Using optimized human peripheral blood mononuclear cell (PBMC) ex vivo assays, we showed that a combustible tobacco product preparation markedly suppresses receptor-mediated intracellularly secreted cytokines and cytolytic ability of effector PBMCs. These rapid assays may be useful in product evaluation and understanding the potential long-term effects of tobacco exposure.
Among other pathophysiological changes, chronic exposure to cigarette smoke causes inflammation and immune suppression, which have been linked to increased susceptibility of smokers to microbial infections and tumor incidence. Ex vivo suppression of receptor-mediated immune responses in human peripheral blood mononuclear cells (PBMCs) treated with smoke constituents is an attractive approach to study mechanisms and evaluate the likely long-term effects of exposure to tobacco products. Here, we optimized methods to perform ex vivo assays using PBMCs stimulated by bacterial lipopolysaccharide, a Toll-like receptor-4 ligand. The effects of whole smoke-conditioned medium (WS-CM), a combustible tobacco product preparation (TPP), and nicotine were investigated on cytokine secretion and target cell killing by PBMCs in the ex vivo assays. We show that secreted cytokines IFN-γ, TNF, IL-10, IL-6, and IL-8 and intracellular cytokines IFN-γ, TNF-α, and MIP-1α were suppressed in WS-CM-exposed PBMCs. The cytolytic function of effector PBMCs, as determined by a K562 target cell killing assay was also reduced by exposure to WS-CM; nicotine was minimally effective in these assays. In summary, we present a set of improved assays to evaluate the effects of TPPs in ex vivo assays, and these methods could be readily adapted for testing other products of interest.
A substantial body of knowledge points to the adverse health effects of chronic cigarette smoking, including cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD) and cancer1,2. Chronic cigarette smoking has been known to cause inflammation and immune suppression, and these alterations are reported to contribute to increased risk of microbial infection and cancer in smokers3. In vitro and ex vivo techniques are useful in elucidating the molecular basis of the pathophysiological effects of cigarette smoke4-9 (Table 1) and are recognized as important tools for guiding the emerging regulation of various tobacco products10,11.
For example, we have demonstrated that combustible tobacco product preparations (TPPs) such as whole smoke-conditioned medium (WS-CM) and total particulate matter (TPM) are far more cytotoxic and damaging to DNA than non-combustible TPPs or nicotine12,13. Consistent with the published work, it was recently reported that combustible TPPs or nicotine12,13. Consistent with the published work, we recently reported that combustible TPPs caused marked immunosuppression. This was evidenced by suppression of Toll- like receptor (TLR)-ligands, stimulated cytokine secretion, and targeted cell (K562) killing by PBMCs in an ex vivo model14. Given the significance of inflammation in cigarette smoke-induced disease processes, further optimization of the assay conditions to evaluate the immune modulatory effects of cigarette smoke is presented in this report.
The ex vivo assays typically measured intracellular and secreted cytokines as well as the cytolytic function of cytotoxic T and NK cells in K562 cell killing assays14. The assays involved pre-incubation with WS-CM and nicotine and subsequent stimulation of PBMCs with TLR agonists over a period of 3 days; the final readouts are performed using enzyme-linked immunosorbent assays (ELISAs) and/or flow cytometry. We utilized bacterial lipopolysaccharide (LPS), which binds to TLR-4 receptors and stimulates PBMCs resulting in the production of intracellular cytokines and secretion of cytokines. In addition to optimization of the various assay steps for evaluating the immunomodulatory effects of TPPs, we also present methods for isolating PBMCs, cell death assays, and IL-8 quantification. These methods may be applied to address other research questions and further refined to evaluate tobacco products in the regulatory context.
Table 1. Published reports of in vitro and ex vivo methods used to study varilus pathophysiological effects of tobacco product preparations. CS, cigarette smoke medium; CSC, cigarette smoke condensate; CSE, cigarette smoke extract; ELISA, enzyme-linked immunosorbent assay; GADPH, glyceraldehyde 3-phosphate dehydrogenase; qPCR, quantitative polymerase chain reaction; RT, real time quantitative polymerase chain reaction; TS, tobacco smoke.
