Frequency of Th17 cells correlates with the presence of lung lesions in pigs chronically infected with Actinobacillus pleuropneumoniae
- Elena L. Sassu1,
- Andrea Ladinig1,
- Stephanie C. Talker2,
- Maria Stadler2,
- Christian Knecht1,
- Heiko Stein1,
- Janna Frömbling3,
- Barbara Richter4,
- Joachim Spergser3,
- Monika Ehling-Schulz3,
- Robert Graage5,
- Isabel Hennig-Pauka†1 and
- Wilhelm Gerner†2Email author
© The Author(s) 2017
Received: 14 September 2016
Accepted: 3 January 2017
Published: 6 February 2017
Porcine contagious pleuropneumonia caused by Actinobacillus pleuropneumoniae (APP) remains one of the major causes of poor growth performance and respiratory disease in pig herds. While the role of antibodies against APP has been intensely studied, the porcine T cell response remains poorly characterized. To address this, pigs were intranasally infected with APP serotype 2 and euthanized during the acute phase [6–10 days post-infection (dpi)] or the chronic phase of APP infection (27–31 dpi). Lymphocytes isolated from blood, tonsils, lung tissue and tracheobronchial lymph nodes were analyzed by intracellular cytokine staining (ICS) for IL-17A, IL-10 and TNF-α production after in vitro stimulation with crude capsular extract (CCE) of the APP inoculation strain. This was combined with cell surface staining for the expression of CD4, CD8α and TCR-γδ. Clinical records, microbiological investigations and pathological findings confirmed the induction of a subclinical APP infection. ICS-assays revealed the presence of APP-CCE specific CD4+CD8αdim IL-17A-producing T cells in blood and lung tissue in most infected animals during the acute and chronic phase of infection and a minor fraction of these cells co-produced TNF-α. APP-CCE specific IL-17A-producing γδ T cells could not be found and APP-CCE specific IL-10-producing CD4+ T cells were present in various organs but only in a few infected animals. The frequency of identified putative Th17 cells (CD4+CD8αdimIL-17A+) in lung and blood correlated positively with lung lesion scores and APP-specific antibody titers during the chronic phase. These results suggest a potential role of Th17 cells in the immune pathogenesis of APP infection.
Actinobacillus pleuropneumoniae (APP) is a gram negative bacterium, belonging to the Pasteurellaceae family that causes porcine respiratory disease worldwide. The outcome of the infection can vary from sudden death with bloody nasal discharge to an acute disease with fever and coughing that frequently results in chronic infections . Vaccination and antibiotic based therapies can help to reduce the severity of the symptoms and decrease the mortality rates, but are not effective in clearing the bacteria . In fact, pigs overcoming the acute phase can become subclinically infected and persistent carriers, harboring APP in tonsils and chronic lung lesions . Since 1957, when APP was first reported, most research activities were focused on the elucidation of the humoral immune response [4–6]. Thereby it also became clear that APP developed several strategies to avoid humoral host defense mechanisms. For example, in vitro experiments indicated that APP can survive in alveolar macrophages , has the capacity for enhanced biofilm formation in anaerobic conditions , and changes the polysaccharide composition of the capsule ; all possibly contributing to an escape from humoral immunity and to the establishment of chronic infection in lung tissue and tonsils.
