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Advances in Experimental Medicine and Biology 1060
Stromal
Immunology
Advances in Experimental Medicine and Biology
Editorial Board:
Stromal Immunology
Editors
Benjamin M.J Owens Matthew A. Lakins
Somerville College F-star Biotechnology Ltd.,
University of Oxford Babraham Research Campus
Oxford, UK Cambridge, UK
EUSA Pharma
Hemel Hempstead
Hertfordshire, UK
This Springer imprint is published by the registered company Springer Nature Switzerland AG.
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
The concept for this book arose as a result of growing interest in the investigation of
non-hematopoietic stromal cells and their impact on immune responses. Through
interactions during diverse doctoral and postdoctoral research programmes spanning
several years at the University of York, the University of Cambridge and the
University of Oxford, we recognised a need for a cohesive group to bring together
scientists interested in the concepts underlying stromal immunology, and the
Stromal Immunology Group (StIG) was born.
Having organised several successful international StIG conferences, we felt that
a missing part of the picture was an advanced book comprising a collection of writ-
ings from leaders in stromal immunology that could act as a primer for professional
researchers new to this specialist field. This book would also provide support for the
teaching of graduate and undergraduate students in science and medicine.
What follows is the collected work of scientists and physicians from across the
world, all of whom share a belief in the huge potential for research into stromal
immunology to contribute to medical research. Topics covered range from the inter-
action between leukocytes and lymph node stromal cells, inflammatory responses of
mesenchymal stem cells and fibroblasts to the key roles of stromal cells in response
to infection, the tumour microenvironment and the healthy and inflamed intestine.
Important avenues for future research are addressed, as are the uses of advanced cell
culture systems for the investigation of human tissue stromal cell function and stro-
mal cell targeting for therapeutic benefit.
Numerous studies have addressed the significant therapeutic potential of exploit-
ing stromal cells in combating disease. Pancreatic cancer, for example, and specifi-
cally pancreatic ductal adenocarcinoma (PDAC), is a stromal-rich, lethal malignancy
fundamentally resistant to standard of care therapies. Much work has been carried
out targeting the desmoplasmic nature of PDAC, particularly the cancer-associated
fibroblast and endothelial cell containing component. Whilst strategies aimed at
depleting these cell types to aid drug perfusion and immune cell infiltration work
well in murine models, the translatability of such approaches remains in question.
This approach is not limited to pancreatic cancer. Many other stromal-rich
tumours which employ a highly desmoplastic stroma as a physical barrier to immune
v
vi Preface
cell infiltration could be treated in such a way. Breast, prostate, and colon cancer all
recruit and influence their tumour microenvironment in order to regulate immune
escape, promote metastasis and aid progression. These cancers, and more recently
others such as non-small cell lung carcinoma, are put through a prognostic test
evaluating their tumour:stroma ratio and the outcome is used to successfully predict
prognosis and the chances of relapse. Soon, tools such as the tumour:stroma ratio
measurement could serve as an influencing factor on suggested treatment and
whether targeting the stroma is a valid approach for those specific diseases.
Similarly, gaining a deeper understanding of specific mediators of stromal cell
activation in chronically inflamed tissue – such as the recent discovery of Oncostatin
M as a driver of intestinal stromal cell activation during inflammatory bowel dis-
ease – may lead to the identification of novel therapeutic axes that can be targeted
to revolutionise therapy for patients with these debilitating inflammatory
conditions.
We hope that this introduction to advanced concepts in stromal immunology
serves as a useful, stimulating and enjoyable tool for those with an interest in
learning more about this exciting area of immunology, and we look forward to
seeing the field expand and grow over the coming years.
And remember, ‘It’s all about the Stroma’
This textbook was produced as a collaboration between the British Society for
Immunology, the BSI Stromal Immunology Group and Springer Publishing,
USA. We are indebted to all the authors for their valuable contributions.
vii
Contents
Index������������������������������������������������������������������������������������������������������������������ 147
ix
Contributors
xi
xii Contributors
Paul M. Kaye Centre for Immunology and Infection, Department of Biology and
Hull York Medical School, University of York, York, UK
Konstantin Knoblich Department of Biochemistry and Molecular Biology,
Monash University, Clayton, VIC, Australia
Institute of Immunology and Immunotherapy, University of Birmingham,
Birmingham, UK
Helen M. McGettrick Rheumatology Research Group, Institute of Inflammation
and Ageing, University of Birmingham, Birmingham, UK
C. G. Mueller CNRS UPR 3572, Laboratory of Immunopathology and Therapeutic
Chemistry/Laboratory of Excellence MEDALIS, Institut de Biologie Moléculaire et
Cellulaire, Université de Strasbourg, Strasbourg, France
Hafsa Munir MRC Cancer Unit/Hutchison, University of Cambridge, Cambridge,
UK
S. Nayar Rheumatology Research Group, Institute of Inflammation and Ageing
(IIA), University of Birmingham, Birmingham, UK
Amy J. Naylor Rheumatology Research Group, Institute for Inflammation and
Ageing, College of Medical and Dental Sciences, University of Birmingham, Queen
Elizabeth Hospital, Birmingham, UK
Iryna V. Pinchuk Departments of Internal Medicine, University of Texas Medical
Branch, Galveston, TX, USA
Microbiology and Immunology, University of Texas Medical Branch, Galveston,
TX, USA
Don W. Powell Departments of Internal Medicine, University of Texas Medical
Branch, Galveston, TX, USA
Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch,
Galveston, TX, USA
David Roberts Institute of Immunology and Immunotherapy, University of
Birmingham, Birmingham, UK
Edward W. Roberts Department of Pathology, University of California San
Francisco, San Francisco, CA, USA
Muath Suliman Institute of Immunology and Immunotherapy, University of
Birmingham, Birmingham, UK
Mattias Svensson Center for Infectious Medicine, F59, Department of Medicine,
Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm,
Sweden
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Contributors xiii
Abstract Lymph nodes play a crucial role in the formation and initiation of immune
responses, allowing lymphocytes to efficiently scan for foreign antigens and serving
as rendezvous points for leukocyte-antigen interactions. Here we describe the major
stromal subsets found in lymph nodes, including fibroblastic reticular cells, lym-
phatic endothelial cells, blood endothelial cells, marginal reticular cells, follicular
dendritic cells and other poorly defined subsets such as integrin alpha-7+ pericytes.
