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Maintenance of graft tissue–resident Foxp3+ cells is necessary for lung transplant tolerance in mice
Wenjun Li, … , Andrew E. Gelman, Daniel Kreisel
Wenjun Li, … , Andrew E. Gelman, Daniel Kreisel
Published March 18, 2025
Citation Information: J Clin Invest. 2025;135(10):e178975. https://doi.org/10.1172/JCI178975.
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Research Article Immunology

Maintenance of graft tissue–resident Foxp3+ cells is necessary for lung transplant tolerance in mice

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Abstract

Mechanisms that mediate allograft tolerance differ between organs. We have previously shown that Foxp3+ T cell–enriched bronchus-associated lymphoid tissue (BALT) is induced in tolerant murine lung allografts and that these Foxp3+ cells suppress alloimmune responses locally and systemically. Here, we demonstrated that Foxp3+ cells that reside in tolerant lung allografts differed phenotypically and transcriptionally from those in the periphery and were clonally expanded. Using a mouse lung retransplant model, we showed that recipient Foxp3+ cells were continuously recruited to the BALT within tolerant allografts. We identified distinguishing features of graft-resident and newly recruited Foxp3+ cells and showed that graft-infiltrating Foxp3+ cells acquired transcriptional profiles resembling those of graft-resident Foxp3+ cells over time. Allografts underwent combined antibody-mediated rejection and acute cellular rejection when recruitment of recipient Foxp3+ cells was prevented. Finally, we showed that local administration of IL-33 could expand and activate allograft-resident Foxp3+ cells, providing a platform for the design of tolerogenic therapies for lung transplant recipients. Our findings establish graft-resident Foxp3+ cells as critical orchestrators of lung transplant tolerance and highlight the need to develop lung-specific immunosuppression.

Authors

Wenjun Li, Yuriko Terada, Yun Zhu Bai, Yuhei Yokoyama, Hailey M. Shepherd, Junedh M. Amrute, Amit I. Bery, Zhiyi Liu, Jason M. Gauthier, Marina Terekhova, Ankit Bharat, Jon H. Ritter, Varun Puri, Ramsey R. Hachem, Hēth R. Turnquist, Peter T. Sage, Alessandro Alessandrini, Maxim N. Artyomov, Kory J. Lavine, Ruben G. Nava, Alexander S. Krupnick, Andrew E. Gelman, Daniel Kreisel

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Figure 1

Allograft-resident and spleen Foxp3+ cells are phenotypically and transcriptionally distinct in tolerant lung transplant recipients.

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Allograft-resident and spleen Foxp3+ cells are phenotypically and transc...
(A–C) Gross image (n = 6) (A), H&E staining (n = 6) (B), and CCSP immunofluorescence staining (n = 2) (C) of left lung transplant from BALB/c donor into CSB-treated B6 recipient, at least 30 days after engraftment. Scale bars: 100 μm. (D) Two-photon intravital microscopy of BALB/c lung at least 30 days after transplantation into CSB-treated B6 CD11c-EYFP/Foxp3-GFP recipient (n = 3). CD11c+ cells are yellow, Foxp3+ cells are green, collagen appears blue owing to second-harmonic generation (SHG), and vessels are red following i.v. injection of quantum dots. Scale bar: 20 μm. (E–I) Representative flow cytometry plots and quantification of abundance of Foxp3-expressing CD45+CD90.2+CD4+CD8– T cells (E), CD25-expressing CD45+CD90.2+CD4+CD8–Foxp3+ T cells (CD25 expression determined based on isotype control staining) (F), effector memory (CD44hiCD62Llo), central memory (CD44hiCD62Lhi), and naive (CD44loCD62Lhi) CD45+CD90.2+CD4+CD8–Foxp3+ T cells (G), CD69-expressing CD45+CD90.2+CD4+CD8–Foxp3+ T cells (H), and (I) PD-1–expressing CD45+CD90.2+CD4+CD8–Foxp3+ T cells in BALB/c lung and recipient spleen at least 30 days after transplantation into CSB-treated B6 recipients (n = 4). At least 30 days after transplantation of BALB/c lungs into CSB-treated B6 Foxp3-GFP mice, CD45+CD90.2+CD4+CD8–GFP+ cells were sorted and processed for TCR and genome sequencing (n = 2). (J) Gini coefficient (0 represents maximal diversity) comparison of clonal expansion (left) and number of cells in the top 11 shared clonotypes between Foxp3+ cells in tolerant lung allografts and recipient spleens (right) (triangles and circles denote individual mice). (K) Heatmap of most highly differentially expressed genes in Foxp3+ cells between tolerant lung allografts and recipient spleens (2 pooled lungs and spleens). (L–N) Gross image (n = 4) (L), H&E staining (n = 4) (M), and CCSP immunofluorescence staining (n = 2) (N) of BALB/c lungs 30 days after transplantation into CSB-treated B6 Foxp3-YFP-Cre Aregfl/fl mice. Scale bars: 100 μm. Results expressed as mean ± SEM. **P < 0.01, ***P < 0.001. d30, day 30; q-dot, quantum dot; Tcm, T central memory; Tem, T effector memory; Treg, regulatory Foxp3+ T cell; TX, transplanted lung.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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