For a more thorough understanding of APP pathogenesis and persistence, cell-mediated immune mechanisms also need to be taken into focus. In particular, T-cell responses may equip the host with additional means to combat APP infections, but could also be involved in dysfunctional immune responses  or could support immune escape mechanisms . Hitherto, the T-cell mediated immune response to APP has been poorly characterized in swine. Early studies indicated the potential relevance of T cells, because the intensity of a T-cell dependent delayed-type hypersensitivity reaction was associated with protection against an APP challenge infection . In addition, a change in the CD4:CD8 ratio in peripheral blood following low-dose APP immunization and high-dose APP challenge has been reported, but the phenotype of involved cells was not further studied . Furthermore, Faldyna et al.  described an increase of CD8α− γδ T cells in bronchoalveolar lavage fluid (BALF) as well as B-cells in tracheobronchial lymph nodes of pigs challenged with APP suggesting a role of γδ T cells in this infection. More recently, IL-17 was shown to be induced on the transcriptional level in lungs of pigs affected by APP  and it has been demonstrated that CD4+ and γδ T cells are capable to produce IL-17 in swine [15–17]. From studies in mice and humans it is known that IL-17-producing CD4+ T (Th17) cells are involved in the clearance of extracellular pathogens in peripheral organs by attraction and stimulation of neutrophils . There is also some evidence that Th17 cells can be involved in chronic airway inflammation . Moreover, in vivo and in vitro studies with Mannheimia haemolytica, which like APP belongs to the Pasteurellaceae family and induces neutrophilic infiltration in the lung, suggested an IL-17 production by bovine γδ T cells . Thus we hypothesized that IL-17 production by Th17 but also γδ T cells might be involved in the porcine immune response to APP. Since the anti-inflammatory cytokine IL-10 may support the survival of microorganisms in the host via inhibiting their cell-mediated immune response [21–23], we investigated in parallel its role in persistence of APP.
To address these issues we developed an APP infection model and an in vitro stimulation assay making use of an APP crude capsular extract (APP-CCE). Cytokine production by CD4+ and γδ T cells was investigated by intracellular cytokine staining (ICS) of lymphocytes isolated from different host compartments during the acute and chronic phase of APP infection. We found that the majority of pigs infected with APP harbor APP-CCE specific IL-17A+ CD4+ T cells in the lung and in the blood during the acute and the chronic phase of APP infection. In chronically infected animals, the frequency of these cells in lung and peripheral blood was found to correlate positively with lung lesions and APP-specific antibody titers.
Materials and methods
Experimental APP infection model
Thirty 5-week-old male castrated pigs (German Landrace), routinely tested to be negative for APP, porcine reproductive and respiratory syndrome virus (PRRSV), toxigenic Pasteurella multocida, endo- and ectoparasites, were derived from a closed breeding herd of high health status in Mecklenburg-Western Pomerania, Germany. Animals were moved to Austria, following European guidelines on protecting the welfare of animals during transport, stated by Regulation (EC) No 1/2005. Upon arrival, animals entered a biosafety level 2 facility at the University of Veterinary Medicine Vienna, where they were kept for the entire duration of the experiment. Animals were weighed, individually marked with ear tags, and then, according to their body weight, divided into a control and an infected group of ten and twenty animals respectively. Control and infected group were housed in separate compartments. Within the infected group, animals were assigned to two subgroups of ten animals each, which were kept under identical conditions but euthanized either 6–10 days post-infection (dpi) (acute infected group) or 27–31 dpi (chronic infected group). At the time of arrival, the APP-free status of the pigs was confirmed by bacteriological examination of nasal and tonsillar swabs and by serological testing for antibodies against Apx-IV using the commercially available IDEXX APP-ApxIV Ab Test ELISA (IDEXX Laboratories, Westbrook, USA). After 2 weeks of adaptation, at day 0 an intranasal spray infection was performed. For the infection, an APP biotype 1 serotype 2 strain (Lab number C3656/0271/11) was used, isolated originally by the Institute of Microbiology, University of Veterinary Medicine, Hanover, Germany from a diseased fattening pig during an acute outbreak of porcine pleuropneumonia in northern Germany . After initial isolation, bacteria were animal-passaged once and lab-passaged four times in PPLO medium supplemented with NAD. Pigs were infected with 2 mL (1 mL into each nostril) of bacterial culture containing 2 × 104 CFU/mL. The bacterial culture was vaporized directly into the nostrils of the pigs by using a mucosal atomization device (LMA MAD Nasal™, Teleflex Medical GmbH, Athlone, Ireland). Control pigs underwent the same procedure, but received 2 mL of 154 mM sterile NaCl instead of the bacterial culture. Daily clinical examinations were carried out and assembled in a clinical score, considering rectal temperature, presence of dyspnea and/or coughing and changes in behavior (see Additional file 1 for details). Additionally, pig body weights were recorded weekly. To screen for presence of APP in the upper respiratory tract, nasal and tonsillar swabs were examined at 14 and 21 dpi. At the end of the experiment, after animals were euthanized, tonsillar tissues were taken instead of swabs. Blood samples were taken by puncture of the V. cava cranialis or V. jugularis on the same days. Sera were used for detection of APP 2 specific antibodies, while heparinized samples were obtained to isolate peripheral blood mononuclear cells (PBMCs). Euthanasia was performed on five consecutive days (two infected pigs and one control pig per day) in two different time frames: 6–10 dpi and 27–31 dpi for the acutely and the chronically infected group, respectively. Within these two periods, animals were randomly selected for euthanasia, which was performed by intracardial administration of T61® (T61®: Embutramid, Mebezoniumiodid, Tetracainhydrochlorid, 1 mL/10 kg BW, MSD, Whitehouse Station, NJ, USA) during anesthesia (Narketan®, Stresnil®). All animal procedures were approved by the institutional ethics committee, the Advisory Committee for Animal experiments (§12 of Law for Animal Experiments, Tierversuchsgesetz—TVG) and the Federal Ministry for Science and Research (reference number bmwfw GZ 68.205/0138-WF/V/3b/2015).