Author (Year of study) | Laan et al. (2004) | Moodie et al. (2004) | Oltmanns et al. (2005) | Vayssier (1998) | Witherden et al. (2004) | Birrell et al. (2008) |
Cells used | Human bronchial endothelium cells (BEAS-2B), human neutrophils | Human alveolar epithelial cells (A549) | Human airway smooth muscle cells (HASMC) | Human premonocytic U937 cells, human monocytes | Alveolar type II epithelial cells (ATII) | Human monocytic cell line (THP-1), human lung macrophages |
TPP used | CSE | CSC | CSE | TS | CSE | CS |
Method used | ELISA, qPCR, migration, electromobility shift | Immunohisto-chemistry, electrophoresis, Arrayscan kit, RT-PCR, ELISA | ELISA, RT-PCR, qPCR, electrophoresis | Gel-mobility shift | Light microscopy, electron microscopy, electrophoresis, ELISA | qPCR, ELISA, E-toxate kit (Sigma), p65 plate assay (TransAM), electrophoresis, various immunoassay kits |
Measure | IL-8, GM-CF, AP-1, NF-κB, migration | Histone acetyltransferases, histone deacetylases, NF-κB, IL-8, p-I κB-α, GADPH | HO-1, GADPH, RANTES, IL-8, eotaxin | Heat shock/stress proteins (HSP/Hsp70), HF transcription factor, NF-κB, TNF-α | Surfactant protein (SP-A, SP-C), IL-8, MCP-1, GRO-α, TNF-α, IL-1β, IFN-γ | IL-8, IL-1β, IL-6, TNF-α, MIP1-α, GRO-α, MAPK/JNK/ERK phosphorylation, cJUN:DNA binding, glutathione, p65:DNA binding |
End result | CSE down-regulates cytokine production via suppression of AP-1 activation. | H2O2 and CSC enhance acetylation of histone proteins, decrease histone deacetylase activity, differentially regulate proinflammatory cytokine release. | Cigarette smoke may cause the release of IL-8 from HASMC, enhanced by TNF-α, 20% CSE less IL-8 release, Inhibition of eotaxin and RANTES by cigarette smoke. | TS activated HF transcription factor, which was associated with Hsp70 overexpression and inhibition of NFkB binding activity and TNF-α release. | Reduced ATII cell-derived chemokine levels compromise alveolar repair, contributing to cigarette smoke-induced alveolar damage and emphysema. | Data provide mechanistic explanation for why smokers have increased respiratory infections. Suppression of the innate response is accompanied by an increase in IL-8. |
NOTE: Written Informed consent to do this study was obtained at a local clinical research unit under IRB approval, per Good Clinical Practices. Processing of blood, isolation of PBMCs and other cell culture experiments are performed under sterile conditions, using microbiologically sterile supplies and reagents.
1. WS-CM Preparation
2. Isolation of PBMCs
3. Freezing and Thawing the PBMCs
4. Cell Death Determination
NOTE: Dilutions listed here are for the purpose of this study. The dilutions can be changed accordingly.
5. EC50 Determination
6. Secreted Cytokines
NOTE: Dilutions listed here are for the purpose of this study. The dilutions can be adjusted accordingly.
7. Cytometric Bead Array Assay
8. IL-8 ELISA
9. Intracellular Staining and Flow Cytometry
NOTE: Dilutions listed here are for the purpose of this study. The dilutions can be adjusted accordingly.
10. K562 Killing Assay
NOTE: K562 cells should be grown in culture at 37 °C and 5% CO2 with RPMI complete medium until they reach 80% confluence before the assay.
