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      High antigen levels induce an exhausted phenotype in a chronic infection without impairing T cell expansion and survival

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          Abstract

          Using recombinant antigen variant-expressing chronic LCMV strains, Zehn and colleagues showed that amount rather than antigen strength is a key determinant of inducing a chronic infection phenotype in T cells.

          Abstract

          Chronic infections induce T cells showing impaired cytokine secretion and up-regulated expression of inhibitory receptors such as PD-1. What determines the acquisition of this chronic phenotype and how it impacts T cell function remain vaguely understood. Using newly generated recombinant antigen variant-expressing chronic lymphocytic choriomeningitis virus (LCMV) strains, we uncovered that T cell differentiation and acquisition of a chronic or exhausted phenotype depend critically on the frequency of T cell receptor (TCR) engagement and less significantly on the strength of TCR stimulation. In fact, we noted that low-level antigen exposure promotes the formation of T cells with an acute phenotype in chronic infections. Unexpectedly, we found that T cell populations with an acute or chronic phenotype are maintained equally well in chronic infections and undergo comparable primary and secondary expansion. Thus, our observations contrast with the view that T cells with a typical chronic infection phenotype are severely functionally impaired and rapidly transition into a terminal stage of differentiation. Instead, our data unravel that T cells primarily undergo a form of phenotypic and functional differentiation in the early phase of a chronic LCMV infection without inheriting a net survival or expansion deficit, and we demonstrate that the acquired chronic phenotype transitions into the memory T cell compartment.

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          Most cited references33

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          Control of viremia in simian immunodeficiency virus infection by CD8+ lymphocytes.

          Clinical evidence suggests that cellular immunity is involved in controlling human immunodeficiency virus-1 (HIV-1) replication. An animal model of acquired immune deficiency syndrome (AIDS), the simian immunodeficiency virus (SIV)-infected rhesus monkey, was used to show that virus replication is not controlled in monkeys depleted of CD8+ lymphocytes during primary SIV infection. Eliminating CD8+ lymphocytes from monkeys during chronic SIV infection resulted in a rapid and marked increase in viremia that was again suppressed coincident with the reappearance of SIV-specific CD8+ T cells. These results confirm the importance of cell-mediated immunity in controlling HIV-1 infection and support the exploration of vaccination approaches for preventing infection that will elicit these immune responses.
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            Tolerance and exhaustion: defining mechanisms of T cell dysfunction.

            CD8 T cell activation and differentiation are tightly controlled, and dependent on the context in which naïve T cells encounter antigen, can either result in functional memory or T cell dysfunction, including exhaustion, tolerance, anergy, or senescence. With the identification of phenotypic and functional traits shared in different settings of T cell dysfunction, distinctions between such dysfunctional states have become blurred. Here, we discuss distinct states of CD8 T cell dysfunction, with an emphasis on: (i) T cell tolerance to self-antigens (self-tolerance); (ii) T cell exhaustion during chronic infections; and (iii) tumor-induced T cell dysfunction. We highlight recent findings on cellular and molecular characteristics defining these states, cell-intrinsic regulatory mechanisms that induce and maintain them, and strategies that can lead to their reversal. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              Viral persistence alters CD8 T-cell immunodominance and tissue distribution and results in distinct stages of functional impairment.

              Chronic viral infections often result in ineffective CD8 T-cell responses due to functional exhaustion or physical deletion of virus-specific T cells. However, how persisting virus impacts various CD8 T-cell effector functions and influences other aspects of CD8 T-cell dynamics, such as immunodominance and tissue distribution, remains largely unknown. Using different strains of lymphocytic choriomeningitis virus (LCMV), we compared responses to the same CD8 T-cell epitopes during acute or chronic infection. Persistent infection led to a disruption of the normal immunodominance hierarchy of CD8 T-cell responses seen following acute infection and dramatically altered the tissue distribution of LCMV-specific CD8 T cells in lymphoid and nonlymphoid tissues. Most importantly, CD8 T-cell functional impairment occurred in a hierarchical fashion in chronically infected mice. Production of interleukin 2 and the ability to lyse target cells in vitro were the first functions compromised, followed by the ability to make tumor necrosis factor alpha, while gamma interferon production was most resistant to functional exhaustion. Antigen appeared to be the driving force for this loss of function, since a strong correlation existed between the viral load and the level of exhaustion. Further, epitopes presented at higher levels in vivo resulted in physical deletion, while those presented at lower levels induced functional exhaustion. A model is proposed in which antigen levels drive the hierarchical loss of different CD8 T-cell effector functions during chronic infection, leading to distinct stages of functional impairment and eventually to physical deletion of virus-specific T cells. These results have implications for the study of human chronic infections, where similar T-cell deletion and functional dysregulation has been observed.
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                Author and article information

                Journal
                J Exp Med
                J. Exp. Med
                jem
                jem
                The Journal of Experimental Medicine
                The Rockefeller University Press
                0022-1007
                1540-9538
                22 August 2016
                : 213
                : 9
                : 1819-1834
                Affiliations
                [1 ]Swiss Vaccine Research Institute, 1066 Epalinges, Switzerland
                [2 ]Division of Immunology and Allergy, Department of Medicine, Lausanne University Hospital, 1011 Lausanne, Switzerland
                [3 ]Division of Experimental Virology, Department of Biomedicine, University of Basel, 4003 Basel, Switzerland
                [4 ]Department of Pathology and Immunology, University of Geneva, 1211 Geneva, Switzerland
                [5 ]World Health Organization Collaborating Center for Vaccine Immunology, University of Geneva, 1211 Geneva, Switzerland
                [6 ]Ludwig Center for Cancer Research, University of Lausanne, 1015 Lausanne, Switzerland
                [7 ]Faculty of Biology and Medicine, Department of Oncology, University of Lausanne, 1015 Lausanne, Switzerland
                [8 ]Bioinformatics Core Facility, SIB Swiss Institute of Bioinformatics, 1015 Lausanne, Switzerland
                Author notes
                Correspondence to Dietmar Zehn: dietmar.zehn@ 123456tum.de

                D.T. Utzschneider’s present address is Dept. of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA 92093.

                F. Alfei, P. Roelli, and D. Zehn’s present address is Division of Animal Physiology and Immunology, School of Life Sciences Weihenstephan, Technical University of Munich, 85354 Freising, Germany.

                Author information
                http://orcid.org/0000-0003-2205-9057
                http://orcid.org/0000-0001-8985-4704
                http://orcid.org/0000-0003-0014-3274
                http://orcid.org/0000-0002-0817-0472
                Article
                20150598
                10.1084/jem.20150598
                4995073
                27455951
                74ef7b87-aa23-489e-ad1a-a7290ff39d30
                © 2016 Utzschneider et al.

                This article is distributed under the terms of an Attribution–Noncommercial–Share Alike–No Mirror Sites license for the first six months after the publication date (see http://www.rupress.org/terms). After six months it is available under a Creative Commons License (Attribution–Noncommercial–Share Alike 3.0 Unported license, as described at http://creativecommons.org/licenses/by-nc-sa/3.0/).

                History
                : 01 April 2015
                : 13 June 2016
                Funding
                Funded by: Swiss National Science Foundation http://dx.doi.org/10.13039/501100001711
                Award ID: CRSII3-141789
                Award ID: PP00P3_144883
                Award ID: PP00P3_135442/1
                Award ID: 310030_149340/1
                Funded by: European Research Council http://dx.doi.org/10.13039/501100000781
                Award ID: 337043-ProtecTC
                Categories
                Research Articles
                Article

                Medicine
                Medicine

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