Gross necropsy and pathological examination
At necropsy, a general pathological examination of the carcass was performed, with focus on the respiratory tract. Organs of interest for the study were extracted in the following order: salivary gland (Glandula mandibularis, GM), tonsils, tracheobronchial lymph node (TBLN) and lung. After evaluation of the thoracic cavity, the lung was extracted from the chest while paying particular attention to the presence of pleural effusion or pleural adhesions. Then the severity of the pathological findings was determined using the lung lesion score (LLS) by Hannan et al.  and using the slaughterhouse pleurisy evaluation system (SPES)  for assessment of the pleura status. After clamping off the left main bronchus, the right lung was flushed with 100 mL of 154 mM sterile NaCl for collection of BALF, while tissue samples were taken from the dorsal portion of the left caudal lobe. If no lesions were detected in this particular area, an additional sample from another affected part of the lung was taken for histologic and bacteriological investigations. For histology, samples were fixed in 10% neutral buffered formalin, processed in 3-µm-thick paraffin-embedded sections and stained with haematoxylin and eosin.
Nasal and tonsillar swabs from living animals and nasal swabs, salivary gland, tonsils, tracheobronchial lymph node, lung and BALF from euthanized animals were investigated for the presence of APP by streaking the samples on Columbia sheep blood agar (Oxoid, Vienna, Austria). Staphylococcus aureus was used as nurse to facilitate the isolation of APP from organs carrying a high bacterial background flora, such as tonsils and nose . Subsequently, APP was transferred to PPLO agar supplemented with 10 mg/L NAD (AppliChem GmbH, Darmstadt, Germany). Plates were incubated overnight at 37 °C and 5% CO2. Identification of the re-isolated bacteria was confirmed by serotype 2 specific PCR, using primers for the capsular biosynthesis genes cps2AB . In addition, snap frozen tissue samples were examined directly by a conventional PCR based on detection of the apxIVA gene .
Determination of APP 2-specific antibody titers in serum
Sera obtained prior to infection (day 0), at the time of euthanasia and at 14 and 21 dpi were analyzed for antibodies against APP 2 using the commercial Swinecheck® APP 2 ELISA (Biovet, St-Hyacinthe, Canada) according to the manufacturer’s instructions. Results were recorded as S/P ratio, obtained by the ratio between optical density (OD) of each sample (S) and the mean OD of the positive control (P): ODs/MODp.
