Peptide-specific CTL responses were confirmed with two cytokines and two cytokine assays
(Figs. 2 3) , indicating that our peptide-pulsed DC vaccination broke the immunotolerance against the self-antigen VEGFR2
400–408. In these assays, IFN-γ and TNF-α were used as indicators for the peptide-specific activation of CTLs.
50 The direction of acquired immunity is regulated by the Th1/Th2 balance, in which Th1 and Th2 CD4 T cells promote cellular and hormonal immunity, respectively, through cytokines inhibitory to each other.
51 52 IFN-γ, produced by Th1 cells and CTLs, is one of the most important cytokines for the induction of cellular immunity. Moreover, IFN-γ was shown to induce endothelial cell apoptosis
53 and to contribute to CTL-mediated tumor rejection,
54 suggesting its role in the presently observed suppression of CNV. TNF-α is capable of activating cell survival and cell death.
55 TNF-α stimulates the nuclear factor-κB pathway, leading to cell proliferation, whereas endothelial cells undergo apoptosis through TNF-α–induced activation of caspase 8.
56 Accordingly, CTL-derived TNF-α is suggested to contribute to cytotoxicity, together with perforin and Fas ligand (FasL),
57 each of which triggers key distinct pathways responsible for CTL-mediated apoptosis. A recent report
58 showed, however, that TNF-α blockade led to significant suppression of CNV in the laser-induced model. At least in nonimmunized CNV mice without CTL induction or activation, macrophage-derived TNF-α, which stimulates RPE production of VEGF, may reasonably function as a proangiogenic factor.
5 FasL, the major cytokine in the TNF family responsible for CTL-mediated cytotoxicity, also proved to be produced by RPE cells
59 and macrophages
60 to regress CNV even without the induction of specific cellular immunity. Additionally, CNV-associated RPE cells were shown to secrete pigment epithelium-derived factor,
61 62 63 a potent inhibitor of angiogenesis. Together, the defense systems to combat CNV seem to be abundantly prepared in vivo, leading to time-dependent regression of CNV even in nonimmunized mice from 2 weeks after the induction (data not shown). In concert with these nonspecific systems, our DC vaccination-induced CTL activity might have enhanced or quickened the reduction of CNV, providing a significant implication as a new therapeutic strategy for CNV.