The results were presented as mean ± standard error of the mean (four donor samples). The student’s t-test between treated and untreated control samples was performed using Excel software as well as t-test comparisons for all treatments with their corresponding controls. The statistical significance was indicated by: *, P < 0.05; **, P < 0.005; ***, P < 0.0005.
To measure the effect of exposure to WS-CM and nicotine, PBMCs were treated with different concentrations of WS-CM and nicotine for 3 h or 24 hr. Cell death was measured by the robust and reliable 7AAD staining method, as 7AAD intercalates into double-stranded nucleic acids and can penetrate cell membranes of dying or dead cells16. A dose-dependent increase in cell death was observed with WS-CM at 24 hr, with a near 80% cell death detected at 4 µg/ml of equi-nicotine units (Figure 1A). A comparable degree of cell death was noted only at 3,000 µg/ml nicotine (Figure 1B). Since we exposed PBMCs for 3 hr with WS-CM and nicotine to assess their effect of cytokine induction and ability to kill target cells, it was necessary to determine whether WS-CM causes significant cytotoxicity following 3 hr treatment. PBMCs treated with 5 µg/ml of equi-nicotine units of WS-CM did not experience significant toxicity (<5%; Figure 1A). Treatment with nicotine for 3 hr caused measurable (8%) cell death only at 2,000 µg/ml (Figure 1B). Thus, exposure to WS-CM or nicotine at the indicated doses and treatment periods did not cause significant cytotoxicity under the experimental conditions.
To measure the immunomodulatory effects, PBMCs were stimulated with LPS for different time periods, and the secreted cytokines were measured by the CBA assay. To optimize the LPS stimulation time, we exposed PBMCs to LPS stimulation for 4 hr, 24 hr, 48 hr, and 72 hr, and secreted cytokines were measured. For example, LPS stimulation for 24 hr yielded maximal secretion of the cytokines IL-6 and IL-8 (Figure 2), and extended time periods did not result in further increases (IL-6) or decreases (IL-8) in cytokine secretion. Similar results were obtained with other secreted cytokines such as IL-10, IL-1β and TNF-α (data not shown).
The pilot time-course experiments suggested that maximal production of cytokines in responses to TLR-4 stimulation by LPS occurs by 24 hr, and hence, secreted cytokines were measured at 24 hr in all subsequent experiments. Treatment with WS-CM and nicotine, followed by stimulation of TLR-4 receptor with LPS, resulted in a dose-dependent decrease of secreted cytokines (Figure 3). Treatment with WS-CM resulted in profound decreases of IFN-γ (Figure 3A), TNF (Figure 3B), IL-10 (Figure 3C) and IL-6 (Figure 3D) at low equi-nicotine units (1.56 µg/ml). Suppression of cytokines was also evident with nicotine. However, the suppression of cytokines with nicotine occurred at significantly higher doses, and the degree of suppression varied among individual cytokines. For example, IFN-γ appeared to be significantly suppressed with nicotine at 50 µg/ml, whereas IL-6 was suppressed at the highest concentration (4 mg/ml) tested (Figurie 3D). Next, we measured IL-8 levels in the same samples using an ELISA assay. IL-8 secretion was effectively suppressed in WS-CM-exposed PBMCs; while nicotine’s suppressive effects were significant at 2 mg/ml (Figure 4).
The levels of intracellular cytokines were quantified in WS-CM- and nicotine-treated cells upon stimulation with LPS. Previously we stimulated PBMCs for 3 days and added Golgiplug during the last 6 hr of incubation to measure intracellular cytokines14. We now significantly reduced the incubation period by combining stimulation with LPS and Golgi plug to a total of 6 hr and measured intracellular cytokine-positive cells (Figure 5). Figure 5 illustrates a dose-dependent percent reduction in IFN-γ-positive cells (Figure 5A), TNF-α-positive cells (Figure 5B) in both nicotine- and WS-CM- exposed PBMCs, whereas a dose-dependent percent reduction in MIP-1α-positive cells (Figure 5C) was observed in WS-CM-exposed PBMCs. In this assay we observed a decrease in the number of intracellular cytokine-positive cells after exposure to WS-CM at lower equi-nicotine units (1.56 µg/ml). Both secreted cytokine and intracellular cytokine assays showed similar results in terms of IFN-γ levels or IFN-γ-positive cells.
