[HTML][HTML] Targeting human Acyl-CoA: cholesterol acyltransferase as a dual viral and T cell metabolic checkpoint

NM Schmidt, PAC Wing, MO Diniz, LJ Pallett… - Nature …, 2021 - nature.com
NM Schmidt, PAC Wing, MO Diniz, LJ Pallett, L Swadling, JM Harris, AR Burton…
Nature Communications, 2021nature.com
Determining divergent metabolic requirements of T cells, and the viruses and tumours they
fail to combat, could provide new therapeutic checkpoints. Inhibition of acyl-CoA: cholesterol
acyltransferase (ACAT) has direct anti-carcinogenic activity. Here, we show that ACAT
inhibition has antiviral activity against hepatitis B (HBV), as well as boosting protective anti-
HBV and anti-hepatocellular carcinoma (HCC) T cells. ACAT inhibition reduces CD8+ T cell
neutral lipid droplets and promotes lipid microdomains, enhancing TCR signalling and TCR …
Abstract
Determining divergent metabolic requirements of T cells, and the viruses and tumours they fail to combat, could provide new therapeutic checkpoints. Inhibition of acyl-CoA:cholesterol acyltransferase (ACAT) has direct anti-carcinogenic activity. Here, we show that ACAT inhibition has antiviral activity against hepatitis B (HBV), as well as boosting protective anti-HBV and anti-hepatocellular carcinoma (HCC) T cells. ACAT inhibition reduces CD8+ T cell neutral lipid droplets and promotes lipid microdomains, enhancing TCR signalling and TCR-independent bioenergetics. Dysfunctional HBV- and HCC-specific T cells are rescued by ACAT inhibitors directly ex vivo from human liver and tumour tissue respectively, including tissue-resident responses. ACAT inhibition enhances in vitro responsiveness of HBV-specific CD8+ T cells to PD-1 blockade and increases the functional avidity of TCR-gene-modified T cells. Finally, ACAT regulates HBV particle genesis in vitro, with inhibitors reducing both virions and subviral particles. Thus, ACAT inhibition provides a paradigm of a metabolic checkpoint able to constrain tumours and viruses but rescue exhausted T cells, rendering it an attractive therapeutic target for the functional cure of HBV and HBV-related HCC.
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