Preparation of APP crude capsular extract for in vitro recall experiments
To stimulate lymphocytes in vitro, a crude capsular extract (CCE) from the APP serotype 2 strain C3656/0271/11, which has been used to infect the animals, was prepared following a modified protocol from Wittkowski et al. . In detail, 300 mL liquid cultures of APP biotype 1, serotype 2, strain C3656, were grown to an OD600 of approximately 0.2 and harvested by centrifugation at 6530 g for 5 min. Aqueous phenol (1%, w/v) was added to the harvested bacteria (18 mL per gram of bacterial wet weight). Thereafter, the suspensions were shaken for 10 min at 37 °C and transferred to conical 25 mL flasks and the solution was gently stirred for 4 h at 4 °C. After centrifugation at 21 420 g for 30 min at 4 °C, the supernatant was filtrated (0.2 µm, Filtropur, Sarstedt, Nümbrecht, Germany), dialyzed against MilliQ-H2O (2–4 L replaced every 4 h during the first day, then every 8 h) at 4 °C for 2 days, using 1 kDa MWCO membrane (Mini Dialysis Kit, GE Healthcare) and finally lyophilized overnight. To preserve the integrity of potential immunogenic proteins in the capsular extract, no further purification was performed. Lyophilized samples were dissolved in phosphate buffered saline (PBS) to reach a final concentration of 1 mg/mL. The stimulus was tested for potential toxicity in ConA-stimulated (3 µg/mL) PBMCs labelled with violet proliferation dye as described elsewhere . After 4 days of cultivation, PBMCs were harvested and stained with Live/Dead® Near-IR stain kit (Invitrogen, Carlsbad, CA, USA) according to manufacturer’s instructions and subjected to flow cytometry (FCM). Frequencies of dead cells and proliferating cells were determined and by a dose titration of the CCE, the optimal working concentration was found to be 4 µg/mL.
Sample collection and isolation of lymphocytes
Blood samples were collected in Lithium-Heparin tubes (Primavette®, KABE Labortechnik, Nümbrecht, Germany) prior to infection (day 0), at 14 and 21 dpi and at the time of death. PBMCs were isolated by density gradient centrifugation (Pancoll human, density 1.077 g/mL, PAN Biotech, Aidenbach, Germany) as described elsewhere . Tonsils and tracheobronchial lymph nodes were subjected to a procedure for isolation of lymphocytes as previously described .
For isolation of lymphocytes from lung tissue, a block of tissue (approx. 4 × 3 × 2 cm) from the dorsal portion of the left caudal lobe was cut into small pieces (approx. 3 × 3 × 3 mm) and lymphocytes were isolated as described elsewhere . Cells from the various tissues and blood were counted and suspended in cell culture medium (RPMI1640 with stable glutamine supplemented with 10% FCS, 100 IU/mL penicillin, 100 µg/mL streptomycin, all from PAN Biotech and 90 µg/mL gentamicin, from Sigma-Aldrich, Schnelldorf, Germany) for in vitro cultivation. To standardize the isolation of lymphocytes from lung tissue, we decided to sample a defined region of the lung, independently of the presence of lesions. The dorsal portion of the left caudal lobe was selected for this purpose, since the caudal lobes have been described to be a common site for APP lesions  but the right lung was washed for the collection of BALF.
Histopathological analysis of lung tissue
Lung samples for histopathological analysis from acutely and chronically infected animals were fixed in neutral buffered formalin and embedded in paraffin wax. Tissue slides were routinely stained with hematoxylin and eosin and examined by a pathologist blinded to the different treatment groups. The samples were located adjacent to tissue used for lymphocyte isolation. Histopathological lesions associated with porcine pleuropneumonia, such as tissue necrosis, neutrophilic, histiocytic and lymphocytic infiltration, vascular leakage (including edema, bleeding, and fibrin in tissue or air spaces) and fibroplasia were graded (0 = not present, 1 = low grade, 2 = moderate grade, 3 = high grade).
In vitro stimulation of lymphocytes
Freshly isolated cells from lung, blood, tracheobronchial lymph nodes and tonsils were stimulated in vitro with APP-CCE (4 µg/mL) for 18 h at 37 °C in 5% CO2. Cells were cultured in round-bottomed 96-well plates, at 5 × 105 cells per well, in a volume of 200 µL. Four hours prior to harvesting the cells, Brefeldin A (BD GolgiPlug™, BD Biosciences, San Jose, CA, USA) was added at a final concentration of 1 µg/mL. In parallel, cells incubated in cell culture medium only served as a negative control. As a positive control for cytokine production, a further set of cells was cultivated in cell culture medium overnight but stimulated with phorbol 12-myristate 13-acetate (PMA; 50 ng/mL; Sigma-Aldrich) and Ionomycin (500 ng/mL; Sigma-Aldrich) during the last 4 h of incubation.