We focus on biomedically relevant interactions with T cells, B cells and dendritic
cells, describing pro-survival mechanisms of support for these cells, promotion of
their migration and tolerance-inducing mechanisms that help keep the body free of
autoimmune-mediated damage.
1.1 Introduction
Lymph nodes are the most prevalent secondary lymphoid organ (SLO), contained in
the neck, armpits, lungs, abdomen, collarbone, knee and groin regions [1]. They
range in size from a few millimetres to over 2 cm and enlarge significantly under
certain conditions involving immune activation, such as infection or cancer [1, 2].
Lymph nodes are structurally organised and contain a cortex, paracortex and
medulla, which are separated into different regions to allow the movement of lymph
through the organ [3]. The cortex is situated beneath the capsule and subcapsular
sinus with B lymphocytes and follicular dendritic cells contained within follicles
present in the cortical region [4]. The paracortex lies deeper within the lymph node
structure with T lymphocytes homing to these regions to interact with antigen-
presenting cells [4]. The medulla consists of B lymphocytes and macrophages dis-
persed within medullary cords which allow for the movement of lymph from the
cortex into efferent lymphatic vessels [4]. This structure allows for antigen-bearing
antigen-presenting cells (APCs) and lymphocytes to efficiently interact within the
lymph node, enabling an appropriate immune response against an invading patho-
gen [5]. The microenvironment of the lymph node is crucial for immune function
and consists of endothelial cells lining lymphatics and blood vessels and fibroblastic
reticular cells which create the internal reticular structure of lymphoid organs [6].
Lymph, which may bear soluble antigen, enters the lymph node through afferent
lymphatic vessels, where it empties into the subcapsular sinus and then traverses
through the medullary sinuses surrounding the medullary cords to interact with B
cells [4]. The lymph filters though the cortex where it exits via the efferent lym-
phatic vessels contained in the hilus [4]. Dendritic cells (DCs) actively migrate into
the lymph node via afferent lymphatics [7]. Dendritic cells then migrate to paracor-
tical T cell zone using stromal cells as a scaffold for migration [8]. B and T cells also
use the stroma to migrate, entering lymph nodes from the bloodstream through spe-
cialised high endothelial venules [9]. Following entry, B cells move to the B cell
follicles in the cortex, while T cells move to the paracortical T cell zone where they
can begin scanning arriving APCs for their cognate antigen [8, 10, 11].
Structural components of the lymph node are now broadly appreciated as pri-
mary regulators of the adaptive immune response [10, 12–26]. These lymphatic
structural components, termed lymph node stromal cells (LNSCs), comprise of non-
haematopoietic cells that can be divided into functionally and phenotypically dis-
tinct subsets based on surface expression of glycoproteins CD31 and podoplanin
(gp38) with an absence of haematopoietic marker CD45 [14]. These include blood
endothelial cells (BECs), lymphatic endothelial cells (LECs), integrin α7+ pericytes
(IAPs), follicular dendritic cells (FDCs) and fibroblastic reticular cells (FRCs) [14,
22, 27]. These stromal cells play a variety of roles in lymph node homeostasis and
function, as they interact with lymphocytes to create an optimal microenvironment
for cell activation and migration.
FRCs play crucial roles in secreting extracellular matrix components and forming a
cellular meshwork to give the lymph node strength, flexibility and structure [8, 14,
22, 28–30].
While not a focus of this review, as a general characteristic, FRCs secrete a broad
array of extracellular matrix components, including collagens and laminins,
decorin, biglycan, fibromodulin and vitronectin, to maintain the lymph node struc-
ture [8, 14, 22] (Fig. 1.1d).
T zone resident FRCs facilitate leukocyte migration and priming by supporting
and secreting a 3D conduit network to maintain the lymph node microenvironment
[8, 14, 30–32]. Conduits are microtubules created by FRCs, which secrete constituent
4 J. D’Rozario et al.
D’Rozario et al. A. B. C.
IL-7
CXCL13
Subcapsular & CCL19 BAFF
CCL21
perifollicular zone (C)
II Y II Y
T cell zone T CCR7+
B T B CXCR5+
ILC3
(A, B, D, E) BAFF-R+ IL-7-R+
O
O
T cell and DC B cell and ILC3
O
O
O
Medulla D. E.
