title: Human CD56+ cytotoxic lung lymphocytes kill autologous lung cells in chronic obstructive pulmonary disease.
abstract: CD56+ natural killer (NK) and CD56+ T cells, from sputum or bronchoalveolar lavage of subjects with chronic obstructive pulmonary disease (COPD) are more cytotoxic to highly susceptible NK targets than those from control subjects. Whether the same is true in lung parenchyma, and if NK activity actually contributes to emphysema progression are unknown. To address these questions, we performed two types of experiments on lung tissue from clinically-indicated resections (n = 60). First, we used flow cytometry on fresh single-cell suspension to measure expression of cell-surface molecules (CD56, CD16, CD8, NKG2D and NKp44) on lung lymphocytes and of the 6D4 epitope common to MICA and MICB on lung epithelial (CD326+) cells. Second, we sequentially isolated CD56+, CD8+ and CD4+ lung lymphocytes, co-cultured each with autologous lung target cells, then determined apoptosis of individual target cells using Annexin-V and 7-AAD staining. Lung NK cells (CD56+ CD3-) and CD56+ T cells (CD56+ CD3+) were present in a range of frequencies that did not differ significantly between smokers without COPD and subjects with COPD. Lung NK cells had a predominantly "cytotoxic" CD56+ CD16+ phenotype; their co-expression of CD8 was common, but the percentage expressing CD8 fell as FEV1 % predicted decreased. Greater expression by autologous lung epithelial cells of the NKG2D ligands, MICA/MICB, but not expression by lung CD56+ cells of the activating receptor NKG2D, correlated inversely with FEV1 % predicted. Lung CD56+ lymphocytes, but not CD4+ or CD8+ conventional lung T cells, rapidly killed autologous lung cells without additional stimulation. Such natural cytotoxicity was increased in subjects with severe COPD and was unexplained in multiple regression analysis by age or cancer as indication for surgery. These data show that as spirometry worsens in COPD, CD56+ lung lymphocytes exhibit spontaneous cytotoxicity of autologous structural lung cells, supporting their potential role in emphysema progression.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00281229.
authors: Research Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America; Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Christine M
authors: CM
authors: Freeman
authors: Research Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America.
authors: Valerie R
authors: VR
authors: Stolberg
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Sean
authors: S
authors: Crudgington
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Fernando J
authors: FJ
authors: Martinez
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: MeiLan K
authors: MK
authors: Han
authors: Graduate Program in Immunology, University of Michigan, Ann Arbor, Michigan, United States of America; Pathology & Laboratory Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America; Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Stephen W
authors: SW
authors: Chensue
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Douglas A
authors: DA
authors: Arenberg
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Catherine A
authors: CA
authors: Meldrum
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America.
authors: Lisa
authors: L
authors: McCloskey
authors: Pulmonary & Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States of America; Graduate Program in Immunology, University of Michigan, Ann Arbor, Michigan, United States of America; Pulmonary & Critical Care Medicine Section, Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America.
authors: Jeffrey L
authors: JL
authors: Curtis
mesh_terms: D000368:Aged; D056809:Alveolar Epithelial Cells / Q000502:physiology; D017209:Apoptosis; D019002:CD56 Antigen / Q000378:metabolism*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000276:immunology* / Q000473:pathology; D013602:T-Lymphocytes, Cytotoxic / Q000502:physiology*
chemical_list: D019002:CD56 Antigen; C522918:NCAM1 protein, human