As a functional measure, the ability of WS-CM- and nicotine-treated PBMCs to kill target K562 cells was determined. Figure 6A depicts representative flow cytometric raw data of 7AAD-positive staining of target (CFSE-labeled K562) cell killing by control, WS-CM-exposed, and nicotine-treated PBMCs. Numbers in the box represent percent 7AAD-positive CFSE-labeled K562 cells. Exposure to 1.56 µg/ml WS-CM significantly reduced the killing ability of the effector cells in PBMCs compared with control and the lower doses. Nicotine treatment at low and high doses did not interfere with the cell killing. Figure 6B shows a dose-dependent decrease in percent K562 cell killing from multiple donors in a single experiment.
Figure 1. Cell death of PBMCs after exposure to increasing concentrations of equi-nicotine units of WS-CM (µg/ml) and nicotine (µg/ml). PBMCs were treated with WS-CM for 3 hr and 24 hr (A) and with nicotine for 3 hr and 24 hr (B). Cell death was measured by 7AAD staining. Each point represents the mean ± SD error bars of four donors from a representative experiment. The statistical significance is indicated by: *P < 0.05; **P < 0.005, ***P < 0.0005.
Figure 2. Secretion of IL-6 and IL-8 by PBMCs stimulated with LPS at different time points. PBMCs were stimulated with LPS for 4 hr, 24 hr, 48 hr, and 72 hr. Levels of IL-6 and IL-8 cytokines in the cell culture supernatants were determined using Human Inflammatory Cytokine Kit (CBA kit) and flow cytometry. These data represent the mean ± SD error bars from one of the two independent experiments using PBMCs from three different donors. The statistical significance is indicated by: *P < 0.05; **P < 0.005.
Figure 3. Reduction of cytokine secretion by PBMCs treated with increasing concentrations of equi-nicotine units of WS-CM (µg/ml) and nicotine (µg/ml) following LPS stimulation. PBMCs were exposed to different concentrations of WS-CM and nicotine for 3 hr and stimulated with LPS for 24 hr. Levels of IFN-γ (A), TNF (B), IL-10 (C), and IL-6 (D) cytokines in the cell culture supernatants were determined using a Th1/Th2 CBA assay and flow cytometry. This data represents the mean ± SD error bars from one of the three independent experiments using PBMCs from four different donors. The statistical significance is indicated by: *P < 0.05; **P < 0.005; ***P < 0.0005. Higher concentrations of WS-CM were also statistically significant with ***P < 0.0005.
Figure 4. Attenuation of IL-8 secretion by PBMCs treated with increasing concentrations of equi-nicotine units of WS-CM (µg/ml) and nicotine (µg/ml) following LPS stimulation. PBMCs were exposed to WS-CM and nicotine, stimulated with LPS for 24 hr, and secreted IL-8 was measured by ELISA. These data represent the mean ± SD error bars from one of the three independent experiments using PBMCs from four different donors. The statistical significance is indicated by: *P < 0.05; **P < 0.005; ***P < 0.0005. Higher concentrations of WS-CM were also statistically significant with ***P < 0.0005.
Figure 5. Reduction of intracellular cytokine-positive cells in PBMCs treated with increasing concentrations of equi-nicotine units of WS-CM (µg/ml) and nicotine (µg/ml). PBMCs were exposed to varying concentrations of WS-CM and nicotine for 3 hr and stimulated with LPS and Golgiplug for 6 hr. The vehicle control for WS-CM and nicotine was RPMI complete medium. Intracellular IFN-γ-positive (A), TNF-α-positive (B), and MIP-1α-positive (C) cells were quantified by flow cytometry. These data represent the mean ± SD error bars from one of the four independent experiments using PBMCs from four different donors. The statistical significance is indicated by: *P < 0.05; **P < 0.005; ***P < 0.0005. Higher concentrations of WS-CM were also statistically significant with ***P < 0.0005.