O
O
Perivascular Pdpn+
Zone (F)
O
O
SYK
P
PDPN CLEC2 VE Cadherin
juncons
Primary B cell follicle (B)
HEV integrity
Fig. 1.1 FRC subsets reside in different lymph node niches and fulfil distinct functions. (a) T zone
FRCs produce CCR7 ligands CCL19 and CCL21, which promote migration of naïve T cells and
dendritic cells [8, 11]. (b) Within primary B cell follicles, B zone FRCs produce BAFF to promote
the survival of naïve B cells [24], while within the paracortex, T zone FRCs produce IL-7 to pro-
mote the survival of naïve T cells [14]. (c) Within the subcapsular zone, marginal reticular cells
produce CXCL13 to interact with innate lymphoid-like cells [39]. In the perifollicular zone close
to primary B cell follicles, during inflammation some FRCs inducibly express CXCL13 to facili-
tate B cell follicle expansion [37]. (d) FRCs within the T zone create the conduit network through
secretion of basement membrane and other extracellular matrix components [8, 14, 22, 33]. (e) T
zone FRCs drive DC migration via signalling through DC-expressed CLEC-2, which binds podo-
planin expressed by FRCs [56]. (f) In the perivascular zone, FRCs maintain the blood-lymph bar-
rier by responding to infiltrating platelets. Platelets express CLEC-2, which binds podoplanin on
FRCs, delivering a SYK-mediated signalling cascade that results in release of sphingosine-1-
phosphate-1 from platelet surfaces, which binds S1P1-receptor on high endothelial venules, stimu-
lating upregulation of VE-cadherin, which tightens endothelial cell junctions and prevents further
nontargeted cell and liquid influx from the bloodstream [34]
FRCs exist throughout the paracortical T cell zone; accordingly, interactions with T
cells have been most closely studied. Chemotactic factors secreted from paracorti-
cal FRCs create the T cell zone by attracting naïve T cells and antigen-presenting
cells (APCs) allowing them to initiate an immune response [10, 11, 14, 43]. This
occurs through secretion of CCL19 and CCL21, which signal to CCR7 expressed
by naïve T cells, leading to their migration through the lymph node [8, 10, 43, 44]
(Fig. 1.1a).
T zone FRCs have also been shown to promote the survival and turnover of naïve
lymphocytes via the secretion of T cell survival and growth factor IL-7 [14]
(Fig. 1.1b). The secretion of this factor regulates and maintains the naïve CD4+ and
CD8+ T lymphocyte pool within the lymph node ready for cell priming [14].
These effects of FRCs are particularly relevant to naïve T cells, since activated T
lymphocytes within the lymph node are retained and can continue to function when
FRCs are depleted [25].
FRCs are capable of robustly suppressing CD8+ T cell proliferation early after their
activation [19–21] (Fig. 1.2a).
Early after activation, T cells secrete inflammatory cytokines interferon gamma
(IFN-γ) and tumour necrosis factor alpha (TNF-α), which stimulate FRCs to secrete
nitric oxide (NO). NO acts in a paracrine manner on T lymphocytes curbing their
proliferation [19–21]. NO is a highly pleiotropic molecule which facilitates many
metabolic and immunologic pathways within the body [45]. Activated T cell-derived
factors increase NO-producing enzyme nitric oxide synthase 2 (NOS2) mRNA and
protein levels in FRCs leading to the release of NO [19–21]. Accordingly, NOS2−/−
FRCs are unable to mediate T cell suppression [19–21]. Cyclooxygenases 1 and 2
6 J. D’Rozario et al.
D’Rozario et al.
A CD8 Fibroblastic
CD4
reticular cell
CD4 CD8
NOS2
T cell
B expression
Fig. 1.2 Lymph node stromal cells impose suppressive and deletional tolerance. (a) Newly acti-
vated CD8+ T cells produce IFN-γ, TNF-α and an unidentified signal, which induce FRCs to
increase expression of enzyme nitric oxide synthase 2 (NOS2) and produce nitric oxide (NO).
FRC-derived NO acts on the T cell population to curb proliferation [19–21]. LECs are similarly
capable of releasing NO to curb T cell proliferation [20]. (b) LECs and FRCs present endoge-
nously expressed tissue-restricted antigens on MHC class I molecules to CD8+ T cells and delete
T cells that respond with sufficient affinity [17, 18]. Similar mechanisms involving MHC class
II-dependent antigen presentation are likely to operate for CD4 T cells [23, 26]
(COX1 and 2) in conjunction with NO2 expression have been hypothesised to play
a potential role in T cell suppression, though further study is required [21].
This mechanism functions in vivo [20], though the immunological reach is still
poorly understood.
Lymph node stromal cells may also induce tolerance in CD4+ T cells types
through expression of MHC class II and associated antigen presentation pathway
molecules under steady state and inflammatory conditions [22, 23, 26]. This theory
has been reinforced by the ability of lymph node stromal cells to tolerise CD4+ T
cells through the presentation of self-antigens via peptide-MHC class II expression
[23, 26] and to induce homeostatic Treg proliferation [23]. In vitro data suggest that
FRCs, LECs and BECs may acquire MHC II molecules from dendritic cells through
cell-to-cell contact [26].
1 Leukocyte-Stromal Interactions Within Lymph Nodes 7
T cell tolerance induction by lymphoid stromal cells was first noted by Lee et al.
[13], who showed that CD8+ T cells expressing a TCR reactive to ovalbumin (OVA)
were specifically tolerised following interactions with lymph node stromal cells
expressing OVA and that this prevented mice that expressed OVA in the gut (iFABP-
tOVA) from developing autoimmunity. It was then shown that this response was due
to FRCs and that FRCs could directly present self-antigen to T cells via MHC class
I [18] (Fig. 1.2b), demonstrating that FRCs were capable of deleting autoreactive T
cells and preventing autoimmunity. PD-1−/− T cells or PD-L1-blocking antibodies
have been used to interfere with tolerance mechanisms in the iFABP-tOVA model,
causing autoimmune enteritis [46].
