The present study indicates that resident MHC class II–negative
LCs are present in the epithelium of the normal murine cornea. Previous
studies in guinea pig, hamster, mouse, and human have established that
MHC class II–positive LCs are present in the epithelium of the
conjunctiva and peripheral cornea but are essentially absent from the
central cornea.
9 12 19 20 21 22 23 24 25 26 27 28 29 The characteristic high
expression of MHC class II by professional APC (including DCs and LCs)
populations, on the one hand, coupled with the failure to routinely
detect class II–positive cells in the uninflamed cornea on the other,
has led to the conclusion that the cornea is devoid of resident
APCs.
9 12 19 20 21 22 23 24 25 26 27 28 29
Using an immunofluorescence double-staining technique applied to
confocal microscopy, we observed two phenotypically distinct
populations of leukocytes throughout the corneal epithelium: a MHC
class II–positive population, located in the periphery of the cornea
and the limbus, and a MHC class II–negative population, located in the
central areas of the normal cornea. TEM studies confirmed the presence
of dendritic-shaped cells in the central corneal epithelium; moreover,
a subset of these cells contained Birbeck granules, identifying them as
having an LC lineage. Given that these cells collectively exhibit
dendritic morphology and, except for MHC class II expression, have
identical expression (or absence of expression) of cell surface markers
(CD45
+, CD11b
−,
CD11c
+, CD3
−,
CD80
−, CD86
−), we believe
that they represent an LC-type DC population.
48 The
absence of CD80 or CD86 expression by these cells regardless of their
location is characteristic of LCs in normal uninflamed
tissues
48 49 and defines these cells as being in an
immature or precursor stage. The negative expression for CD3 and CD11b
excludes the presence of T-cells (including Thy-1 positive
dendrite-shaped T-cells), and monocytes-macrophages in this lineage.
The MHC class II–positive LCs in the periphery account for slightly
more than half of the total resident LCs (CD11c
+ CD45
+) in the cornea. The MHC class II–positive
LC density of 100 cells/mm
2 in the periphery
correlates with results previously obtained by other
groups.
9 50 However, to our knowledge, we are the first
group to report the presence of MHC class II–negative LCs in the
cornea. In 1964, when LCs were thought to be melanocytes, Segawa et al.
described three different populations of LCs in the human
cornea.
51 One of these populations, the “nonpigmented
dendritic cell” was found in “all” parts of the cornea, including
the center of the epithelium. In retrospect, it is not clear whether
Segawa et al. were looking at the same cells as are described
in this study. In several studies, MHC class II–negative LCs have been
described in the skin.
52 53 54 55 Because CD1a is a highly
reliable indicator for noncorneal LCs, those studies demonstrate that
CD1a
+ LCs may be class II negative in the skin
epidermis.
The comparison between CD1a and MHC class II antigen expression, is not
possible in the corneal epithelium, however, because corneal LCs do not
express the CD1a antigen, in contrast to their counterparts in the
skin.
31 56 57 Therefore, it may not be surprising that the
novel MHC class II–negative LC population described herein was not
detected previously. In addition, our studies are based on confocal
microscopic evaluation of corneal epithelial sheets, which has the
advantage of examining multiple layers over a broad surface area. In
our experience, even with confocal microscopy, detection of LC
populations in the cornea is very difficult in cross-sectional studies,
because the transection of the LCs makes it difficult to evaluate these
cells’ morphology. This may explain why some investigators have
described occasional class II
+ dendrite-like
cells
11 14 24 30 31 32 in the cross-sectioned cornea, but
were unable to make any firm conclusions regarding their identity.
We found that in inflammation, the expression of MHC class II and B7
molecules (CD80 and CD86) is potently upregulated. This upregulation
was observed in cauterized corneas uniformly at day 3 after
cauterization: first near the cautery sites and later throughout the
cornea. Although cells migrating into the cornea from the limbus also
contribute to the increased density of MHC class
II
+ and B7
+ cells, our data
suggest that most of these cells, especially in the central and
paracentral areas, are resident LCs. There are several lines of
evidence to support this: First, although the total number of
CD11c
+ cells increased from
80/mm
2 in the normal cornea to
103/mm
2 in the inflamed cornea, the number of MHC
class II
+ cells increased from
0/mm
2 to 51/mm
2, suggesting
that recruitment of cells into the corneal center was not entirely
responsible for changes in MHC class II expression. Second, at early
time points after cautery, MHC class II and B7 positive cells were
first present around cautery sites in the corneal center, whereas the
peripheral sites were still negative for these activation markers,
suggesting that cells expressing these markers were not simply being
recruited from the periphery. Third, in the transplantation
experiments, we noted novel expression of donor-derived MHC Ia antigens
among the graft’s CD11c
+ cells 24 hours after
transplantation, similarly suggesting that recruitment of cells from
the (host) periphery could not entirely explain the upregulation of
MHCs in the graft.
