This article presents a method for inducing tolerance (referred to as 'suppression' throughout this text) in a mouse model of contact hypersensitivity (CHS) and for reversing this tolerance (referred to as 'contrasuppression' throughout this text) via epicutaneous (EC) application of an antigen alone or in combination with ligands for pathogen recognition receptors (PRRs), respectively1. In described protocol (a) haptenized mouse immunoglobulins (TNP-Ig) are used as antigen to suppress contact hypersensitivity or (b) antigen with pathogen-associated molecular patterns (PAMPs), ligands for Toll-like receptors (TLR) and nucleotide-binding oligomerization domain-containing protein (NOD)-like receptors (NLRs), to reverse skin-induced suppression2,3,4. The findings indicate that EC-induced immunomodulation is mediated by antigen-non-specific T suppressor (Ts) cells and antigen-specific T contrasuppressor (Tcs) cells. These cells can be examined in a mouse model of adoptive cell transfer to determine the mechanism of the tested reactions. The current protocol describes two models of cell transfer, "adoptive transfer IN" and "adoptive transfer OUT". Adoptive transfer IN is useful for testing the immunomodulation in the afferent and efferent phases of CHS. On the other hand, "adoptive transfer OUT" reflects the effect of immunomodulation only in the efferent phase of CHS.
The article describes a method of skin-induced suppression via the epicutaneous application of an antigen in a murine model of human allergic contact dermatitis (ACD) - contact hypersensitivity (CHS) mediated by T helper type 1 lymphocytes (Th1)5. However, this approach was also tested for its efficacy in regulating (suppressing, tolerance) experimental models of T cytotoxic lymphocyte type 1 (Tc1)-mediated CHS6,7, autoimmune diseases such as collagen-induced arthritis (CIA)8,9 , experimental autoimmune encephalomyelitis (EAE)10,11, and ulcerative colitis12. Moreover, the protocol describes the method of skin-induced contrasuppression (reversed suppression) via EC application of an antigen together with PRR ligands in a murine model of CHS13,14,15,16. The presented results indicate that EC-induced antigen-nonspecific suppression can be reversed by purifying TLR2, TLR3, TLR4, TLR9, and NOD2 ligands. The method of skin-induced contrasuppression was also employed in an animal model of atopic dermatitis (AD), showing that EC treatment with an antigen in the presence of synthetic single-stranded DNA molecules containing unmethylated oligodeoxynucleotides (CpG) - ligand for TLR9 can suppress Th2-mediated responses in an antigen-specific manner (shifts the immune response toward a Th1/Th17 phenotype)17. The described method was also tested in pneumococcal pneumonia, demonstrating that EC immunization with pneumococcal polysaccharide conjugated to bovine serum albumin (PC-BSA), together with CpG, could potentially enhance immunity to Streptococcus pneumoniae18.
A pivotal aspect of EC-induced immunomodulation is the selection of the model and the nature of the antigen. The article includes a table detailing the antigens used, the antigen exposure duration, and the tested models' T-cell specificity (see Table 1). The described method for immunomodulation is targeted towards diseases involving antigen-specific T lymphocytes. The effectiveness of this method was assessed by utilizing a compatible EC-applied antigen in the process. The compatibility of the antigen is crucial to ensure that it effectively interacts with the T lymphocytes involved in the disease process. The application of a protein or peptide patch on intact skin facilitates antigen penetration through the epidermis19,20. This increased antigen penetration is attributed to heightened perspiration beneath the dressing. Alterations in epidermal permeability occur within 4-10 h of patch application, while EC-induced immunomodulation may remain effective for up to two weeks5,14.
Although EC treatment is widely used, the existence of many variations of this method could raise questions. Current understanding suggests that the extent of epidermal damage prior to antigen administration may influence the nature of the resulting immune response21. Superficial epidermal damage triggers the release of anti-inflammatory cytokines by Langerhans cells, favoring the initiation of the Th2 response22. In contrast, more extensive epidermal damage promotes the release of pro-inflammatory cytokines and facilitates antigen delivery to dermal dendritic cells23.The presented protocol highlights (a) the recognition of challenges when applying this method in small and active animals, particularly mice; (b) considering factors such as skin condition after razor shaving, proper contact of substances with the skin, exposure time, and hygienic conditions of the skin during EC treatment which can determine the treatment's effectiveness. It is crucial to consider the method of skin depilation, whether physical or chemical, before antigen application, as different skin preparations can affect the skin's condition in various ways. It is acknowledged that all these procedures can activate skin immune cells, potentially leading to skin infections or influencing disease progression. The potential side effects on skin conditions after depilation should be a primary consideration when selecting the depilation method. The researchers described a method of T-cell-mediated immune suppression induced via the EC application of an antigen on razor-shaved dorsal skin, demonstrating its effect on various mouse models of immune responses. The antigen's EC application, along with PAMPs, induces antigen-specific T contrasuppressor cells. Moreover, the presented method of EC application, particularly with repeated exposure to antigens or PAMPs, does not cause concerning side effects.
The described protocol underlines the importance of various factors in achieving reliable and repeatable results with this method, especially in small animals like mice. The non-invasive nature of this approach typically results in a lower risk of adverse reactions (such as pain, infection, or scarring) compared to intradermal or injectable immunization techniques. Epicutaneous immunization is user-friendly and easily administered in non-clinical settings, improving accessibility and compliance compared to more invasive methods.
Table 1: EC-induced modulation of immune response in different mouse disease models. Abbreviations: ACD = allergic contact dermatitis; AD = atopic dermatitis; Ag = antigen; CIA = collagen-induced arthritis; CHS = contact hypersensitivity; CFA = complete Freund's adjuvant; COLL II = type II collagen; DNFB = 2,4-dinitrofluorobenzene; DNP-BSA = dinitrophenyl conjugated to bovine serum albumin; EAE = experimental autoimmune encephalomyelitis; EC = epicutaneous; LPS = lipopolysaccharide; OVA = ovalbumin; PAMP = pathogen-associated molecular pattern; PC-BSA = pneumococcal polysaccharide conjugated to bovine serum albumin; Th1 = T helper type 1 lymphocyte; Tc1 = T cytotoxic type 1 lymphocyte; TNCB = 2,4,6-trinitrochlorobenzene; TNP-Ig = 2,4,6-trinitrophenyl-conjugated mouse immunoglobulins; Ts = T suppressor cells; Tcs = T contrasuppressor cells. Please click here to download this Table.