Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany.
Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany.
J Virol. 2020 Aug 31;94(18). doi: 10.1128/JVI.00795-20.
Checkpoint inhibitors are effective in restoring exhausted CD8 T cell responses in persistent viral infections or tumors. Several compounds are in clinical use for different malignancies, but trials in patients with chronic viral infections have also been conducted. In a mouse model of persistent lymphocytic choriomeningitis virus (LCMV) infection, it was shown that checkpoint inhibitor treatment increased T cell proliferation and functionality, but its influence on the antigen-specific T cell receptor (TCR) repertoire is unknown. NP396-specific CD8 T cells dominate during acute LCMV infection and are predominantly exhausted during chronic infection. Next-generation sequencing of NP396-specific TCRs showed that exhaustion corresponds with a significantly reduced NP396-specific TCR repertoire diversity: Shannon indices of 4 in immunized mice to 2.6 in persistently infected mice. Anti-PD-L1 treatment during persistent LCMV infection restored NP396-specific T cell responses and reduced viral titers. Nevertheless, anti-PD-L1-treated mice showed an even more narrowed TCR repertoire, with reduced TCR diversity compared to that of persistently infected control mice (Shannon indices of 2.1 and 2.6, respectively). Interestingly, anti-PD-L1 treatment-induced narrowing of the TCR repertoire negatively correlates with functional and physical restoration of the antigen-specific T cell response. Further, we found that private, hyperexpanded TCR clonotypes dominated the T cell response after anti-PD-L1 treatment. Although being private, these top clonotypes from anti-PD-L1-treated mice revealed a more closely related CDR3 motif than those of top clonotypes from persistently infected control mice. In conclusion, although targeting the PD-1/PD-L1 pathway reinvigorates exhausted CD8 T cells, it fails to restore T cell repertoire diversity. Checkpoint inhibitors are effective immunotherapeutics to restore cancer- and virus-induced exhausted CD8 T cells, by enhancing the quality and survival of immune responses. Although checkpoint inhibitors are already used as therapy against various cancers, not much is known about their multifaceted impact on the exhausted CD8 T cell receptor (TCR) repertoire. This report describes for the first time the evolvement of an exhausted antigen-specific CD8 TCR repertoire under checkpoint inhibitor treatment. By using a well-established virus model, we were able to show major shifts toward oligoclonality of the CD8 TCR repertoire response against a massively exhausted lymphocytic choriomeningitis virus (LCMV) epitope. While supporting viral control in the LCMV model, oligoclonality and more private of TCR repertoires may impact future pathogenic challenges and may promote viral escape. Our results may explain the ongoing problems of viral escapes, unpredictable autoimmunity, and heterogeneous responses appearing as adverse effects of checkpoint inhibitor treatments.
检查点抑制剂在恢复持续性病毒感染或肿瘤中的耗尽的 CD8 T 细胞反应方面非常有效。有几种化合物已用于治疗不同的恶性肿瘤,但也对慢性病毒感染患者进行了临床试验。在持续的淋巴细胞性脉络丛脑膜炎病毒 (LCMV) 感染的小鼠模型中,已经表明检查点抑制剂治疗可增加 T 细胞的增殖和功能,但尚不清楚其对抗原特异性 T 细胞受体 (TCR) 库的影响。在急性 LCMV 感染期间,NP396 特异性 CD8 T 细胞占主导地位,而在慢性感染期间则主要处于耗竭状态。NP396 特异性 TCR 的下一代测序表明,耗竭与 NP396 特异性 TCR 库多样性的显著降低相对应:免疫小鼠的 Shannon 指数为 4,持续感染小鼠为 2.6。在持续性 LCMV 感染期间,抗 PD-L1 治疗可恢复 NP396 特异性 T 细胞反应并降低病毒滴度。尽管如此,与持续性感染对照小鼠相比,抗 PD-L1 治疗的小鼠仍表现出更狭窄的 TCR 库,TCR 多样性降低(Shannon 指数分别为 2.1 和 2.6)。有趣的是,抗 PD-L1 治疗诱导的 TCR 库变窄与抗原特异性 T 细胞反应的功能和物理恢复呈负相关。此外,我们发现,在抗 PD-L1 治疗后,私人、超扩展的 TCR 克隆型主导 T 细胞反应。尽管是私人的,但来自抗 PD-L1 治疗的小鼠的这些顶级克隆型比来自持续感染对照小鼠的顶级克隆型具有更密切相关的 CDR3 基序。总之,尽管靶向 PD-1/PD-L1 途径可恢复衰竭的 CD8 T 细胞,但无法恢复 T 细胞库的多样性。检查点抑制剂是通过增强免疫反应的质量和存活来恢复癌症和病毒诱导的衰竭的 CD8 T 细胞的有效免疫疗法。尽管检查点抑制剂已被用作治疗各种癌症的药物,但人们对它们对衰竭的 CD8 T 细胞受体 (TCR) 库的多方面影响知之甚少。本报告首次描述了在检查点抑制剂治疗下,衰竭的抗原特异性 CD8 TCR 库的演变。通过使用成熟的病毒模型,我们能够显示出针对大量衰竭的淋巴细胞性脉络丛脑膜炎病毒 (LCMV) 表位的 CD8 TCR 库反应向寡克隆性的主要转变。虽然在 LCMV 模型中支持病毒控制,但 TCR 库的寡克隆性和更多的私人性可能会影响未来的致病挑战,并可能促进病毒逃逸。我们的结果可能解释了病毒逃逸、不可预测的自身免疫和作为检查点抑制剂治疗不良反应出现的异质性反应等持续存在的问题。
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