title: Indoleamine 2,3-dioxygenase-expressing leukemic dendritic cells impair a leukemia-specific immune response by inducing potent T regulatory cells.
abstract: BACKGROUND
  The immunoregulatory enzyme indoleamine 2,3-dioxygenase, which catalyzes the conversion of tryptophan into kynurenine, is expressed in a significant subset of patients with acute myeloid leukemia, resulting in the inhibition of T-cell proliferation and the induction of regulatory T cells. Acute myeloid leukemia cells can be differentiated into dendritic cells, which have increased immunogenicity and have been proposed as vaccines against leukemia.
  
  
  METHODS
  Leukemic dendritic cells were generated from acute myeloid leukemia cells and used as stimulators in functional assays, including the induction of regulatory T cells. Indoleamine 2,3-dioxygenase expression in leukemic dendritic cells was evaluated at molecular, protein and enzymatic levels.
  
  
  RESULTS
  We demonstrate that, after differentiation into dendritic cells, both indoleamine 2,3-dioxygenase-negative and indoleamine 2,3-dioxygenase-positive acute myeloid leukemia samples show induction and up-regulation of indoleamine 2,3-dioxygenase gene and protein, respectively. Indoleamine 2,3-dioxygenase-positive acute myeloid leukemia dendritic cells catabolize tryptophan into kynurenine metabolite and inhibit T-cell proliferation through an indoleamine 2,3-dioxygenase-dependent mechanism. Moreover, indoleamine 2,3-dioxygenase-positive leukemic dendritic cells increase the number of allogeneic and autologous CD4(+)CD25(+) Foxp3(+) T cells and this effect is completely abrogated by the indoleamine 2,3-dioxygenase-inhibitor, 1-methyl tryptophan. Purified CD4(+)CD25(+) T cells obtained from co-culture with indoleamine 2,3-dioxygenase-positive leukemic dendritic cells act as regulatory T cells as they inhibit naive T-cell proliferation and impair the complete maturation of normal dendritic cells. Importantly, leukemic dendritic cell-induced regulatory T cells are capable of in vitro suppression of a leukemia-specific T cell-mediated immune response, directed against the leukemia-associated antigen, Wilms' tumor protein.
  
  
  CONCLUSIONS
  These data identify indoleamine 2,3-dioxygenase-mediated catabolism as a tolerogenic mechanism exerted by leukemic dendritic cells and have clinical implications for the use of these cells for active immunotherapy of leukemia.
authors.affiliation: Department of Hematology and Oncological Sciences L. & A. Seràgnoli, Via Massarenti, 9, 40138, Bologna, Italy. antonio.curti2@unibo.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Curti
authors.forename: Sara
authors.initials: S
authors.lastname: Trabanelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Onofri
authors.forename: Michela
authors.initials: M
authors.lastname: Aluigi
authors.forename: Valentina
authors.initials: V
authors.lastname: Salvestrini
authors.forename: Darina
authors.initials: D
authors.lastname: Ocadlikova
authors.forename: Cecilia
authors.initials: C
authors.lastname: Evangelisti
authors.forename: Sergio
authors.initials: S
authors.lastname: Rutella
authors.forename: Raimondo
authors.initials: R
authors.lastname: De Cristofaro
authors.forename: Emanuela
authors.initials: E
authors.lastname: Ottaviani
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lemoli
mesh_terms: D000208:Acute Disease; D000328:Adult; D055162:Biocatalysis; D015153:Blotting, Western; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D018920:Coculture Techniques; D003713:Dendritic Cells / Q000201:enzymology* / Q000276:immunology / Q000473:pathology; D005434:Flow Cytometry; D015971:Gene Expression Regulation, Enzymologic; D015973:Gene Expression Regulation, Leukemic; D006801:Humans; D016130:Immunophenotyping; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D007737:Kynurenine / Q000378:metabolism; D007951:Leukemia, Myeloid / Q000201:enzymology* / Q000276:immunology / Q000473:pathology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D050378:T-Lymphocytes, Regulatory / Q000166:cytology / Q000276:immunology / Q000378:metabolism*; D014364:Tryptophan / Q000031:analogs & derivatives / Q000378:metabolism / Q000494:pharmacology; D014407:Tumor Cells, Cultured
chemical_list: D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase; D007737:Kynurenine; D014364:Tryptophan; C525396:1-methyltryptophan
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