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Abstract
Department of Genetics and Pathology, Antibodies administered in vivo together with the antigen they are specific for
Uppsala University, Uppsala, Sweden can regulate the immune response to that antigen. This phenomenon is called
antibody-mediated feedback regulation and has been known for over 100 years.
Both passively administered and actively produced antibodies exert immuno-
Received 10 May 2006; Accepted in revised
form 13 June 2006 regulatory functions. Feedback regulation can be either positive or negative,
resulting in >1000-fold enhancement or >99% suppression of the specific
Correspondence to: Dr B. Heyman, Department antibody response. Usually, the response to the entire antigen is up- or down-
of Genetics and Pathology, Rudbeck regulated, regardless of which epitope the regulating antibody recognizes. IgG
Laboratory, Uppsala University, SE-751 85
of all isotypes can suppress responses to large particulate antigens like erythro-
Uppsala, Sweden. E-mail: birgitta.heyman@
genpat.uu.se cytes, a phenomenon used clinically in Rhesus prophylaxis. IgG suppression
works in mice lacking the known Fc-c receptors (FccR) and a likely mechan-
ism of action is epitope masking. IgG1, IgG2a and IgG2b administered
together with soluble protein antigens will enhance antibody and CD4+ T-cell
responses via activating FccR, probably via increased antigen presentation by
dendritic cells. IgG3 as well as IgM also enhance antibody responses but their
effects are dependent on their ability to activate complement. A possible
mechanism is increased B-cell activation caused by immune complexes
co-crosslinking the B-cell receptor with the complement-receptor 2/CD19
receptor complex, known to lower the threshold for B-cell activation. IgE-anti-
bodies enhance antibody and CD4+ T-cell responses to small soluble proteins.
This effect is entirely dependent on the low-affinity receptor for IgE, CD23,
the mechanism probably being increased antigen presentation by CD23+ B
cells.
FccR or complement. There is to date no evidence to genic TCR. Specific T cells expanded rapidly and peaked
support that Rh prophylaxis requires FccRIIB in vivo, 3 days after immunization [38] (Fig. 2). The enhanced
although this, based on in vitro studies, is sometimes T-cell response was followed by an enhanced OVA-speci-
assumed to be the mechanism. Although IgG-mediated fic antibody response and both T- and B-cell responses
suppression of antibody responses to sheep erythrocytes were dependent on activating FccR [38]. This observation
in vitro is dependent on FccRIIB, suppression in vivo is compatible with the idea that complexes of IgG and
works equally well in the absence of this receptor [12]. antigen are captured by FccR+ APC and that they
Therefore, one has to be careful when interpreting the in enhance immune responses in vivo via increased antigen
vivo relevance of findings made in vitro. presentation to specific T helper cells (Fig. 3). The biolo-
Although IgG antibodies are used with great success gical role of IgG-mediated enhancement is most likely to
to suppress anti-RhD responses in humans and easily help in the induction of an efficient memory response, as
suppress >99% of a vigorous anti-SRBC response in antigen-specific IgG would often be present in the circu-
mice, the biological role of this feedback pathway is lation when the immune system encounters a booster
probably not to completely suppress antibody responses. dose of an immunogen.
More likely, the masking of certain epitopes by high FccRIIB is the only inhibitory FccR and is expressed
affinity IgG antibodies emerging relatively early in an on most cells of the immune system except NK and T
immune response may give the immune system the cells. It exerts its negative regulation on ITAM-bearing
opportunity of responding also to other epitopes and receptors such as the BCR, FccRI, FccRIII, FccRIV and
thereby ensure a broader range of antibody specificities. FceRI [39]. This gives FccRIIB a central role in immu-
noregulation and it has been shown to negatively regulate
a number of immune responses such as B-cell activation,
IgG1-, IgG2a- and IgG2b-mediated enhancement
BCR-mediated antigen presentation, antigen presentation
of antibody responses
by DC, maturation of DC and release of mediators
Although IgG1, IgG2a and IgG2b suppress responses to
particulate antigens, they are able to enhance responses
when administered together with soluble protein antigens
such as ovalbumin (OVA), bovine serum albumin and
keyhole limpet haemocyanine (KLH). This dual effect is
indeed dependent on the type of antigen and not on dif-
ferences in the IgG antibodies used: one and the same
monoclonal trinitrophenyl (TNP)-specific IgG suppressed
SRBC-specific responses when administered with SRBC-
TNP but enhanced KLH-specific responses when admin-
istered with KLH-TNP [25, 26]. These IgG isotypes
enhance primary as well as memory responses [27–29]
and immunization with IgG1 anti-nitrophenyl (NP)/NP-
KLH complexes increases somatic mutations in NP-speci-
fic germinal centre B cells [30].
IgG1-, IgG2a- and IgG2b-mediated enhancement is
dependent on the presence of activating FccR and these
must be expressed on bone marrow-derived cells [29, 31].