Intracellular cytokine staining and FCM analysis
Source of primary Ab
Intracellular cytokine staining for IL-17A and TNF-α
Intracellular cytokine staining for IL-10
945A 4C4 37B1
FCM samples were analyzed on a FACSCanto™ II flow cytometer (BD Biosciences) equipped with three lasers (405, 488 and 633 nm). For automatic calculation of the compensation, single-stain samples were prepared. Between 5 × 105 and 1 × 106 lymphocytes were recorded per sample. Gating of the lymphocytes, doublet discrimination and dead-cell exclusion were performed for all samples as displayed in Additional file 2. Data were processed by FACSDiva software (Version 6.1.3 BD Biosciences) and transferred to Microsoft Excel (Office 2010; Microsoft, Redmond, WA, USA) for further calculations and preparation of graphs.
Spearman’s rank correlation test was used to investigate the correlation between the frequency of Th17 cells and disease parameters in individual pigs. Spearman’s rank correlation coefficients (ρ) and corresponding p values were calculated in SPSS software (2011, IBM, SPSS Statistics for Windows, Version 20.0, Armonk, NY, IBM Corp.). SPSS was also applied to produce correlation graphs. For further elaboration of graphs, Inkscape (Version 0.91; Free and Open Source Software licensed under the GPL) was used.
Establishment of an infection model for APP subclinical infection
Macroscopically visible lung tissue alterations were highly variable, which is partially reflected by the lung lesion and SPES scores (Figure 1B; Additional file 3 for representative animals). On average, LLS scores from animals sacrificed during the acute phase were higher than during the chronic phase. Typical histopathological findings indicating porcine pleuropneumonia were found in infected pigs varying from acute (hyperemia, edema, neutrophilic infiltration) to chronic (sequestration of necrotic areas by a mixed inflammatory infiltrate and fibroplasia) inflammatory tissue alterations (Additional file 4).
To evaluate the health status of the pigs, rectal temperature was measured daily together with other clinical parameters. Generally, infected animals developed clinical symptoms like dyspnea and coughing and were more lethargic than controls within the first 10 dpi. No significant differences in average daily weight gain were observed between infected (mean 724.7 g ± standard deviation of 92.6 g) and control (785.3 g ± standard deviation of 130.7 g) animals during the first 3 weeks post infection. Body temperature of infected animals started rising towards 40 °C immediately after the day of infection (day 0), with some animals reaching high temperature levels within 1–10 dpi (Figure 1C). Then, the rectal temperature stabilized between 39.5 and 40 °C for 2 weeks to finally align with the levels of control animals at the end of the study period (25–31 dpi). In parallel, the APP 2-specific humoral response was evaluated throughout the experiment (Figure 1D). Most of the infected animals produced antibodies against APP 2 after 14 days, i.e., antibodies were only detectable in animals that survived until the chronic phase of infection. No APP 2 antibodies were detectable in control animals at any time point.
Production of IL-17A and/or TNF-α by CD4+ T cells in response to APP-CCE
APP-CCE stimulation induced production of IL-17A by a subset of lymphocytes that is neither TCR-γδ+ nor CD4+
Inconsistent IL-10 production by CD4+ T cells following APP-CCE stimulation
Frequency of IL-17A+ CD4+ T cells correlates positively with disease parameters during the chronic phase of infection
The main focus of the study was to characterize the cytokine response of T cells isolated from pigs undergoing either an acute or a subclinical APP infection. To address this question, we first aimed to establish an infection model that evokes typical but not lethal APP disease symptoms and induces a status of subclinical infection. Most of the experimental infections described in the literature so far focused on studying the acute phase of APP infection [35–37]. The outcome of APP infection is depending on the route of infection, the dose and the virulence of the strain . Baarsch et al.  demonstrated that the route of infection influences the distribution of lung lesions, with the intranasal inoculation provoking mainly unilateral lesions and the endotracheal infection inducing diffuse bilateral pneumonia. To better mimic natural infection, we decided to perform an intranasal inoculation. To avoid loss of bacterial solution by swallowing or miscalculation of the