FRCs were shown to express an array of organ-specific and tissue-restricted anti-
gens [17, 18]. Tissue-restricted antigens (TRAs) are self-antigens native to periph-
eral tissues and organs and expressed at low levels within lymphoid organs for the
purpose of educating the immune system for tolerance induction [47]. A major
regulator of TRA expression in the thymus is the autoimmune regulator gene (Aire)
[47]. However, in non-haematopoietic lymph node stromal subsets, Aire is not
expressed [18]. It has been shown in human and murine tissues that increased
expression of the Aire-like protein DEAF-1 correlates with peripheral tissue antigen
(PTA) expression [48]. While other factors may simultaneously exist, these results
suggest a role of the DEAF-1 gene in regulating lymphatic PTA expression, which
requires further elucidation.
tion [50]. IL-7 derived from FRCs was also shown to promote T cell
immunocompetence leading to structural adaptation of the lymph node microenvi-
ronment following systemic viral infection [50]. Damage to FRCs in clinical set-
tings, in particular HIV infection, causes profound T cell immunodeficiency
independent of viral load [51, 52].
Cremasco et al. [24] portray the loss of FRCs as detrimental to humoral immunity
with immunisation with an inactivated influenza A virus leading to a reduction in
influenza-specific immunoglobulin M in conditional FRC knockouts (CCL19-
Cre × iDTRfl/fl mice) compared to control mice. In addition, these mice also exhib-
ited impaired B cell viability and poor B cell follicle organisation, suggesting a
systemic FRC importance in humoral immune responses.
In mouse graft-versus-host disease (GVHD) models, CD157+ FRC damage has
been shown to impair IgG and IgA humoral immune responses to subcutaneous and
oral antigens as B cell follicles are disrupted following FRC reduction [55].
Lymph node stroma has been shown in vivo to promote DC motility into and within
the lymph node via the interactions between FRCs or LECs bearing podoplanin and
activated DCs expressing Clec-2 [56]. Using Clec1b (CLEC-2) −/−foetal liver chi-
meras compared to wild type, it was shown that CLEC-2+ DCs navigate from
parenchymal tissues to lymphoid organs by migrating along stromal scaffolds that
1 Leukocyte-Stromal Interactions Within Lymph Nodes 9
Marginal reticular cells (MRCs) populate the outer regions of the cortex of lymph
nodes [39]. They are located deep to the floor of the subcapsular sinus (SCS) and are
phenotypically distinct from T zone fibroblastic reticular cells (FRCs) and follicular
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10 J. D’Rozario et al.
dendritic cells (FDCs). MRCs strongly express MAdCAM-1, CXCL13 and RANKL
[39, 40]. The latter is an essential cytokine for lymph node development [60, 61].
However, the markers CCL21 expressed by T zone FRCs and CR1/CD35 expressed
by FDCs are, respectively, absent or only trace expressed [39], indicating that MRCs
are indeed a distinct stromal subset to these populations. Phenotypically similar
groups of reticular cells have been found in other secondary lymphoid organs
(SLOs), including the spleen and mucosa-associated lymphoid tissues [39, 62].
Contrastingly no similar groups of cells have been found in the tertiary lymphoid
organs (TLOs) [5] associated with chronic inflammation.
During organogenesis, lymph nodes develop from accumulations of mesenchyme
and haematopoietic cells associated with epithelium or vasculature, known as anla-
gen [63]. The haematopoietic cells are known as lymphoid tissue inducer (LTi) cells
which bear the phenotype CD45+ CD4+ CD3−. LTi cells interact with the mesen-
chymal cells known as lymphoid tissue organiser (LTo) cells. LTo cells express adhe-
sion molecule (ICAM-1, VCAM-1, MAdCAM-1) and chemokine (CXCL13,
CCL19, CCL21) profiles upon stimulation by LTi through their secretion of lympho-
toxin (LT)-α1β2 [63, 64]. Subsequently CXCL13 attracts LTi through binding cells
at its CXCR5 receptor, propagating a positive feedback loop of development [63,
65–67]. MRCs are thought to be a direct descendent of LTo cells [40]. While yet to
be proven, supportive evidence includes their similar molecular phenotypes and the
high concentration of LTo cells and RANKL expression in the outer areas of embry-
onic LNs, which in adult lymph nodes becomes a niche for MRCs [39, 68].
In addition to their embryonic developmental role, the ability of MRCs to give
rise to FDCs in the adult lymph node has also been demonstrated. The MRCs exhibit
maturation into a transitional phenotype before evolving into phenotypically mature
FDCs through a two-step process [41]. FDCs in the spleen arise through other
mechanisms, developing from perivascular precursors [69].
Immune-stromal interactions of MRCs are still poorly understood. MRCs are
located in various SLOs adjacent to the primary route of antigenic entry, suggesting
that they may play a role in the regulation of antigen transportation pathways [39,
68]. In adult mice, MRCs produce CXCL13 to attract CXCR5+ innate lymphoid-
like cells type 3 (ILC3), which drive lymph node repair and regeneration after dam-
age [50, 70]. CXCL13 is also a B cell chemoattractant, and it has been hypothesised
that MRCs may be involved in the transport of antigens from the SCS into the B
follicle or to facilitate the motility of B cells in the outer follicle through their
expression of adhesion molecules [39].
The cytokines IL-7 and RANKL are both expressed to high levels by MRCs [39,
68] and are thought to be crucial for lymphoid homeostasis. IL-7 is a naïve T cell
survival factor suggesting that it is also involved in regulation of T cell survival. In
an in vitro murine model, the inoculation of mice with LTβR-Fc resulted in disor-
ganisation of the follicular assembly of the white splenic pulp, and the disappear-
ance of MRC layers, demonstrated by a loss of CXCL13 and RANKL staining [68].
