We characterized a novel population of tolerogenic myeloid dendritic cells (tmDCs) defined as CD11cKeywords: CD11b r CD11c r CD14 r Kawasaki disease r T cellsAdditional supporting information may be found in the online version of this article at the publisher's web-site
IntroductionLittle is known about the immune mechanisms by which infants and young children process the barrage of neoantigens that they In the current study we describe the unique phenotype and functions of a novel population of tolerogenic myeloid DCs (tmDCs) that are abundant in healthy children and in children with acute inflammation compared to adults. These innate myeloid cells express high levels of the adenosine A 2A receptor (A 2A R) which, when stimulated, facilitates IL-10 secretion mediated by the Fc. Adenosine is known to regulate mouse and human macrophage and dendritic cell differentiation and function via Gs-coupled A2A and A2B adenosine receptors that stimulate intracellular cAMP accumulation [3].Functional experiments suggest that tmDCs inhibit the differentiation of naïve T cells toward a pro-inflammatory phenotype. These findings indicate that circulating immunoglobulins play a role in the continuous stimulation of tmDC to maintain immune homeostasis and highlight a novel role of antibodies, adenosine and cAMP in immune regulation.
Results
Characterization of tolerogenic mDCs in pediatric and adult subjectsWe previously reported that circulating myeloid DCs (mDCs) are abundant in infants and children with acute Kawasaki disease (KD) or with acute viral infections, and we defined a mature population of mDCs that expresses the monocyte marker CD14 and secretes IL-10 when stimulated with Fc [4]. Here we expand these findings by phenotypically characterizing and enumerating these tmDCs in various pediatric cohorts, including children of different ages who are healthy, have acute viral infections, systemic onset juvenile idiopathic arthritis, or acute KD.In a cohort of 12 healthy children (cohort 1), we found that circulating myeloid cells, defined by the expression of CD11c and CD11b, ranged from 9.4 to 20% (median 17.75, ) and the majority expressed the maturation marker, CD86 (median 97.45,). HLA-G, a minor HLA class I allele that binds ILT-4, was expressed on only a small percentage of tmDCs (median, 7.9, IQR 3.1-9.72). We therefore defined tmDCs as CD11cHaving characterized tmDCs in healthy children, we next enumerated tmDCs in PBMC derived from children with various acute illnesses (cohort 2): adenoviral infection (n = 1), acute viral syndrome (n = 3), or juvenile idiopathic arhritis (JIA) (n = 1).
Numbers of CD11c+ CD11b + myeloid cells in these cohorts were similar to healthy children ( Fig. 1B) To determine if tmDCs are elevated in children vs. adults, we studied four healthy adults and enumerated their myeloid cells subpopulations. In contrast to the abundance of tmDCs in pediatric subjects, the levels in adults were much lower (median tmDCs = 3.7% of CD11c + CD11b + myeloid cells and 0.5% of PBMCs) (Fig. 2). As in chi...