M yasthenia gravis (MG) is a T cell-regulated, antibodymediated autoimmune disease. Impaired neuromuscular transmission characteristic of MG results from antibodies against the nicotinic acetylcholine receptor (AChR) of skeletal muscle (1, 2). Nevertheless, a role for T cells in MG and experimental autoimmune MG (EAMG) was shown in several studies (3-7). Previous work performed in our laboratory demonstrated that two peptides representing sequences of the human AChR ␣-subunit, p195-212 and p259-271, were able to stimulate peripheral blood lymphocytes of patients with MG, and to serve as immunodominant T cell epitopes of SJL and BALB͞c mice respectively (8, 9). Altered myasthenogenic peptides, which are single amino acid-substituted analogs of p195-212 (207Ala) and p259-271 (262Lys), as well as a dual altered peptide ligand (APL) composed of the tandemly arranged two single analogs (Lys-262-Ala-207), were synthesized and were shown to inhibit the proliferative responses of both p195-212-and p259-271-specific T cell lines in vitro as well as the in vivo priming to the myasthenogenic peptides (10-12). In addition, the single and the dual APL were also found to be capable of inhibiting the proliferative responses of peripheral blood lymphocytes of MG patients to both myasthenogenic peptides p195-212 and p259-271 (13). The dual APL could reverse myasthenogenic manifestations in mice with EAMG induced either by pathogenic T cell lines or by the Torpedo AChR (10,14). In an attempt to elucidate the mechanism͞s by which the dual APL downregulates EAMG-associated responses, we demonstrated that the dual APL acts by actively suppressing myasthenogenic T cell responses in a specific manner. The active suppression is mediated, at least partially, by the up-regulation of the secretion of transforming growth factor (TGF)- [T helper (Th) 3-type cytokine], which was accompanied by down-regulation of IFN-␥ and IL-2 (Th 1-type cytokines) secretion (15). Furthermore, the inhibitory effect of the dual APL could be adoptively transferred to p195-212 or Torpedo AChR-immunized mice (15). Nevertheless, the mechanisms by which the dual APL exerts its effect in vivo have not been completely elucidated yet. Hence, the purpose of this study has been to attempt a better insight into these in vivo mechanisms.The term ''regulatory T cell'' describes a variety of T cells that display suppressive functions in vitro or in vivo. One of the best characterized subsets is defined by a constitutive expression of the IL-2 receptor ␣-chain (CD25) (16). These CD4
Materials and MethodsMice. Female mice of the inbred strain SJL (The Jackson Laboratory) were used at the age of 8-12 wk.