In vitro and ex vivo, antigens complexed to IgG are cap-
tured by FccR-expressing antigen-presenting cells (APCs)
and presented more efficiently to CD4+ T cells than anti-
gen alone [32–36]. To test whether such a mechanism
also explains IgG-mediated enhancement of antibody
Figure 2 Visualization of proliferating ovalbumin (OVA)-specific CD4+
responses, we have used a system where expansion of
T cells after immunization with antigen/antibody complexes. Mice were
antigen-specific CD4+ T cells can be studied directly adoptively transferred with CD4+ T cells from DO11.10 mice, expres-
in vivo [37]. CD4+ T cells from DO11.10 mice, trans- sing a transgenic T-cell receptor (TCR) specific for an OVA-peptide on
genic for a T-cell receptor (TCR) recognizing an OVA- MHC-II Ad. The day after transfer, mice were immunized i.v. with
peptide together with MHC-II Ad, were transferred to 20 lg OVA-trinitrophenyl (TNP) alone or together with 50 lg mono-
clonal IgG3 anti-TNP, IgG2a anti-TNP or IgE anti-TNP. Seventy-two
syngeneic wild-type BALB/c mice. After immunization
hours after immunization spleens were removed, sectioned and analysed
with IgG2a anti-TNP/OVA-TNP intravenously without by confocal microscopy. OVA-specific T cells (red) are stained with a
adjuvants, the expansion of OVA-specific T cells was fol- monoclonal antibody specific for the transgenic OVA-specific TCR and
lowed using a monoclonal antibody specific for the trans- B cells (blue) are stained with anti-B220.
in C1q-binding. Therefore, it seems logical that these IgE-mediated enhancement of antibody responses
isotypes use Fc-receptors for their feedback-enhancing
effects. In the 1990s, in vitro experiments showed that IgE-com-
It is not understood why complement has such a dra- plexed antigens, binding to the low-affinity receptor for
matic impact on antibody responses, but several, not IgE (CD23) on the surface of B cells, could be internal-
mutually exclusive, mechanisms are possible: ized and presented efficiently to T helper cells [77, 78].
(1) Antibody/antigen/complement complexes co-cross- These observations led to the hypothesis that a physiolo-
link the BCR and the CR2/CD19 complex, known to gical role of IgE may be to capture antigens and enhance
lower the threshold for B-cell activation [65] (Fig. 4). T helper-cell activation [79]. We tested this idea in an
(2) Antibody/antigen/complement complexes are cap- in vivo system where mice were immunized with mono-
tured by FDC in the spleen and lymph nodes, increasing clonal IgE anti-TNP together with various protein anti-
the effective concentration of antigen [54, 66–68]. gens coupled to TNP and found that IgE indeed
(3) Antibody/antigen/complement complexes are endo- upregulated carrier-specific antibody responses [80]. IgE
cytosed efficiently via CR1/CR2 on B cells and presented enhances responses to small soluble protein antigens but
to T helper cells which in turn help B cells to produce not to erythrocytes or large proteins such as KLH [80,
antibodies. In vitro, B cells can take up antigen via CR1/ 81]. All isotypes, including IgE, are upregulated and the
CR2 and present to T cells [69–72], but in vivo studies IgG response peaks as early as 6 days after priming [81,
in adoptive transfer/hapten-carrier systems do not support 82]. The enhancing effect of IgE is mediated by CD23,
a role for complement in T helper-cell activation [45, evidenced by lack of enhancement in mice where CD23
73]. is blocked by a monoclonal antibody [80, 81] or in
Regardless of which mechanism(s) that cause anti- CD23-deficient mice [61, 83, 84]. Lack of involvement of
body/complement-mediated enhancement, it remains to the high-affinity IgE-receptor (FceRI) was confirmed by
be explained how a primary antibody response can be the normal IgE-mediated enhancement in FcRc-chain-
dependent on classical (antibody induced) complement deficient mice, which do not express FceRI [31].
activation: in naive mice very low amounts of specific IgE-mediated enhancement works normally in IL-4-
IgM or IgG3 is available to form complexes with the deficient mice [85]. As IL-4 is required for expression of
antigen. One possibility is that capture of antigen by the CD23b isoform [86], this observation suggests that
natural IgM and IgG3 suffices to start complement acti- enhancement is mediated via the constitutively expressed
vation in primary antibody responses. Once activation of CD23a isoform. In mice, CD23a is expressed only on B
specific B cells has taken place, these will secrete anti- cells and FDC. Adoptive transfer experiments demonstra-
gen-specific IgM and IgG3, further enhancing the posit- ted that FDC are not involved, leaving the B cells as the
ive feedback loop. In line with this, mice lacking likely effector cells [84]. Therefore, should the IgE-
secretory IgM had impaired antibody responses [74–76] enhanced antibody response in vivo be caused by enhanced
which could be reconstituted by transfusion of IgM from presentation of antigenic peptides to T helper cells, in
naive mice [74]. analogy with in vitro findings [77, 78], it would imply
that B cells can activate naive T cells. This is usually
considered to be performed by DC [87], and to investi-
gate whether IgE/antigen complexes do indeed activate
specific T cells in vivo, we used the DO11.10 experimen-
tal system described above. IgE anti-TNP administered
together with OVA-TNP induced a marked proliferation
of OVA-specific CD4+ T cells peaking 3 days after
immunization [61] (Fig. 2). Enhancement of T-cell
responses required the presence of CD23 which had to be
expressed on B cells. However, once such cells were pre-
sent (in chimaeric mice), also CD23) B cells produced
enhanced levels of specific antibody after immunization
with IgE/antigen [61]. These observations are compatible
with the antigen presentation hypothesis suggesting that
Figure 4 Suggested mechanism for IgM- and IgG3-mediated enhance- the enhanced antibody levels are a result of increased
ment of antibody responses. IgM and IgG3 forming a complex with T-cell help to specific B cells (Fig. 5). IgE-mediated
specific antigen activates complement leading to attachment of comple- enhancement, as well as all other feedback regulatory
ment factors to the immune complexes. The IgM or IgG3/antigen/com- pathways, is specific for the antigen within the immune
plement complexes co-crosslink the B-cell receptor (BCR) to the CR2/
CD19 co-receptor complex and lowers the threshold for B-cell activa-
complex. This means that although all CD23+ B cells
tion, thereby leading to enhanced antibody responses. regardless of BCR specificity, take up and present
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