Extracellular adenosine reversibly inhibits the activation of human regulatory T cells and negatively influences the achievement of the operational tolerance in liver transplantation

Am J Transplant. 2019 Jan;19(1):48-61. doi: 10.1111/ajt.15023. Epub 2018 Aug 31.

Abstract

The artificial induction of tolerance in transplantation is gaining strength. In mice, a differential role of extracellular adenosine (eADO) for regulatory and effector T cells (Tregs and Teffs, respectively) has been proposed: inhibiting Teffs and inducing Tregs. The aim of this study was to analyze the action of extracellular nucleotides in human T cells and, moreover, to examine the influence of CD39 and CD73 ectonucleotidases and subsequent adenosine signaling through adenosine 2 receptor (A2 R) in the induction of clinical tolerance after liver transplant. The action of extracellular nucleotides in human T cells was analyzed by in vitro experiments with isolated T cells. Additionally, 17 liver transplant patients were enrolled in an immunosuppression withdrawal trial, and the differences in the CD39-CD73-A2 R axis were compared between tolerant and nontolerant patients. In contrast to the mice, the activation of human Tregs was inhibited similarly to Teffs in the presence of eADO. Moreover, the expression of the enzyme responsible for the degradation of ADO, adenosine deaminase, was higher in tolerant patients with respect to the nontolerant group along the immunosuppression withdrawal. Our data support the idea that eADO signaling and its degradation may play a role in the complex system of regulation of liver transplant tolerance.

Keywords: T cell biology; basic (laboratory) research/science; cellular biology; immune regulation; immunosuppression/immune modulation; immunosuppressive regimens - minimization/withdrawal; liver transplantation/hepatology; signaling/signaling pathways; tolerance: clinical; translational research/science.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 5'-Nucleotidase / metabolism
  • Adenosine / metabolism*
  • Adenosine Deaminase / metabolism
  • Aged
  • Animals
  • Apyrase / metabolism
  • Cell Proliferation
  • Female
  • GPI-Linked Proteins / metabolism
  • Humans
  • Immunosuppression Therapy
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation*
  • Lymphocyte Activation / drug effects*
  • Male
  • Mice
  • Middle Aged
  • Phosphorylation
  • Receptors, Adenosine A2 / metabolism*
  • T-Lymphocytes, Regulatory / cytology*
  • Transplantation Tolerance / drug effects*

Substances

  • GPI-Linked Proteins
  • Immunosuppressive Agents
  • Receptors, Adenosine A2
  • 5'-Nucleotidase
  • NT5E protein, human
  • Adenosine Deaminase
  • Apyrase
  • ENTPD1 protein, human
  • Adenosine