8 32 37 Moreover, the negative
expression of donor MHC antigens at early time points after
transplantation rules out contamination as a cause of this expression.
We also noted that the CD11c cells migrated centrifugally toward the
graft–host interface before class II upregulation, suggesting that the
environment at the graft–host border plays a major role in the
upregulation of class II in these cells.
Candidate molecules that are known to upregulate expression of
costimulatory and MHC class II molecules and induce the maturation of
DCs and LCs, include tumor necrosis factor (ΤNF)-α,
granulocyte-macrophage colony-stimulating factor (GM-CSF), and
interleukin (IL)-1.
58 59 60 61 62 Previous studies by our group
using the IL-1 receptor antagonist (IL-1ra) to suppress IL-1 function
locally, showed that topical IL-1ra suppresses LC activities and
ultimately promotes ocular immune privilege and corneal transplant
survival.
63 64 One way IL-1ra’s immune modulatory effect
could be explained is its suppression of limbal (host) APC recruitment
into the graft, which would result in decreased capacity for antigen
processing. However, in view of our current data, we speculate that one
additional mechanism by which anti-inflammatory agents may downmodulate
corneal immunity is by suppressing the maturation of resident APCs in
the cornea. This hypothesis is supported by previous data from our
laboratory in which we showed that intracorneal injection of LCs can
promote generation of immunity to intracameral antigens, but that
suppression of IL-1 activity (even in the presence of high numbers of
intracorneal LCs) abrogates the capacity of LCs to promote immunity to
ocular antigens.
64 Hence, we propose that the absence (or
generation) of immunity to corneal antigens cannot be explained simply
by the numbers of APCs present in the cornea, but also must take into
account these cells’ maturation state.
The cells described herein fit the phenotypic characteristics of
progenitor or immature APCs. Progenitor and immature APCs (including
DCs and LCs) in general have negligible to absent MHC class II and B7
costimulatory expression.
65 Although immature LCs are
highly capable of antigen uptake and processing, in contrast to mature
LCs, they have a weak stimulatory capacity for activating T cells, due
to their failure to provide naive T cells with requisite costimulatory
signals.
65 However, exposure of these cells to the proper
(proinflammatory) cytokine microenvironment promotes their maturation,
during which these cells lose their capacity to process antigens and
instead gain the capacity to stimulate T cells. Our data suggest that
the proinflammatory milieu induced by cauterization or transplantation
of the cornea is associated with maturation of resident corneal LCs.
Little is known about the exact molecular mechanisms that regulate LC
maturation in the cornea on the one hand, or those that retain large
numbers of these LCs in an immature state on the other. It is known
that prostaglandin E
2 66 and
cytokines such as TGF-β and IL-10
49 67 have a profound
capacity to suppress the stimulatory role of LCs and to downregulate
MHC class II expression. Given that there is constitutive expression of
a variety of immunosuppressive factors in the eye (including the
cornea), it is attractive to propose that active suppression of LC
maturation, with associated absence of MHC class II and costimulatory
molecule expression, may in fact represent an important facet of ocular
immune privilege.
The presence of an MHC class II–negative subpopulation of immature LCs
in the cornea may have important implications for a wide range of
immunoinflammatory responses in the anterior segment, including
alloimmune, autoimmune, and innate immune responses. Further studies
are needed, to determine the molecular mechanisms that regulate the
maturation of these cells and their immunobiologic phenotype in
stimulating (or tolerizing) T cells generated in response to ocular
antigens.
The authors thank their colleagues at the Schepens Eye Research
Institute, Ilene Gipson and Wayne Streilein, for helpful advice; Don
Pottle (Confocal Microscopy Unit) for excellent technical assistance;
and Pat Pearson (Morphology Unit) for providing invaluable help in the
corneal TEM studies.