A liver immune rheostat regulates CD8 T cell immunity in chronic HBV infection

  • Nature. 2024 Jul;631(8022):867-875. doi: 10.1038/s41586-024-07630-7.
Miriam Bosch  #  1 ,  Nina Kallin  #  1 ,  Sainitin Donakonda  1 ,  Jitao David Zhang  2 ,  Hannah Wintersteller  1 ,  Silke Hegenbarth  1 ,  Kathrin Heim  3 ,  Carlos Ramirez  4 ,  Anna Fürst  1 ,  Elias Isaac Lattouf  5 ,  Martin Feuerherd  5 ,  Sutirtha Chattopadhyay  1 ,  Nadine Kumpesa  2 ,  Vera Griesser  2 ,  Jean-Christophe Hoflack  2 ,  Juliane Siebourg-Polster  2 ,  Carolin Mogler  6 ,  Leo Swadling  7 ,  Laura J Pallett  7 ,  Philippa Meiser  1 ,  Katrin Manske  1 ,  Gustavo P de Almeida  8 ,  Anna D Kosinska  9  10  11 ,  Ioana Sandu  12 ,  Annika Schneider  1 ,  Vincent Steinbacher  1 ,  Yan Teng  9 ,  Julia Schnabel  13 ,  Fabian Theis  14 ,  Adam J Gehring  15  16 ,  Andre Boonstra  17 ,  Harry L A Janssen  17  18 ,  Michiel Vandenbosch  19 ,  Eva Cuypers  19 ,  Rupert Öllinger  20 ,  Thomas Engleitner  20 ,  Roland Rad  20 ,  Katja Steiger  21 ,  Annette Oxenius  12 ,  Wan-Lin Lo  22 ,  Victoria Klepsch  23 ,  Gottfried Baier  23 ,  Bernhard Holzmann  24 ,  Mala K Maini  6 ,  Ron Heeren  19 ,  Peter J Murray  25 ,  Robert Thimme  3 ,  Carl Herrmann  4  5 ,  Ulrike Protzer  8  9  10 ,  Jan P Böttcher  1 ,  Dietmar Zehn  8 ,  Dirk Wohlleber  1 ,  Georg M Lauer  5 ,  Maike Hofmann  3 ,  Souphalone Luangsay  2 ,  Percy A Knolle  26  27  28
Affiliations
  • 1. Institute of Molecular Immunology, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
  • 2. Roche Pharmaceutical Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland.
  • 3. Third Department of Medicine, University Hospital Freiburg, Freiburg, Germany.
  • 4. Health Data Science Unit, Biomedical Genomics Group, Bioquant, Faculty of Medicine Heidelberg, Heidelberg, Germany.
  • 5. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • 6. Institute of Pathology, School of Medicine and Health, TUM, Munich, Germany.
  • 7. Division of Infection and Immunity, Institute of Immunity and Transplantation, University College London, London, UK.
  • 8. Institute of Immunology and Animal Physiology, School of Life Science, TUM, Munich, Germany.
  • 9. Institute of Virology, School of Medicine and Health, TUM, Munich, Germany.
  • 10. Helmholtz Zentrum München, Munich, Germany.
  • 11. German Center for Infection Research, Munich site, Munich, Germany.
  • 12. Institute of Microbiology, ETH Zürich, Zürich, Switzerland.
  • 13. Institute of Machine Learning and Biomedical Imaging, Helmholtz Zentrum Munich, Munich, Germany.
  • 14. Institute of Computational Biology, TUM, Munich, Germany.
  • 15. Toronto Centre for Liver Disease and Toronto General Hospital Research Institute, Toronto, Ontario, Canada.
  • 16. Department of Immunology, University of Toronto, Toronto, Ontario, Canada.
  • 17. Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • 18. Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • 19. Institute of Multimodal Imaging, University of Maastricht, Maastricht, The Netherlands.
  • 20. Institute of Molecular Oncology and Functional Genomics, School of Medicine and Health, TUM, Munich, Germany.
  • 21. Comparative Experimental Pathology, School of Medicine and Health, TUM, Munich, Germany.
  • 22. Department of Pathology, University of Utah, Salt Lake City, UT, USA.
  • 23. Institute of Cell Genetics, Medical University of Innsbruck, Innsbruck, Austria.
  • 24. Department of Surgery, School of Medicine and Health, TUM, Munich, Germany.
  • 25. Max Planck Institute of Biochemistry, Martinsried, Munich, Germany.
  • 26. Institute of Molecular Immunology, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany. [email protected].
  • 27. German Center for Infection Research, Munich site, Munich, Germany. [email protected].
  • 28. Institute of Molecular Immunology, School of Life Science, TUM, Munich, Germany. [email protected].
  • # Contributed equally.
Abstract

Chronic hepatitis B virus (HBV) Infection affects 300 million patients worldwide1,2, in whom virus-specific CD8 T cells by still ill-defined mechanisms lose their function and cannot eliminate HBV-infected hepatocytes3-7. Here we demonstrate that a liver immune rheostat renders virus-specific CD8 T cells refractory to activation and leads to their loss of effector functions. In preclinical models of persistent Infection with hepatotropic viruses such as HBV, dysfunctional virus-specific CXCR6+ CD8 T cells accumulated in the liver and, as a characteristic hallmark, showed enhanced transcriptional activity of cAMP-responsive element modulator (CREM) distinct from T cell exhaustion. In patients with chronic hepatitis B, circulating and intrahepatic HBV-specific CXCR6+ CD8 T cells with enhanced CREM expression and transcriptional activity were detected at a frequency of 12-22% of HBV-specific CD8 T cells. Knocking out the inhibitory CREM/ICER isoform in T cells, however, failed to rescue T cell immunity. This indicates that CREM activity was a consequence, rather than the cause, of loss in T cell function, further supported by the observation of enhanced phosphorylation of protein kinase A (PKA) which is upstream of CREM. Indeed, we found that enhanced cAMP-PKA-signalling from increased T cell adenylyl cyclase activity augmented CREM activity and curbed T cell activation and effector function in persistent hepatic Infection. Mechanistically, CD8 T cells recognizing their antigen on hepatocytes established close and extensive contact with liver sinusoidal endothelial cells, thereby enhancing adenylyl cyclase-cAMP-PKA signalling in T cells. In these hepatic CD8 T cells, which recognize their antigen on hepatocytes, phosphorylation of key signalling Kinases of the T cell receptor signalling pathway was impaired, which rendered them refractory to activation. Thus, close contact with liver sinusoidal endothelial cells curbs the activation and effector function of HBV-specific CD8 T cells that target hepatocytes expressing viral Antigens by means of the adenylyl cyclase-cAMP-PKA axis in an immune rheostat-like fashion.

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