In lymph nodes, LTβR-Fc downregulated CXCL13 but did not alter RANKL stain-
ing. This indicates that either RANKL expression in lymph nodes is independent of
LTβR-NIK signalling or that another RANKL-expressing cell type is able to com-
pensate for loss of LTβR ligands within the lymph node [68].
1 Leukocyte-Stromal Interactions Within Lymph Nodes 11
LECs create afferent and efferent lymphatic vessels, primarily to allow for the entry
of antigen-presenting dendritic cells and soluble antigens into the paracortex of the
lymph node [71, 72] and the egress of lymphocytes from the medulla [73]. LECs are
also contained within medullary sinuses and line the ceiling (cLECs) and the floor
(fLECs) of the subcapsular sinus [72]. It is thought that because of their prime posi-
tion close to lymph, LECs might also be an early cell type to encounter and present
antigens by environmental sampling [74]. LECs from different areas of the lymph
node show differing expression of key surface markers: subcapsular LECs are
PD-L1hi, ICAM-1hi, MAdCAM-1+ and LTbRlo; medullary LECs are PD-L1hi,
ICAM-1hi, MAdCAM-1neg and LTbR+; and cortical LECs are PD-L1int, ICAM-
1int, MAdCAM-1neg and LTbR+ [75].
Under inflammatory conditions, LECs direct macrophages and antigen-bearing
dendritic cells along lymphatics, between LECs lining the subcapsular sinus, into
the lymph node structure. LECs express podoplanin and similar to FRCs are capable
of driving DC migration towards and within lymph nodes through signalling to
CLEC-2 [56] (see Sect. 1.2.4). They produce CCL21 [22] and are thought to regu-
late availability of chemokines such as CCL21 and CCL19 in the subcapsular sinus
and local parenchymal tissue through expression of scavenging receptors ACKR2
and ACKR4 [76] (Fig. 1.3a). ACKR2 is a scavenging receptor tasked with removing
inflammatory cytokines from the cell surface of LECs during inflammation [76].
This allows for suppression of immature DCs and other inflammatory cells and
keeps leukocytes from adhering to LECs. ACKR4 is thought to control the distribu-
tion of CCL19 and CCL21 to assist DC migration through cognate receptor CCR7,
by maintaining optimal availability of these chemokines [76].
While mouse LECs are able to adhere to plastic like FRCs, human LECs are
unable to do so indicating a difference in adhesion factors or requirements that is not
yet understood [77]. This might be a case of gene downregulation, as many as 50%
of LEC-defining genes were found to be silenced under culture conditions com-
pared to freshly isolated cells [78].
12 J. D’Rozario et al.
D’Rozario et al.
HEV
VE-Cadherin
unzipped
Rolling Acvaon Adhesion Intraluminal
crawling
Fig. 1.3 Crosstalk between endothelial cell subsets and leukocytes. (a) Lymphatic endothelial
cells (LECs) produce IL-7 to promote survival of naïve T cells, binding to the IL-7 receptor (IL-
7R) [79]. They express programmed death ligand 1 (PD-L1) which binds PD-1 on T cells. When
this interaction occurs after T cells recognise self-antigen presented by LECs via MHC class I,
deletional tolerance is induced [17, 74]. LECs also control leukocyte migration and adhesion
through expression of atypical cytokine receptor ACKR2, which sequesters inflammatory CC che-
mokines, and ACKR4, which binds CCL19 and CCL21 [107]. (b) High endothelial venules are
constructed from blood endothelial cells (BECs) expressing peripheral node addressin (PNAd)
[58]. Naïve leukocytes enter the lymph node through interactions with HEVs. First, they roll and
loosely tether to the HEV when L-selectin binds PNAd on the HEV. Next, the T cell undergoes
chemokine-mediated activation when CCL21 and CCL19 secreted into the lumen of the vessel
bind CCR7. This induces conformational changes to LFA-1, allowing it to undergo tight adhesion
by binding ICAM-1. Lastly, homeotypic interactions between CD31 and CD99, each expressed by
both the leukocyte and endothelial cell, position the leukocyte between two endothelial cells,
where VE-cadherin junctions unzip allowing the leukocyte to move through [84]. (c) BECs
undergo homeostatic proliferation through signals with FRCs, which produce VEGF, and dendritic
cells, through mechanisms that may include secretion of IL-1b [58, 93]
LECs are a robust source of IL-7 and together with FRCs, which also produce IL-7,
likely to be important regulators of T cell homeostasis [79] (Fig. 1.3a). IL-7 has
proliferative and anti-apoptotic signalling abilities and is important for T cell
1 Leukocyte-Stromal Interactions Within Lymph Nodes 13
LECs are capable of suppressing the proliferation of newly activated CD4 and
CD8+ T cells through the production of nitric oxide, similar to FRCs [20] (Fig. 1.2a).
Under inflammatory conditions, but in the absence of infection, LECs suppress
maturation of DCs, reducing expression of CD86 and their ability to prime CD8+ T
cells [80]. This occurred through binding between ICAM-1 on LECs and Mac-1 on
DCs and is hypothesised to reduce the risk of immune priming under inflammatory
conditions in the absence of infection [80].
LECs show upregulation of surface MHC class II 18 h after initiation of an
inflammatory response [22]. This may contribute to CD4 T cell tolerance through
increased antigen presentation. This upregulation is IFNg dependent [26]. LECs are
capable of transiently acquiring peptide-MHC class II from DCs in vivo and in vitro,
directly proportional to the number of DCs present [26]. In the same study, LECs
were shown to promote apoptosis of CD4+ T cells in an antigen-specific fashion
[26].
