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Published online before print August 3, 2007
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T Cells Are Necessary for Platelet and Neutrophil Accumulation in Limbal Vessels and Efficient Epithelial Repair after Corneal Abrasion


From the Department of Pediatrics,* Section of Leukocyte Biology, Childrens Nutrition Research Center, ¶ and the Department of Medicine,
Section of Cardiovascular Sciences, Baylor College of Medicine, Houston, Texas; Medical Care Line,
Michael E. DeBakey Veterans Administration Medical Center, Houston, Texas; and the Department of Ophthalmology,
Institute of Tissue Transplantation and Immunology, Jinan University, Guangzhou, China
| Abstract |
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T-cell receptor (TCR). Corneal abrasion in wild-type, CD11a–/–, and P-sel–/– mice increased the numbers of 
T cells in the limbal and peripheral corneal epithelium and in the corneal stroma adjacent to the limbal blood vessels. Intercellular adhesion molecule (ICAM)-1–/– mice exhibited a reduction in 
T-cell accumulation. TCR
–/– mice exhibited reduced inflammation and delayed epithelial wound healing as evidenced by delayed wound closure, reduced epithelial cell division, reduced neutrophil infiltration, and reduced epithelial cell density at 96 hours after wounding. TCR
–/– mice also exhibited >60% reduction in platelet localization in the limbus despite similar platelet counts and platelet function assessed with an in vivo thrombosis model. These results are consistent with the conclusion that 
T cells are necessary for efficient inflammation, platelet localization in the limbus, and epithelial wound healing after corneal abrasion.
In the current study, we investigate the contributions of T cells to the healing and inflammatory events after corneal epithelial abrasion. Our focus is on 
T cells because we observed that >90% of the T cells resident in the limbal epithelium were positive for antibody GL3, a pan-
T-cell marker,14
and because 
T cells resident in the epidermis apparently contribute to wound healing.15-17
Our results reveal a dependence of neutrophil and platelet localization in limbal vessels on 
T cells.
| Materials and Methods |
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TCR
–/– mice on the C57BL/6 background and C57BL/6 mice were from The Jackson Laboratory (Bar Harbor, ME). Intercellular adhesion molecule (ICAM)-1–/–,18
P-selectin–/–,19
and CD11a–/–20
mice were backcrossed as previously described at least 10 generations with C57BL/6 mice. All animals were bred and housed in our facility21
according to the guidelines described in the Association for Research in Vision and Ophthalmology Statement for the Use of Animals in Vision and Ophthalmic Research and Baylor College of Medicine Animal Care and Use Committee policy. Mice were used at 10 to 14 weeks of age.
Corneal Epithelial Wounding Model
The central corneal wound was performed as previously described.22
In brief, mice were anesthetized by intraperitoneal injection of pentobarbital (50 mg/kg body weight), and the central corneal epithelium was demarcated with a 2-mm trephine and then removed using a diamond blade for refractive surgery (Accutome, Malvern, PA) under a dissecting microscope. Wound closure was assessed using fluorescein staining of the ocular surface and digital analysis of the stained area. At various times corneal tissues including the limbus were excised and processed for immunohistology. Some mice were depleted of 
T cells as previously described23
by an intraperitoneal injection of 500 µg of hamster anti-T-cell receptor (TCR) 
monoclonal antibody (mAb) (clone GL314
; BD Pharmingen, La Jolla, CA) in a volume of 0.30 ml of phosphate-buffered saline before corneal abrasion. Sham depletion was accomplished with hamster immunoglobulin (The Jackson Laboratory).
Immunohistology
Taking care to include the limbus, wounded corneas were dissected, fixed, permeabilized, and incubated with the following labeled monoclonal antibodies as described6,7,22,24
: anti-Gr-1-fluorescein isothiocyanate (FITC) (clone RB6-8C5), anti-TCR
-phycoerythrin (PE) (clone GL3), anti-CD41-PE (clone MWReg30), and anti-CD31-FITC (clone MEC 13.3) (BD PharMingen), which were selected for staining neutrophils, 
T cells, platelets, and endothelial cells of the limbal vessels, respectively. Radial cuts were made in the cornea so that it could be flattened by a coverslip, and the cornea was mounted in Airvol (Celenase, Ltd., Dallas, TX) containing 1 µmol/L 4',6-diamidino-2-phenylindole (DAPI; Sigma Chemical, St. Louis, MO) to assess nuclear morphology. Cell division was assessed as previously described.6
Digital images were captured and saved for computer analysis (Delta Vision; Applied Precision, Issaquah, WA). A standard pattern for morphometric analysis was used throughout the study as we described before (shown in Figure 3, inset).6,7,22,24
Whole mounts were evaluated using a x40 oil immersion lens to assess each field of view across the cornea from limbus to limbus. For neutrophils, a central frame covering 8% of the field of view was used to count neutrophils throughout the depth of the cornea from the epithelial to endothelial surfaces (a range of
90 µm). To compare the relative level of neutrophils in the different areas from the limbus to the central cornea, each cornea was counted separately. To compare the relative level of platelet accumulation in the limbal areas, each cornea was counted in eight random fields along limbal vessels separately. For epithelial cell division, cells per entire field of view were counted at the focal plane of the basal cell layer of the epithelium. For epithelial density, a central frame 162 x 102 µm in the field of view was counted at the focal plane of the basal cell layer of the epithelium. At least four corneas were examined for immunohistology, and four quadrants were analyzed for each to obtain the average number per field. The limbus was defined as the intervening zone between the cornea and conjunctiva as the most peripheral field.