Figure 6. Reduction of PBMCs target killing ability with exposure to increasing concentrations of equi-nicotine units of WS-CM (µg/ml) and nicotine (µg/ml). PBMCs were treated with indicated concentrations of WS-CM and nicotine for 3 hr, and CFSE-labeled K562 cells were then added as target cells and incubated for additional 5 hr. Cells were stained with 7AAD and flow cytometry was used to gauge killing ability. Figure 6A shows the representative flow cytometry results with percent killing shown in the gated boxes. Arrow indicates reduced percent killing in 1.56 µg/ml exposed WS-CM. Figure 6B shows representative mean ± SD error bars from four independent experiments using PBMCs from four different donors. The statistical significance is indicated by: **P < 0.005; ***P < 0.0005. Higher concentrations of WS-CM were also statistically significant with ***P < 0.0005.
We and others have previously demonstrated that treatment of PBMCs with TPPs suppresses several responses, including expression and secretion of cytokines and functional measures such as target cell killing14. The experimental methods described in the previous work require longer incubation periods and were modest in magnitude14. Given the potential applications of this attractive ex vivo model for basic and applied research, we investigated whether any of the assay parameters in these multi-step biological assays could be optimized. Here, we present simplified methods to measure TLR-mediated immune responses using a TPP-treated ex vivo PBMC model.
Isolation of viable PBMCs is a key requirement for these ex vivo assays. Given the individual variability and physiological status in potential donors, it is ideal to obtain PBMCs that are responsive. For the purpose of this study, we isolated PBMCs from generally healthy adult subjects using a previously published method15. Further, in this study to minimize variability among donors, we excluded those with allergies, infections, or who were taking any prescriptions or over the counter drugs such as aspirin. Additionally, isolation of PBMCs from freshly collected blood is desirable, as it ensures optimal viability and functionality of the cells in subsequent experiments.
Previous methods utilized stimulation with TLR agonists for 67–72 h to measure intracellular cytokines and secreted cytokines14. A time-course of cytokine secretion in TLR-stimulated cells (under control conditions with no WS-CM or nicotine) suggested that maximal secretion occurred at 24 hr. Furthermore, we combined the incubation with TLR agonists and Golgiplug and reduced the time of incubation to a total of 6 h for measuring intracellular cytokines. While this required a separate assay to measure cytokine-positive cells, the data are more robust compared with the previous method14. Consistent with the previous results, WS-CM strongly suppressed the induction of intracellular and secreted cytokines. Thus, these modifications led to substantially reduced assay times and yielded very similar results as those described in literature. While we have utilized flow cytometry and ELISA methods to evaluate cytokine levels, other techniques such as real time quantitative polymerase chain reaction (RT-qPCR) may also be utilized as a complementary technique.
Historically, target cell killing by effector PBMCs utilized radiolabeled methods (e.g., 51Cr-release assay). The method described in this report eliminates the use of radioactivity and employs loading cells with a fluorescent dye whose presence could be monitored by flow cytometry. Another advantage of the described method herein is that it is relatively rapid and may be adapted to high-throughput assays. Since the incubation period of target and effector cells is 5 hr, this assay may be completed in 8 hr. This in contrasts with other published methods, which are more involved as they require isolation of subtypes of PBMCs and activation/stimulation over a period of several days, or analysis of NK cell and K562 cell conjugates to monitor cytotoxicity17,18. Another advantage of the current method is that it uses cryopreserved PBMCs directly as effector cells, which affords greater flexibility.