Recently, Hirosue et al. [74] demonstrated that LECs can absorb exogenous OVA
and will process and cross-present the OVA-derived SIINFEKL peptide fragment to
CD8+ T cells in vitro [74] (Fig. 1.3a). LECs also upregulated PD-L1, which signals
to PD-1 expressed by T cells and is a well-known cause of T cell exhaustion under
conditions of prolonged inflammation (Fig. 1.3a). OVA-specific CD8+ T cell
activation was impaired; T cells stimulated by LECs made less IL-2 and upregulated
CTLA-4 earlier than those activated by DCs [74].
Similar to FRCs, LECs within lymph nodes express a variety of peripheral tissue-
restricted antigens (PTAs), including Deaf-1 controlled Ins2 and Ppy [48, 81],
though FRCs and LECs do not express identical arrays of PTAs [17, 18]. PTA
expression by tolerance-inducing cells, such as LECs, is pivotal to delete T cells
reactive to endogenous antigens expressed in relatively few tissues. Cohen et al.
[17] showed using an endogenous melanocyte-specific self-antigen derived from
tyrosinase that LECs directly presented self-antigen to Tyr-specific CD8+ T cells,
deleting those that respond and purging the repertoire of autoimmune clones
(Figs. 1.2b and 1.3a). In contrast, LECs indirectly induce CD4+ T cell anergy by
presentation of PTAs to DCs [82], showing that LECs utilise different mechanisms
of tolerance induction for CD4+ and CD8+ T cells.
14 J. D’Rozario et al.
In the thymus, Aire controls the expression of PTAs, but in lymph node stromal
cells, Aire is not expressed [18]. However, studies in NOD mice demonstrate that
PTA genes that are Aire-controlled in the thymus, such as Ambp, Fgb and Ppy, are
regulated by the transcription factor Deaf-1 in the lymph node [48], which is
expressed by LECs as well as FRCs [18]. During the progression of diabetes, alter-
native splicing of Deaf-1 occurs reducing PTA expression in mice and humans, but
the effect of alternative splicing and PTA expression with respect to development of
diabetes and other diseases is yet to be determined [48].
LECs do not express CD80, CD86, OX40L, 4-1BBL or CD70. These are essen-
tial molecules to drive accumulation of activated T cells, and their lack of costimu-
latory molecule expression may help account for their ability to delete naïve
autoantigen expressing T cells. However, LECs express high levels of PD-L1, a
molecule associated with deletion of tolerance-specific CD8+ T cells [17, 75].
Lymph node LECs were unique in their high expression of PTAs and PD-L1,
compared with LECs in peripheral tissues such as the diaphragm and colon, show-
ing that the lymph node microenvironment is uniquely specialised for tolerance
induction [75].
BECs facilitate the migration of naïve lymphocytes into lymph nodes by forming
specialised postcapillary venules known as high endothelial venules (HEVs) [3].
BECs comprising HEVs show a distinctive cuboidal morphology supported by a
basement membrane and have been shown to play a specialised role in allowing
lymphocyte entry to SLOs through the process known as diapedesis, transendothe-
lial migration or leukocyte extravasation (Fig. 1.3b). Migration into lymph nodes
does not require inflammation, but bears similarities with migration of leukocytes to
inflamed sites [83]. HEVs act as gatekeepers for lymph nodes by creating pockets
holding newly arrived lymphocytes until space in the parenchyma becomes avail-
able, granting entry at a rate proportionate to egress from the lymph node [9].
During cell circulation, naïve T and B cells enter the medulla by squeezing
between tightly adherent endothelial cells forming high endothelial venules (HEVs).
The process of slowing down and breaching the endothelial barrier involves well-
characterised interactions including leukocyte rolling, activation, adhesion and
intraluminal crawling [84], which involve targeted interactions between endothe-
lium and T cells [85] (Fig. 1.3b).
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couldn’t even if he were up. They are stealing my spoons,
Wunderlich, and I am going into the river!’
“Well, I kept holding her, and I said what one would in such cases:
‘Courage, dear lady. It will be all right. Control yourself, I beg of you.
We will go and speak with them. Let us go.’ And I got her to go back
up the street to her house. The soldiery were up in the dining-room,
where Madame had left them, some twenty of them, at the great
silver-chest.
“‘Gentlemen,’ I say politely, ‘with which one of you may I have the
pleasure of a little conversation?’ ‘They begin to laugh, and they say:
‘With all of us, Papa.’ But one of them steps out and presents
himself, a fellow as tall as a tree, with a black waxed moustache and
big red hands sticking out of his braided cuffs. ‘Lenoir,’ he said, and
saluted with his left hand, for he had five or six spoons in his right.
‘Sergeant Lenoir. What can I do for you?’
“‘Herr Officer,’ I say, appealing to his sense of honour, ‘after your
magnificent charge, how can you stoop to this sort of thing? The
town has not closed its gates to the Emperor.’
“‘What do you expect?’ he answered. ‘War is war. The people need
these things....’
“‘But you ought to be careful,’ I interrupted him, for an idea had
come into my head. ‘This lady,’ I said—one will say anything at a
time like that—‘the lady of the house, she isn’t a German. She is
almost a compatriot of yours—she is a Frenchwoman....’ ‘Oh, a
Frenchwoman,’ he repeated. And then what do you suppose he said,
this big swashbuckler? ‘Oh, an emigrée? Then she is an enemy of
philosophy!’