actual infection dose by aerosol administration, the inoculum was sprayed directly into the nostrils rather than deposited as a liquid. Considering that vaporizing the bacterial solution into finely atomized particles increases the chance of APP reaching the alveoli , the infection dose was kept to low levels to avoid the induction of a per-acute form. The endpoints where chosen to compare acute and subclinical phase of infection. We hypothesized that at days 6–10 a first activation of T cells may be measurable like previously reported for acute influenza A virus infection . Additionally, the median duration of APP tonsillar colonization was reported around 7–8 weeks post-infection (pi)  leading to the assumption that APP would still be present at days 27–31 pi causing a subclinical infection. Pathological and clinical findings confirmed the establishment of a bi-phasic course of infection. The variety of rectal temperatures obtained during the acute phase paralleled with the variety of lung lesions observed at necropsy, with patterns ranging from severe and diffuse pneumonia with dark red–purple areas (per-acute), localized necrotizing pneumonia accompanied by fibrinous pleurisy (acute) to firm adhesive pleurisy and organized sequestra (chronic). On the opposite, during the chronic phase animals showed more uniform lesions and their body temperatures dropped down to physiological levels. These results indicate that our infection model successfully induced an acute infection that resolved into a subclinical one. Furthermore, this dichotomy could also be found by analyzing the presence of APP at different host compartments. During the acute phase, APP was mostly detected in the lung (7 out of 10), and hardly in the tonsils (3 out of 10). During the chronic phase, only one animal was positive in the lung, whereas in the tonsils 8 out of 10 tested positive. This might indicate a shift in the tropism of the bacteria from the lower to the upper respiratory tract and might be interpreted as an attempt of the bacteria to escape from the local immune response in the lung.
In frame of this study, we developed an in vitro stimulation assay using a crude capsular extract of APP. This assay was used to investigate the production of IL-17A, TNF-α and IL-10 in lymphocytes isolated from lung, peripheral blood, tracheobronchial lymph node and tonsil. Our data suggest that IL-17A-producing CD4+ T cells are induced in the lung tissue and blood of most APP-infected pigs. IL-17 is a pro-inflammatory cytokine, known to play a role in pulmonary infection and neutrophil recruitment [42, 43]. Its role in veterinary animal species  and its up-regulation in the surroundings of APP colonies in affected lung lesions on mRNA level have been previously described . Thus it is tempting to speculate that the APP-CCE-reactive IL-17A producing CD4+ T cells identified in this study represent APP-specific Th17 cells. The specificity of these cells is corroborated by two findings. First, similar to PMA/Ionomycin-induced IL-17A+ CD4+ T cells, these putative APP-specific Th17 cells expressed low or intermediate levels of CD8α. Its expression in porcine CD4+ T cells is related to activation and/or memory formation [34, 45]. Therefore, this CD8α expression can be interpreted as an indication that APP-CCE-reactive IL-17A-producing CD4+ T cells performed an in vitro recall response. Secondly, APP-CCE reactive IL-17A producing CD4+ T cells were nearly completely absent in lymphocytes isolated from control pigs, indicating that APP-naive CD4+ T cells did not respond to in vitro stimulation with APP-CCE.
Human  and porcine  CD4+ T cells have the capacity to co-produce IL-17A and TNF-α following PMA/Ionomycin stimulation. Furthermore, a synergistic effect between IL-17 and TNF-α has been reported, enhancing neutrophil migration . Also, TNF-α is known to play a major role in the immune-pathogenesis of APP infection [35, 48]. Following APP-CCE stimulation, we found that the majority of CD4+ T cells that produced IL-17A did not co-produce TNF-α. This suggests that CD4+ T cells are not a main source of TNF-α during APP infection.
Interestingly, a small subset of CD4− TCR-γδ− cells showed production of IL-17A upon APP-CCE stimulation but was also identified in control animals. Innate sources of IL-17 are described  such us iNKT cells , NK cells  and innate lymphoid cells type 3 (ILC3) . To affirm that the population revealed in our study is actually belonging to one of the subsets mentioned above, further investigations would be needed.
