Immunosuppressive CD71+ erythroid cells compromise neonatal host defence against infection

Abstract

Newborn infants are highly susceptible to infection. This defect in host defence has generally been ascribed to the immaturity of neonatal immune cells; however, the degree of hyporesponsiveness is highly variable and depends on the stimulation conditions1–7. These discordant responses illustrate the need for a more unified explanation for why immunity is compromised in neonates. Here we show that physiologically enriched CD71+ erythroid cells in neonatal mice and human cord blood have distinctive immunosuppressive properties. The production of innate immune protective cytokines by adult cells is diminished after transfer to neonatal mice or after co-culture with neonatal splenocytes. Neonatal CD71+ cells express the enzyme arginase-2, and arginase activity is essential for the immunosuppressive properties of these cells because molecular inhibition of this enzyme or supplementation with l-arginine overrides immunosuppression. In addition, the ablation of CD71+ cells in neonatal mice, or the decline in number of these cells as postnatal development progresses parallels the loss of suppression, and restored resistance to the perinatal pathogens Listeria monocytogenes and Escherichia coli8,9. However, CD71+ cell-mediated susceptibility to infection is counterbalanced by CD71+ cell-mediated protection against aberrant immune cell activation in the intestine, where colonization with commensal microorganisms occurs swiftly after parturition10,11.Conversely, circumventing such colonization by using antimicrobials or gnotobiotic germ-free mice overrides these protective benefits. Thus, CD71+ cells quench the excessive inflammation induced by abrupt colonization with commensal microorganisms after parturition. This finding challenges the idea that the susceptibility of neonates to infection reflects immune-cell-intrinsic defects and instead highlights processes that are developmentally more essential and inadvertently mitigate innate immune protection. We anticipate that these results will spark renewed investigation into the need for immunosuppression in neonates, as well as improved strategies for augmenting host defence in this vulnerable population.

An Immunological Perspective on Neonatal Sepsis

“…Recent data has revealed an important immune regulatory role for erythrocytes. These authors suggested that CD71+ nucleated red blood cells (nRBCs) actively suppress both innate and adaptive immune responses through the expression of arginase, which inhibits nitric oxide synthesis [72]. However, this conclusion was disputed by others whose data suggested that the heightened intestinal immune activation in mice treated with anti-CD71 to deplete the nRBCs was unaffected by replenishment of these cells [73].…”

High expression levels of macrophage migration inhibitory factor sustain the innate immune responses of neonates

“…Large clinical studies testing associations between functional MIF polymorphisms and MIF expression levels with susceptibility to or severity of neonatal sepsis are now required to substantiate whether MIF represents a potential attractive target for immune-modulating adjunctive therapies for neonatal sepsis. Adding to the recent studies challenging the idea that the neonatal immune system is purely immature (71)(72)(73)(74)(75), the recognition of a unique role for MIF in regulating innate immunity supports the concept that neonatal immune responses are tightly regulated by a balance of pro-and antiinflammatory mediators.…”

Distinct phenotypic features of neonatal murine macrophages

“…Recently, CD71 + erythroid cells have been shown to suppress the inflammatory response of neonatal murine macrophages by a mechanism involving arginase activity [33]. Other authors postulated that a lack of T cells contributes to the excessive inflammatory response of neonatal splenocytes [34].…”