Mitochondrial stress induced by continuous stimulation under hypoxia rapidly drives T cell exhaustion

NE Scharping, DB Rivadeneira, AV Menk… - Nature …, 2021 - nature.com
NE Scharping, DB Rivadeneira, AV Menk, PDA Vignali, BR Ford, NL Rittenhouse, R Peralta…
Nature immunology, 2021nature.com
Cancer and chronic infections induce T cell exhaustion, a hypofunctional fate carrying
distinct epigenetic, transcriptomic and metabolic characteristics. However, drivers of
exhaustion remain poorly understood. As intratumoral exhausted T cells experience severe
hypoxia, we hypothesized that metabolic stress alters their responses to other signals,
specifically, persistent antigenic stimulation. In vitro, although CD8+ T cells experiencing
continuous stimulation or hypoxia alone differentiated into functional effectors, the …
Abstract
Cancer and chronic infections induce T cell exhaustion, a hypofunctional fate carrying distinct epigenetic, transcriptomic and metabolic characteristics. However, drivers of exhaustion remain poorly understood. As intratumoral exhausted T cells experience severe hypoxia, we hypothesized that metabolic stress alters their responses to other signals, specifically, persistent antigenic stimulation. In vitro, although CD8+ T cells experiencing continuous stimulation or hypoxia alone differentiated into functional effectors, the combination rapidly drove T cell dysfunction consistent with exhaustion. Continuous stimulation promoted Blimp-1-mediated repression of PGC-1α-dependent mitochondrial reprogramming, rendering cells poorly responsive to hypoxia. Loss of mitochondrial function generated intolerable levels of reactive oxygen species (ROS), sufficient to promote exhausted-like states, in part through phosphatase inhibition and the consequent activity of nuclear factor of activated T cells. Reducing T cell–intrinsic ROS and lowering tumor hypoxia limited T cell exhaustion, synergizing with immunotherapy. Thus, immunologic and metabolic signaling are intrinsically linked: through mitigation of metabolic stress, T cell differentiation can be altered to promote more functional cellular fates.
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