In summary, we described several assays to determine the effect of TLR-mediated immune response in combustible TPP-treated PBMCs, which can be readily applied for testing different compounds. The use of cryopreserved components allows for significant flexibility, and together with established techniques such as flow cytometry, CBA assays, and ELISAs, robust and consistent results could be obtained rapidly across different laboratories.
The authors have nothing to disclose.
This work is funded by R.J. Reynolds Tobacco Company (RJRT) under a collaborative research agreement with Wake Forest University School of Medicine. G.L. Prasad is a full time employee of RJRT.
Name of Material/ Equipment | Company | Catalog Number | Comments/Description |
12 X 75 tubes | BD Falcon | 352058 | |
15 ml conical tubes | Corning | 430790 | |
2 mL Microtubes | Axygen | MCT-150-C-S | |
3R4F reference cigarettes | Univ. of Kentucky, College of Agriculture | 3R4F | |
50 ml conical tubes | Corning | 430828 | |
500 ml bottle | Corning | 430282 | |
7AAD | BD Pharmingen | 559925 | |
96 well flat bottom plate | Termo Nunc | 439454 | |
96 well round bottom plates | BD Falcon | 353077 | |
Cell culture hood | Thermo Scientific | 1300 Series A2 | |
Centrifuge | Eppendorf | 58110R | |
CFSE | Molecular Probes Life Technologies | C34554 | |
Cluster tubes | Corning | 4401 | Harmful if swallowed, carcinogen |
Cytofix/Cytoperm (Permwash) | BD Biosciences | 555028 | Flammable |
DMSO (Dimethyl sulfoxide ) | Sigma-Aldrich | D8418 | |
DPBS | Lonza | 17-512F | |
FBS | Sigma-Aldrich | F2442 | |
FCAP Array | BD Biosciences | 652099 | Software analyzes CBA data |
Filter unit | Nalgene | 156-4020 | |
Flow Cytometer | BD Biosciences | FACS Canto II | 8 colors, at Ex 405 and Em785. |
Flow Cytometer | BD Biosciences | FACS Calibur | 4 colors at Ex 495 and Em 785. |
Flow cytometry analysis software | Tree Star | FlowJo | |
Freezing Container | Nalgene | 5100-0001 | Contains DMSO, irritant |
GogliPlug | BD Biosciences | 555029 | Carcinogen, Irritant, Corrosive |
H2SO4 | Sigma-Aldrich | 339741 | |
Human Inflammatory Cytokine Kit | BD Biosciences | 551811 | |
IFN-γ V-500 Antibody | BD Horizon | 561980 | skin sensitizer |
IL-8 ELISA Kit | R and D Systems | DY208 | |
Isolation Buffer | Isolymph, CTL Scientific Corp. | 1114868 | Flammable liquid, Irritant |
Isopropyl alcohol | Sigma-Aldrich | W292907 | |
L-Glutamine | Gibco Life Technologies | 25030-081 | |
LPS | Sigma-Aldrich | L2630 | |
MIP1-α PE Antibody | BD Pharmingen | 554730 | Acute toxicity, Oral |
Monensin | Sigma-Aldrich | M5273 | |
NaCl | Sigma-Aldrich | S7653 | |
Nicotine | Sigma-Aldrich | N3876 | Acute toxicity, Environmental hazard |
Parafilm | Bemis | “M” | |
Paraformaldehyde | Sigma-Aldrich | P6148 | Flammable, Skin irritation |
Pen/strep | Gibco Life Technologies | 15140-122 | |
RPMI 1640 | Gibco Life Technologies | 11875-093 | |
Running buffer | MACS Running Buffer, Miltenyi Biotech | 130-091-221 | |
Th1/Th2 CBA Kit | BD Biosciences | 551809 | |
TNF-α Alexa Fluor 488 Antibody | BioLegend | 502915 | |
Transfer pipette | Fisher Scientific | 13-711-20 | |
Tris Base | Sigma-Aldrich | T1503 |