For several persistent pathogens like Mycobacterium tuberculosis , Leishmania spp.  and Toxoplasma gondii , IL-10 has been reported to impair their clearance by influencing the delicate balance between suppression and activation of host immune responses. In this study we therefore evaluated the production of IL-10 by CD4+ T cells in different organs but a specific induction upon APP-CCE stimulation was found only in few animals and frequencies of IL-10+ CD4+ T cells were rather low. In a previous study, IL-10 mRNA was predominantly found within lung lesions of APP-infected pigs but was only minimal in non-affected areas. . Of note, lung tissue samples in our study were derived from a defined anatomic area (dorsal portion of the left caudal lobe) and only in a single animal (#11) sequestra were included in that area. The frequency of IL-10-producing CD4+ T cells derived from this animal was high in both APP-CCE-(0.17%) and medium-(0.17%) stimulated cultures, resulting in a medium-corrected value of zero (Figure 6B, lung). Thus, we cannot exclude a potential role of IL-10 in the immune pathogenesis of APP infection. Further studies on affected lung lesions should be carried out in future studies to decipher the exact role of IL-10 in APP infections.
Finally, we observed that the frequency of Th17 cells in lung and PBMCs from chronically infected animals correlated positively with the lung lesion score and APP-specific antibody titers. Such a correlation was not found in the animals during the acute infection phase. This could be related to the enormous variety of lung lesions (diffuse/local necrotic and hemorrhagic areas, fibrosis, formation of sequestra, absence of lesions) observed at the necropsy during the acute phase, as described above. Moreover, no positive correlation between Th17 cells and the histological score of lung tissue samples from which lymphocytes had been isolated was found in the chronic phase of infection. Together with the positive correlation between frequency of Th17 cells in lung tissue as well as blood and the lung lesion score, this may indicate that these APP-specific Th17 cells have a general capacity for lung homing and also recirculate via the bloodstream. This would correspond with functional attributes ascribed to effector memory T cells . However, the precise functional role of these Th17 cells in APP pathology and persistence remains speculative. It is well established that cytokine production by Th17 cells can have protective but also pathologic roles in lung immunity . An excessive recruitment of neutrophils due to IL-17 production by CD4+ T cells could lead to progressive inflammation, which might explain the positive correlation between lung lesion and IL-17 production. Additionally, APP chronic lung lesions are usually characterized by fibroplasia  and IL-17 was shown to be involved in the occurrence and the development of pulmonary fibrosis in rats . Nevertheless, our in vitro stimulation system does not allow a distinction between actively IL-17A-producing CD4+ T cells in vivo (at the time of isolation) and the re-stimulation of quiescent APP-specific Th17 memory cells upon a second exposure to the antigen. Therefore, the precise role of the putative APP-specific Th17 cells in APP immunity, identified in our study, remains to be elucidated.
In conclusion, our results support previous findings that T cells are involved in the immune response to APP infection. We could show for the first time that APP-specific T cells with functional attributes of Th17 cells are induced in most APP-infected animals, which during the chronic phase of infection seem to positively correlate with lung lesion formation. Thus, our findings highlight the relevance of detailed immunological studies addressing T-cell differentiation for a better understanding of host-pathogen interactions in APP. Moreover, our infection model provides a solid basis for such studies in a controlled setting. This will contribute to a better understanding of APP pathogenesis and persistence.
The authors declare that they have no competing interests.
ES, WG, AL, IHP: conceived and designed the experiments; JF and JS: prepared the inoculum and carried out microbiological analysis; MS: helped to set up the in vitro assay, isolated the lymphocytes from the organs and applied the stimulus; ES and HS: performed the infection, clinical examination and collected samples; CK, HS, AL, RG: performed the necropsies and harvested samples; BR: performed histopathological analyses; ES: produced the stimulus. ES and ST performed the intracellular cytokine staining and FCM measurements; ST: established the protocol for the intracellular cytokine staining; ES and WG: analyzed and interpreted the results; AL, IHP and MES: contributed to the organization of the experiments and edited the manuscript; ES and WG: wrote the manuscript. All authors read and approved the final manuscript.
The authors thank Michaela Koch and Lisa Reiter for their excellent work in the lab and Hanna Koinig for her precious help with the organization of the animal experiment. Elena L. Sassu, Stephanie C. Talker and Janna Frömbling were supported by the Graduate School for Pig and Poultry Medicine of the University of Veterinary Medicine Vienna.
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