Active amyloid -peptide (A) immunization of patients with Alzheimer's disease (AD) caused meningoencephalitis in ϳ6% of immunized patients in a clinical trial. In addition, long-term studies of AD patients show varying degrees of A Ab responses, which correlate with the extent of A clearance from the brain. In this study, we examined the contribution of various HLA-DR alleles to these immune-response variations by assessing A T cell reactivity, epitope specificity, and immunogenicity. Analysis of blood samples from 133 individuals disclosed that the abundant DR haplotypes DR15 (found in 36% of subjects), DR3 (in 18%), DR4 (12.5%), DR1 (11%), and DR13 (8%) were associated with A-specific T cell responses elicited via distinct T cell epitopes within residues 15-42 of A. Because the HLA-DRB1*1501 occurred most frequently, we examined the effect of A challenge in humanized mice bearing this allele. The observed T cell response was remarkably strong, dominated by secretion of IFN-␥ and IL-17, and specific to the same T cell epitope as that observed in the HLA-DR15-bearing humans.
A ccumulation of amyloid -peptide (A)4 in the brain is a hallmark of Alzheimer's disease (AD) (1). Although A can be deposited in brains of elderly individuals without causing clinical symptoms, it appears to play a key role in AD pathogenicity, both in the form of soluble oligomers that cause synaptotoxicity (2-4) and as compact plaques promoting chronic glial activation and neurotoxicity (5, 6). Clearance of A, achieved by A vaccination, has been shown to prevent its deposition in the brain as well as the associated glial activation and cognitive deficits (7-14). In a clinical trial of AD patients, however, such treatment resulted in unexpected complications in the form of meningoencephalitis in ϳ6% of participants (15, 16), presumably caused by pathogenic activation of A-specific T cells in certain A-immunogenic individuals.The extent of A T cell activation differs significantly among mouse strains bearing different MHC class II (MHC-II) haplotypes (17)(18)(19)(20). For example, SJL mice, which bear the H-2 s haplotype, were substantially more A-immunogenic than C57BL/6 mice, which bear the H-2 b haplotype (19). The dominant T cell epitopes in SJL and in C57BL/6 mouse strains were mapped to residues A10 -24 and A16 -30, respectively (19), demonstrating a direct association between MHC-II alleles and A immunogenicity.Differing strengths of T cell responses to A have also been observed in PBMCs of human subjects (21). Although the average response of A-reactive T cells, both in healthy elderly individuals and in patients with AD, was significantly more pronounced than that of adult healthy individuals, the responses of individuals within each group showed substantial variation. The T cell epitopes detected by analysis of A-specific T cells lines were mapped to A16 -30 (similarly to the epitope in C57BL/6 mice) but also to C-terminal portions of the A peptide such as A18 -32 and A28 -42 (21). A peptide-induced T ...