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ResearchIn-Press PreviewImmunologyInfectious disease Open Access | 10.1172/JCI200628

CXCR6+CD127– Tr1 cells balance immunity and persistence in Plasmodium falciparum infection

Jason Nideffer,1 Florian Bach,1 Steven Strubbe,2 Luis Lopez,1 Maato Zedi,3 Felistas Nankya,3 Jessica Briggs,4 Kattria van der Ploeg,1 Kenneth Musinguzi,3 Soyeon Kim,1 Aracely Garcia Romero,1 Arefin Keya,4 Kylie Camanag,1 Savannah Lewis,1 Muhammad Abdelbasset,1 Bing Wang,2 Allison Boss,2 Evelyn Nansubuga,3 Joaniter I. Nankabirwa,3 Emmanuel Arinaitwe,3 Saki Takahashi,5 Grant Dorsey,4 Bryan Greenhouse,4 Isabel Rodriguez-Barraquer,4 Moses R. Kamya,3 Rosa Bacchetta,2 Isaac Ssewanyana,3 Ashraful Haque,6 Maria Grazia Roncarolo,2 and Prasanna Jagannathan1

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Nideffer, J. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Bach, F. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Strubbe, S. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Lopez, L. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Zedi, M. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Nankya, F. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Briggs, J. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by van der Ploeg, K. in: PubMed | Google Scholar |

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Kim, S. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Garcia Romero, A. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Keya, A. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Lewis, S. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Abdelbasset, M. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Wang, B. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Boss, A. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Takahashi, S. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Dorsey, G. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Greenhouse, B. in: PubMed | Google Scholar |

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Rodriguez-Barraquer, I. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

Find articles by Kamya, M. in: PubMed | Google Scholar

1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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1Department of Medicine, Stanford University, Stanford, United States of America

2Division of Hematology, Oncology, Stem Cell Transplantation and Regenerativ, Stanford University, Stanford, United States of America

3Infectious Diseases Research Collaboration, Kampala, Uganda

4Department of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States of America

5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

6Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Parkville, Australia

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Published May 5, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI200628.
Copyright © 2026, Nideffer et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published May 5, 2026 - Version history
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Abstract

Plasmodium falciparum (Pf) induces the clonal expansion of antigen-specific type 1 regulatory T (Tr1) cells capable of long-term memory. Tr1 cells comprise nearly 90% of the Pf blood stage antigen-specific CD4+ T cell pool in children. Though, whether Tr1 cells contribute to protection from malaria remains undetermined. To address this critical knowledge gap, we first performed scRNA-seq on gated cell populations and validated CXCR6+ CD127- as new phenotypic markers to enrich for bona-fide Tr1 cells. Importantly, these Tr1 cells potently suppressed the proliferation of other CD4+ T cells in vitro via IL-10 secretion. Among children living in malaria-endemic Uganda, CXCR6+ CD127- Tr1 cells were the dominant responding subset to Pf-infected red blood cell stimulation in vitro. They also rapidly expanded following malaria and expressed IL-10 and IFNγ during infection in vivo. Tr1 abundance correlated with plasma concentrations of granzyme A, IFNγ, IL-10, and LAG3, suggesting that these cells act systemically. Higher CXCR6+ CD127- Tr1 cell frequencies correlated with a lower probability of symptoms given parasitemia but were also associated with delayed parasite clearance among untreated, asymptomatic children. These data suggest that Tr1 cells help mediate clinical immunity to malaria but may also facilitate parasite persistence through mechanisms of immune regulation.

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