“I was quite taken aback, but I managed not to laugh. ‘You are a
man of intellect, I see,’ said I. ‘I repeat that I consider your conduct
unworthy.’ He was silent for a moment. Then he got red, tossed his
half-dozen spoons back into the chest, and exclaimed, ‘Who told you
I was going to do anything with these things but look at them? It’s
fine silver. If one or two of my men take a piece as a souvenir....’
“Well, in the end, they took plenty of souvenirs, of course. No use
appealing to justice, either human or divine. I suppose they knew no
other god than that terrible little Corsican....”
CHAPTER V
“Did you ever see him, Herr Pastor?”
The plates were being changed again. An enormous brick-red boiled
ham appeared, strewn with crumbs and served with a sour brown
onion sauce, and so many vegetables that the company could have
satisfied their appetites from that one vegetable-dish. Lebrecht
Kröger undertook the carving, and skilfully cut the succulent slices,
with his elbows slightly elevated and his two long forefingers laid out
along the back of the knife and fork. With the ham went the Frau
Consul’s celebrated “Russian jam,” a pungent fruit conserve
flavoured with spirits.
No, Pastor Wunderlich regretted to say that he had never set eyes
on Bonaparte. Old Buddenbrook and Jean Jacques Hoffstede had
both seen him face to face, one in Paris just before the Russian
campaign, reviewing the troops at the Tuileries; the other in Dantzig.
“I must say, he wasn’t a very cheerful person to look at,” said the
poet, raising his brows, as he disposed of a forkful of ham, potato,
and sprouts. “But they say he was in a lively mood, at Dantzig.
There was a story they used to tell, about how he would gamble all
day with the Germans, and make them pay up too, and then spend
the evening playing with his generals. Once he swept a handful of
gold off the table, and said: ‘Les Allemands aiment beaucoup ces
petits Napoléons, n’est-ce pas, Rapp?’ ‘Oui, Sire, plus que le Grand!’
Rapp answered.”
There was general laughter—Hoffstede had told the story very
prettily, even mimicking the Emperor’s manner. Old Buddenbrook
said: “Well, joking aside, one can’t help having respect for his
personal greatness.... What a nature!”
The Consul shook his head gravely.
“No, no—we of the younger generation do not see why we should
revere the man who murdered the Duc d’Engien, and butchered
eight hundred prisoners in Egypt....”
“All that is probably exaggerated and overdrawn,” said Pastor
Wunderlich. “The Duke was very likely a feather-brained and
seditious person, and as for the prisoners, their execution was
probably the deliberate and necessary policy of a council of war.”
And he went on to speak of a book at which he had been looking, by
one of the Emperor’s secretaries, which had appeared some years
before and was well worth reading.
“All the same,” persisted the Consul, snuffing a flickering candle in
the sconce in front of him, “I cannot understand it—I cannot
understand the admiration people have for this monster. As a
Christian, as a religious man, I can find no room in my heart for such
a feeling.”
He had, as he spoke, the slightly inclined head and the rapt look of a
man in a vision. His father and Pastor Wunderlich could be seen to
exchange the smallest of smiles.
“Well, anyhow,” grinned the old man, “the little napoleons aren’t so
bad, eh? My son has more enthusiasm for Louis Philippe,” he said to
the company in general.
“Enthusiasm?” repeated Jean Jacques Hoffstede, rather
sarcastically.... “That is a curious juxtaposition, Philippe Égalité and
enthusiasm....”
“God knows, I feel we have much to learn from the July Monarchy,”
the Consul said, with serious zeal. “The friendly and helpful attitude
of French constitutionalism toward the new, practical ideals and
interests of our time ... is something we should be deeply thankful
for....”
“Practical ideals—well, ye-es—” The elder Buddenbrook gave his
jaws a moment’s rest and played with his gold snuff-box. “Practical
ideals—well—h’m—they don’t appeal to me in the least.” He dropped
into dialect, out of sheer vexation. “We have trade schools and
technical schools and commercial schools springing up on every
corner; the high schools and the classical education suddenly turn
out to be all foolishness, and the whole world thinks of nothing but
mines and factories and making money.... That’s all very fine, of
course. But in the long run, pretty stupid, isn’t it?... I don’t know
why, but it irritates me like the deuce.... I don’t mean, Jean, that the
July Monarchy is not an admirable régime....”
Senator Langhals, as well as Gratjens and Köppen, stood by the
Consul.... They felt that high praise was due to the French
government, and to similar efforts that were being made in
Germany. It was worthy of all respect—Herr Köppen called it
“respeck.” He had grown more and more crimson from eating, and
puffed audibly as he spoke. Pastor Wunderlich had not changed
colour; he looked as pale, refined, and alert as ever, while drinking
down glass after glass of wine.
The candles burned down slowly in their sockets. Now and then they
flickered in a draught and dispersed a faint smell of wax over the
table.
There they all sat, on heavy, high-backed chairs, consuming good
heavy food from good heavy silver plate, drinking full-bodied wines
and expressing their views freely on all subjects. When they began
to talk shop, they slipped unconsciously more and more into dialect,
and used the clumsy but comfortable idioms that seemed to embody
to them the business efficiency and the easy well-being of their
community. Sometimes they even used an overdrawn pronunciation
by way of making fun of themselves and each other, and relished
their clipped phrases and exaggerated vowels with the same
heartiness as they did their food.
The ladies had not long followed the discussion. Madame Kröger
gave them the cue by setting forth a tempting method of boiling
carp in red wine. “You cut it into nice pieces, my dear, and put it in
the saucepan, add some cloves, and onions, and a few rusks, a little
sugar, and a spoonful of butter, and set it on the fire.... But don’t
wash it, on any account. All the blood must remain in it.”
