Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) is an essential regulator of T-cell responses, and its absence precipitates lethal T-cell hyperactivity. However, whether CTLA-4 acts simply to veto the activation of certain clones or plays a more nuanced role in shaping the quality of T-cell responses is not clear. Here we report that T cells in CTLA-4–deficient mice show spontaneous T-follicular helper (T
FH) differentiation in vivo, and this is accompanied by the appearance of large germinal centers (GCs). Remarkably, short-term blockade with anti–CTLA-4 antibody in wild-type mice is sufficient to elicit T
FH generation and GC development. The latter occurs in a CD28-dependent manner, consistent with the known role of CTLA-4 in regulating the CD28 pathway. CTLA-4 can act by down-regulating CD80 and CD86 on antigen presenting cells (APCs), thereby altering the level of CD28 engagement. To mimic reduced CD28 ligation, we used mice heterozygous for CD28, revealing that the magnitude of CD28 engagement is tightly linked to the propensity for T
FH differentiation. In contrast, other parameters of T-cell activation, including CD62L down-regulation and Ki67 expression, were relatively insensitive to altered CD28 level. Altered T
FH generation as a result of graded reduction in CD28 was associated with decreased numbers of GC B cells and a reduction in overall GC size. These data support a model in which CTLA-4 control of immunity goes beyond vetoing T-cell priming and encompasses the regulation of T
FH differentiation by graded control of CD28 engagement.Control of the magnitude and nature of adaptive immune responses is critical for health. The cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4)/CD28 axis has long been known to control the magnitude of T-cell responses, however whether it also influences their nature has not been clear. Early studies suggested that CD28 may be particularly important for Th2 differentiation (
1,
2), although others identified roles for CD28 in both Th1 and Th2 responses (
3,
4). It is known that CD28 is an absolute requirement for the differentiation of follicular helper T cells (T
FHs) that support germinal center (GC) formation (
5,
6). However, these studies generally make use of CD28-deficient T cells, and therefore, results may reflect a failure of the cells to properly activate, proliferate, or survive, particularly given the known contribution of CD28 to these processes.A key outstanding question is whether CD28 costimulation in vivo is more complex than a binary checkpoint for T-cell priming. It is clear that expression of costimulatory ligands on antigen presenting cells (APCs) fluctuates in response to environmental stimuli, being up-regulated by inflammatory cytokines and TLR agonists and down-regulated by Treg-expressed CTLA-4 (
7–
11). Thus, variable levels of costimulatory ligands will be available for CD28 binding depending on the microenvironmental context. However, whether this simply alters the number of T cells that achieve the required threshold to commit to a response or whether it influences the nature of the response is not clear. Effective immune homeostasis appears to be reliant on maintaining an appropriate level of CD28 engagement. For example, basal expression of CD28 ligands, in particular dendritic cell-expressed CD86 (
12), is critical to Treg homeostasis (
13,
14), whereas excessive CD28 engagement in the absence of CTLA-4 results in lethal autoimmunity (
15,
16). Nonetheless, distinguishing whether these effects are simply quantitative is not straightforward. Thus, although levels of CD28 ligands are clearly variable in vivo, our understanding of the impact of altering the level of CD28 engagement is still incomplete.To explore the impact of varying levels of CD28 ligation, we have used the CTLA-4–deficient mouse as a model of excessive CD28 stimulation. In these mice, we observed a striking skewing toward T
FH differentiation, with induction of IL-21 and spontaneous formation of GCs. In a complementary approach, we used CD28 heterozygosity to decrease T cell CD28 expression: This revealed that the level of CD28 engagement is tightly coupled to the level of inducible T-cell costimulator (ICOS) induction, T
FH generation, and GC formation, whereas other parameters of T-cell activation were less affected. Finally, we demonstrate that induction of the microRNA cluster miR17-92, recently linked with T
FH differentiation (
17,
18), varies proportionally with APC costimulatory ligand expression and is modulated by CTLA-4 deficiency or blockade. Collectively, these data suggest that the CTLA-4/CD28 axis provides quantitative and qualitative control of T-cell help for humoral immunity.
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