Histological Assessment of Corneal Thickness
Enucleated eyes were fixed overnight at 4°C in 0.1 mol/L sodium cacodylate buffer (pH 7.2) containing 2.5% glutaraldehyde. The cornea was then excised, taking care to include the limbal tissue, and postfixed in 1% osmium tetroxide for 1 hour at room temperature, dehydrated through an ethanol series, and embedded in resin (LX 112; Polysciences, Warrington, PA). Thick (0.5 µm) sections were cut on an ultramicrotome (RMC 7000; Venana Medical Systems, Tucson, AZ) equipped with a diamond knife. Sections were stained with toluidine blue O and viewed on an inverted microscope (DeltaVision Spectris; Applied Precision) using a x20 objective, transverse measurements of the central epithelial thickness were made using the calibrated linear measurement tool contained in the supplied imaging software (Applied Precision SoftWorx).
In Vivo Thrombosis Model
Platelet function in vivo was assessed with a light/dye-induced model of platelet thrombus formation in cremaster venules of pentobarbital-anesthetized mice, as described previously.11,25,26
In brief, platelet thrombi were induced by epi-illumination of FITC-dextran (150 kd, 10 ml/kg of a 5% solution), injected via a jugular venous line. Thrombosis kinetics were assessed by determining the time of onset of platelet aggregates and time of thrombotic occlusion, by an investigator blinded to the mouse genotype. In some experiments, mice were pretreated 1 hour earlier with 0.2 mg i.v. of monoclonal antibodies against glycoprotein Ib
(Emfret Analytics, Würzburg, Germany), used by us previously to induce platelet depletion in vivo.6
In antibody-treated mice, venules that failed to develop thrombotic occlusion after 60 minutes of epi-illumination were assigned a value of 60 minutes.
Statistical Analysis
Data analysis was performed using analysis of variance and pairwise multiple comparisons using Tukeys test. A P value of <0.05 was considered significant. Data are expressed as means ± SEM.
| Results |
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50%.24
In the current study >90% of resident CD3+ cells were positive for antibody GL3, a marker of 
T cells (Figure 1, a and b)
–/– mice were negative for GL3 (Figure 1, c and d)
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Because 
T cells may participate in epidermal wound healing,15
corneal epithelial healing in the TCR
–/– mice was assessed. Central epithelial abrasion without stromal injury results in three general phases of healing.22,24,30,31
The initial lag phase lasts
6 hours. The migration phase in which epithelial cells (basal and suprabasal) crawl over the provisional matrix on the stromal surface to close the wound lasts
24 hours. This is evident as increasing epithelial cell density in the abraded area (Figure 3)
, first seen in region 4 between 6 and 12 hours and region 5 at 18 to 24 hours after injury. The third phase, epithelial division, is initially prominent at 18 hours (Figure 3)
. Dividing cells in the limbal epithelium increased from 1.9 ± 0.36 per field at 12 hours to 16.9 ± 1.6 per field (n = 8, P < 0.01) at 18 hours.
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–/– mice exhibited marked depression of epithelial division at 18 hours (Figure 4)
–/– mice.
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T-Cell Accumulation and Epithelial Cell Division in Response to Epithelial Abrasion
Two important adhesion molecules involved in leukocyte migration are CD11a/CD18 (LFA-1), a member of the ß2 integrin family expressed on lymphocytes,32
and ICAM-1 (CD54), expressed on limbal vessel endothelial cells and corneal epithelium during the time period (ie, 18 hours after wounding) in which 
T-cell numbers increase.22
Accumulation of 
T cells was analyzed in two strains of C57BL/6 mice with targeted deletions. CD11a–/– mice exhibited no significant reduction at 18 hours in GL3+ cell accumulation after central corneal abrasion (Figure 6A)
. Animals deficient in ICAM-1 exhibited significant reductions in the GL3+ cell accumulation at 18 and 24 hours after corneal abrasion (Figure 6A)
. Epithelial basal cell division was delayed in ICAM-1–/– mice and its duration was shortened compared with that in wild-type and CD11a-deficient mice (Figure 6B)
. Consistent with observations in the wild-type mice, treatment of the CD11a–/– mice with GL3 before corneal abrasion significantly inhibited cell division at 18 hours (Figure 7)
.
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Experimental conditions preventing neutrophil emigration (eg, CD18 deficiency or neutropenia) reduce wound closure and early onset of epithelial division.7
To determine whether reduced healing in the TCR
–/– mice is possibly linked to reduced neutrophil emigration, neutrophil accumulation was analyzed throughout the first 48 hours after abrasion. Neutrophils were significantly reduced in the TCR
–/– mice and in wild-type mice pretreated with antibody GL3 (Figure 8)
. Antibody GL3 interrupted neutrophil influx if given at 18 hours after abrasion in wild-type mice (Figure 8C)
. Blood neutrophil counts in TCR
–/– mice were not different from wild type (6.3 x 102/µl and 8.6 x 102/µl, respectively, laboratory normal range 5 to 20 x 102/µl). Blood lymphocyte, monocyte, and eosinophil counts also did not differ.
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In published studies6
we have shown that platelet accumulation contributes to the early aspects of healing after central corneal abrasion. Platelet accumulation in the limbus is initially coincident with that of neutrophils, peaking within the first 12 hours after injury, and platelet accumulation is markedly reduced in neutropenic mice. In the current studies, TCR
–/– mice also revealed significant reduction in platelet accumulation in the limbus (Figure 9, A and B)
. The reduced platelet accumulation in limbus of TCR
–/– mice was not a result of lower circulating platelets, because these mice had comparable blood platelet counts compared with wild-type mice (Figure 10A)
. Likewise, platelet function in vivo of TCR
–/– mice, assessed with a light/dye-induced thrombosis model,11,25,26
did not differ from that of wild-type mice. The TCR
–/– mice had similar time of onset of platelet aggregates as wild-type mice (18 ± 1 versus 22 ± 2 seconds, respectively; N.S.) and similar time to thrombotic occlusion (Figure 10A)
. In contrast, anti-GPIb
antibodies, which reduced platelet counts in wild-type mice by
85%, induced a marked delay in microvascular thrombosis.
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T cells are insufficient to promote healing in the absence of platelets. | Discussion |
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T cells are necessary for the early localization of neutrophils and platelets in the limbus and initiation of epithelial cell division within 18 hours after central abrasion are supported by the following evidence: i) Antibody GL3 (anti-TCR
) bound to CD3+ cells in the limbal epithelium, and TCR
–/– mice lacked binding of this antibody to CD3+ cells in the limbus. ii) TCR
–/– mice exhibited marked reductions in epithelial cell division as well as neutrophil and platelet accumulation after epithelial abrasion. iii) Administration of antibody GL3 before corneal abrasion reproduced the pattern of epithelial, neutrophil, and platelet response in wild-type mice that occurred in TCR
–/– mice. iv) Mice with a targeted deletion of ICAM-1 had reduced accumulation of GL3+ cells (also neutrophils and platelets as seen in our earlier study6
) and significantly delayed epithelial cell division.
The conclusion that platelets form a mechanistic link between 
T cells and early epithelial cell division is supported by the following observations: i) anti-GP1b
-induced depletion of circulating platelets significantly delays epithelial cell division and wound closure.6
ii) Mice with targeted deletion of P-selectin (P-sel–/–) have >80% reduction in platelet accumulation in the limbus after central corneal abrasion.6
iii) P-sel–/– mice exhibit reduced wound healing evidenced by reduced epithelial cell division and delayed wound closure.6
iv) Passive intravenous transfer of wild-type platelets in P-sel–/– mice promotes epithelial cell recovery from abrasion (evidenced by increased cell division and migration of epithelial cells into the wounded area6
). v) 
T cells were insufficient to promote normal epithelial cell division because resident levels and the increases in numbers of 
T cells in the cornea after injury were unaffected in the P-sel–/– mice.
Our interest in this previously unreported finding that 
T cells are necessary for platelet and neutrophil localization in the limbus arises from the current understanding that 
T cells are an important part of the populations of innate T lymphocytes, and they have been reported to influence epithelial cell growth and participate in epithelial repair in other organs.16,33

TCRs vary with the roles they play in different tissues34
and are considered important to the maintenance of tissue homeostasis,35
response to injury,15
or resistance to infection.36-38
Different populations of 
T cells with distinct TCRs migrate from the thymus to various organs during ontogeny.39,40
For example, V
5 V
1 TCR-expressing cells (also known as V
3 V
1) migrate to the skin, V
4 V
1 TCR-expressing cells migrate to the reproductive tract, and V
1 TCR-expressing cells migrate to the lung. Consistent with other organs, the 
T cells resident in the peripheral corneal and limbal surface are within the epithelium and, like those in the skin,15
have a dendritic morphology (see Figure 1a
). There is convincing evidence that the 
T cells in the skin, also called dendritic epidermal T cells, play a critical role in wound healing15,41
and in the maintenance of epidermal integrity.35,42,43
Dendritic epidermal T cells apparently recognize endogenous factors released or expressed on stressed or damaged epidermal cells42,44
and are activated through ligation of the TCR. Activation may result in release of proinflammatory chemokines such as XCL1, CXCL1, CCL3, CCL4, and CCL545
that are capable of attracting other leukocytes and releasing growth factors such as FGF-7 and FGF-1041
that influence the division and migration of keratinocytes. In addition, some 
T-cell subsets limit inflammation or assist in the resolution of inflammation by direct cytotoxic interactions on activated macrophages46,47
through a mechanism that involves FasL expression on 
T cells (eg, those expressing V
1 TCR) interacting with Fas expressed on target cells.46
There is evidence for anti-inflammatory activity through the production and release of thymosin-ß4,40
of possible interest in the cornea given published data for an anti-inflammatory and beneficial wound-healing effect of thymosin-ß4 in the cornea.48,49
The finding that ICAM-1–/– mice exhibited reduced accumulation of 
T cells and delayed, abbreviated epithelial basal cell division remains to be explained, especially because the CD11a–/– mice were not significantly different from wild type. ICAM-1 is known to be a dominant ligand for CD11a/CD18 (LFA-1), but in this specific inflammatory condition, it seems to be functioning in some other capacity. It is unlikely to be functioning as a ligand for CD11b/CD18 (Mac-1) in this setting because CD11b–/– mice exhibit exaggerated leukocyte accumulation in the cornea after epithelial abrasion.22
Comparison of our results with recently published reports on wound healing in the skin reveals possibly distinct features of the corneal response. Jameson and colleagues41
reported that dermal wound healing (excisional wounds) was characterized by significantly delayed re-epithelialization, reduced keratinocyte cell division, and reduced macrophage infiltration, but neutrophil accumulation was not different from that of wild-type mice. Alexander and colleagues17
reported that postburn wound healing in the skin of 
T-cell-deficient mice was also significantly altered, but neutrophil accumulation in response to the burn injury was not diminished. Our results demonstrate that neutrophil influx and platelet accumulation are significantly depressed in the 
T-cell-deficient mice after corneal epithelial wounding compared with wild-type mice, an apparent difference between skin and cornea. Because platelet depletion significantly delays corneal healing it seems that 
T cells may contribute to corneal healing in part by promoting platelet accumulation. The mechanistic links between 
T cells and platelets are likely complex, but our previous studies indicate that neutrophil localization is necessary for platelet accumulation in the limbus.6
We have determined that CXCL1 and CXCL524
and XCL1 (unpublished) are elevated in wild-type corneas after epithelial abrasion and coordinated with neutrophil influx. XCL1, reported to be released from some 
T cells,45
has been shown to be an attractant for neutrophils that express the receptor XCR1.50
We assume, though, that the mechanisms for platelet accumulation are multifactorial, but that P-selectin-dependent adhesion of platelets to neutrophils forms a necessary link.6
In summary, these observations support a conceptual model whereby 
T cells are necessary for platelet and neutrophil localization in the limbal vessels within 12 to 18 hours after epithelial abrasion, and platelet and neutrophil accumulation are necessary for early initiation of epithelial cell division.6,7
Adhesion molecules distinguish aspects of these events. P-selectin is necessary for platelet localization in the limbal vessels.6
ICAM-1, but not LFA-1 or P-selectin, participates in 
T-cell accumulation after abrasion.
| Footnotes |
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Supported by National Institutes of Health (grants HL-079368 and HL070357), the United States Department of Agriculture (grant 6250-51000-046-01A), and the National Natural Science Foundation of China (grants 39970250 and 30672287).
Accepted for publication June 11, 2007.
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