The elder Kröger was telling the most delightful stories; and his son
Justus, who sat with Dr. Grabow down at the bottom of the table,
near the children, was chaffing Mamsell Jungmann. She screwed up
her brown eyes and stood her knife and fork upright on the table
and moved them back and forth. Even the Överdiecks were very
lively. Old Frau Överdieck had a new pet name for her husband:
“You good old bell-wether,” she said, and laughed so hard that her
cap bobbed up and down.
But all the various conversations around the table flowed together in
one stream when Jean Jacques Hoffstede embarked upon his
favourite theme, and began to describe the Italian journey which he
had taken fifteen years before with a rich Hamburg relative. He told
of Venice, Rome, and Vesuvius, of the Villa Borghese, where Goethe
had written part of his Faust; he waxed enthusiastic over the
beautiful Renaissance fountains that wafted coolness upon the warm
Italian air, and the formal gardens through the avenues of which it
was so enchanting to stroll. Some one mentioned the big wilderness
of a garden outside the Castle Gate, that belonged to the
Buddenbrooks.
“Upon my word,” the old man said, “I still feel angry with myself that
I have never put it into some kind of order. I was out there the other
day—and it is really a disgrace, a perfect primeval forest. It would be
a pretty bit of property, if the grass were cut and the trees trimmed
into formal shapes.”
The Consul protested strenuously. “Oh, no, Papa! I love to go out
there in the summer and walk in the undergrowth; it would quite
spoil the place to trim and prune its free natural beauty.”
“But, deuce take it, the free natural beauty belongs to me—haven’t I
the right to put it in order if I like?”
“Ah, Father, when I go out there and lie in the long grass among the
undergrowth, I have a feeling that I belong to nature and not she to
me....”
“Krishan, don’t eat too much,” the old man suddenly called out, in
dialect. “Never mind about Tilda—it doesn’t hurt her. She can put it
away like a dozen harvest hands, that child!”
And truly it was amazing, the prowess of this scraggy child with the
long, old-maidish face. Asked if she wanted more soup, she
answered in a meek drawling voice: “Ye-es, ple-ase.” She had two
large helpings both of fish and ham, with piles of vegetables; and
she bent short-sightedly over her plate, completely absorbed in the
food, which she chewed ruminantly, in large mouthfuls. “Oh, Un-cle,”
she replied, with amiable simplicity, to the old man’s gibe, which did
not in the least disconcert her. She ate: whether it tasted good or
not, whether they teased her or not, she smiled and kept on,
heaping her plate with good things, with the instinctive, insensitive
voracity of a poor relation—patient, persevering, hungry, and lean.
CHAPTER VI
And now came, in two great cut-glass dishes, the “Plettenpudding.”
It was made of layers of macaroons, raspberries, lady-fingers, and
custard. At the same time, at the other end of the table, appeared
the blazing plum-pudding which was the children’s favourite sweet.
“Thomas, my son, come here a minute,” said Johann Buddenbrook,
taking his great bunch of keys from his trousers pocket. “In the
second cellar to the right, the second bin, behind the red Bordeaux,
two bottles—you understand?” Thomas, to whom such orders were
familiar, ran off and soon came back with the two bottles, covered
with dust and cobwebs; and the little dessert-glasses were filled with
sweet, golden-yellow malmsey from these unsightly receptacles.
Now the moment came when Pastor Wunderlich rose, glass in hand,
to propose a toast; and the company fell silent to listen. He spoke in
the pleasant, conversational tone which he liked to use in the pulpit;
his head a little on one side, a subtle, humorous smile on his pale
face, gesturing easily with his free hand. “Come, my honest friends,
let us honour ourselves by drinking a glass of this excellent liquor to
the health of our host and hostess in their beautiful new home.
Come, then—to the health of the Buddenbrook family, present and
absent! May they live long and prosper!”
“Absent?” thought the Consul to himself, bowing as the company
lifted their glasses. “Is he referring to the Frankfort Buddenbrooks,
or perhaps the Duchamps in Hamburg—or did old Wunderlich really
mean something by that?” He stood up and clinked glasses with his
father, looking him affectionately in the eye.
Broker Gratjens got up next, and his speech was rather long-winded;
he ended by proposing in his high-pitched voice a health to the firm
of Johann Buddenbrook, that it might continue to grow and prosper
and do honour to the town.
Johann Buddenbrook thanked them all for their kindness, first as
head of the family and then as senior partner of the firm—and sent
Thomas for another bottle of Malmsey. It had been a mistake to
suppose that two would be enough.
Lebrecht Kröger spoke too. He took the liberty of remaining seated,
because it looked less formal, and gestured with his head and hands
most charmingly as he proposed a toast to the two ladies of the
family, Madame Antoinette and the Frau Consul. As he finished, the
Plettenpudding was nearly consumed, and the Malmsey nearing its
end; and then, to a universal, long-drawn “Ah-h!” Jean Jacques
Hoffstede rose up slowly, clearing his throat. The children clapped
their hands with delight.
“Excusez! I really couldn’t help it,” he began. He put his finger to his
long sharp nose and drew a paper from his coat pocket.... A
profound silence reigned throughout the room.
His paper was gaily parti-coloured. On the outside of it was written,
in an oval border surrounded by red flowers and a profusion of gilt
flourishes:
“On the occasion of my friendly participation in a delightful
house-warming party given by the Buddenbrook family.
October 1835.”
He read this aloud first; then turning the paper over, he began, in a
voice that was already somewhat tremulous: