cell activation after CD28- SA injection in vivo, recipients were either Treg-competent or Treg-deficient, wild type or DEREG mice, respectively. Subsequent CD28-SA administration resulted in induction of systemic pro-inflammatory cytokine release, dominated by IFN, that was observed to be much more pronounced and robust in Treg-deficient recipients. Employing a newly established in vitro system mirroring the in vivo responses to CD28-SA stimulation of Th1 cells revealed that antigen-presenting cells (APCs) amplify CD28-SAinduced IFN release by Th1 cells due to CD40/CD40L-interactions. Thus, these data are the first to show that mouse Th1 cells are indeed sensitive to CD28-SA stimulation in vivo and in vitro responding with strong IFN release accompanied by secretion of further pro-inflammatory cytokines, which is compatible with a CRS. In conclusion, this study will facilitate preclinical testing of immunomodulatory agents providing a mouse model constituting more "human-like" conditions allowing a higher degree of reliability and translationability.},
  subject      = {CD28},
  language  = {en}
}
@phdthesis{Froehlich2018,
  author    = {Fr{\"o}hlich, Monika Gabriele},
  title     = {Die Bedeutung von CD28 vermittelter Kostimulation f{\"u}r CD8 T-Zell-Ged{\"a}chtnisreaktionen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158791},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Immunologische Ged{\"a}chtnisreaktionen sind die Grundlage um wiederkehrende Erreger schnell und effizient zu bek{\"a}mpfen und um einen Impfschutz zu generieren. Das zellvermittelte Ged{\"a}chtnis wird unter anderem durch CD8 Ged{\"a}chtnis-T-Zellen aufgebaut, welche vor allem im Kontext von Immunreaktionen gegen intrazellul{\"a}rer Erreger vonn{\"o}ten sind, um bei Reinfektion mit den Erregerst{\"a}mmen einen schnellen Schutz zu gew{\"a}hrleisten. Ein detailliertes Wissen {\"u}ber die Generierung, Kontrolle und Reaktivierung der Ged{\"a}chtniszellen ist n{\"u}tzlich, um Ged{\"a}chtnisreaktionen verstehen und lenken zu k{\"o}nnen. Durch die Entdeckung des TZR und CD28 wurden Meilensteine f{\"u}r das Verst{\"a}ndnis der T-Zellaktivierung gelegt und die Grundlage geschaffen, CD8 Ged{\"a}chtnisreaktionen zu verstehen. Auch wenn f{\"u}r prim{\"a}re Immunreaktionen die „2-Signal-Theorie" lange als erwiesen gilt, so blieb die Rolle der Kostimulation f{\"u}r Ged{\"a}chtnisreaktionen lange umstritten. In dieser Arbeit wurden verschiedene methodische Herangehensweisen verwendet, mit denen durchgehend die Bedeutung von CD28 vermittelter Kostimulation f{\"u}r immunologische CD8 T-Zell-Ged{\"a}chtnisreaktionen nachgewiesen wurde. CD28 blockierende Antik{\"o}rper und CD28 induzierbar deletierbare Mauslinien wurden im Modellinfektionssystem mit Ovalbumin produzierenden Listeria monocytogenes zur Analyse der Prim{\"a}r- und Sekund{\"a}rantworten verwendet. Mit diesen Methoden konnte eine Beeintr{\"a}chtigung der Expansion von CD8 Ged{\"a}chtniszellen in Abwesenheit von CD28 bewiesen werden. Weiterhin werden Effektorfunktionen wie Degranulation und Produktion von IFN-γ w{\"a}hrend der Sekund{\"a}rinfektion in Abwesenheit von Kostimulation eingeschr{\"a}nkt. Mit Hilfe von Experimenten, bei denen CD28 suffizienten M{\"a}usen eine geringe Anzahl an naiven, antigenspezifischen, CD28 deletierbaren CD8 T-Zellen transferiert wurden, wurde die Bedeutung der Kostimulation f{\"u}r die Expansion von Ged{\"a}chtniszellen best{\"a}tigt, jedoch konnte {\"u}berraschenderweise auch ein Anstieg der Effektorfunktionen in Abwesenheit von CD28 sowohl w{\"a}hrend der Prim{\"a}r- als auch der Sekund{\"a}rantwort dokumentiert werden. Diese zur globalen Blockade bzw. Deletion widerspr{\"u}chlichen Ergebnisse lassen eine Beteiligung anderer CD28 abh{\"a}ngiger Zelltypen an der Induktion der Effektorfunktionen der CD8 T-Zellen plausibel erscheinen, wie zum Beispiel Einfl{\"u}sse von T-Helferzellen, welche die Effektorfunktionen positiv verst{\"a}rken, solange sie selbst Kostimulationssignale empfangen k{\"o}nnen. Weiterhin konnte gezeigt werden, dass sich Ged{\"a}chtniszellen an den CD28 defizienten Ph{\"a}notyp - eine CD28 intakte immunologische Umgebung vorausgesetzt - adaptieren k{\"o}nnen, wenn ausreichend Zeit nach Deletion und vor Sekund{\"a}rinfektion verstreichen konnte.},
  subject      = {Antigen CD28},
  language  = {de}
}