T cell memory relies on the generation of antigen-specific progenitors with stem-like properties.However, the identity of these progenitors has remained unclear, precluding a full understanding of the differentiation trajectories that underpin the heterogeneity of antigen-experienced T cells.We used a systematic approach guided by single-cell RNA sequencing data to map the organizational structure of the human CD8 + memory T cell pool under physiological conditions. We identified two previously unrecognized subsets of clonally, epigenetically, functionally, phenotypically, and transcriptionally distinct stem-like CD8 + memory T cells. Progenitors lacking the inhibitory receptors programmed death-1 (PD-1) and T cell immunoreceptor with Ig and ITIM domains (TIGIT) were committed to a functional lineage, whereas progenitors expressing PD-1 and TIGIT were committed to a dysfunctional, exhausted-like lineage.Collectively, these data revealed the existence of parallel differentiation programs in the human CD8 + memory T cell pool, with potentially broad implications for the development of immunotherapies and vaccines. 3 MAIN TEXTAntigen recognition by CD8 + naive T cells initiates a program of clonal expansion and effector differentiation that leads to the clearance of infected or malignant cells and the subsequent formation of heterogeneous memory populations that confer durable immunity 1 . These memory populations are thought to be organized in a developmental hierarchy, according to which stem cell memory T (TSCM) cells self-renew and generate long-lived central memory T (TCM) cells and short-lived effector memory T (TEM) cells 2-6 . However, the mechanisms that underlie the enhanced multipotency of TSCM cells relative to TCM cells have not been clearly defined in molecular terms 7 .Memory T cell differentiation can become corrupted under conditions of persistent antigenic stimulation, as observed during chronic viral infections and progressive malignancies, which promote a state of T cell exhaustion, characterized by an orderly loss of effector functions, impaired proliferation, and the upregulation of inhibitory receptors 8 . This dynamic process occurs over a period of weeks after the initial priming event 9,10 and involves the genome-wide accumulation of epigenetic modifications 11,12 . Recent studies have shown that exhausted T (TEX) cell populations are developmentally and functionally heterogeneous, incorporating stem-like progenitors that express T cell factor 1 (TCF1) which give rise to highly differentiated TEX cells that are constitutively dysfunctional and lack TCF1 [13][14][15][16] . Importantly, the therapeutic benefits of immune checkpoint blockade in the context of chronic viral infections and various cancers are thought to operate via these TCF1 + progenitors, which appear susceptible to interventions that specifically target the inhibitory receptor programmed death-1 (PD-1) 13,15,17-20 .
Key Points• T SCM are abundant early after allogeneic hematopoietic stem cell transplantation and derive from naive T cells that survived pt-Cy.• Pt-Cy allows the generation of donor primary and recall responses in transplanted patients, even in the presence of persistent antigen.Early T-cell reconstitution following allogeneic transplantation depends on the persistence and function of T cells that are adoptively transferred with the graft. Posttransplant cyclophosphamide (pt-Cy) effectively prevents alloreactive responses from unmanipulated grafts, but its effect on subsequent immune reconstitution remains undetermined.Here, we show that T memory stem cells (T SCM ), which demonstrated superior reconstitution capacity in preclinical models, are the most abundant circulating T-cell population in the early days following haploidentical transplantation combined with pt-Cy and precede the expansion of effector cells. Transferred naive, but not T SCM or conventional memory cells preferentially survive cyclophosphamide, thus suggesting that posttransplant T SCM originate from naive precursors. Moreover, donor naive T cells specific for exogenous and self/tumor antigens persist in the host and contribute to peripheral reconstitution by differentiating into effectors. Similarly, pathogen-specific memory T cells generate detectable recall responses, but only in the presence of the cognate antigen. We thus define the cellular basis of T-cell reconstitution following pt-Cy at the antigen-specific level and propose to explore naive-derived T SCM in the clinical setting to overcome immunodeficiency. These trials were registered at www.clinicaltrials.gov as #NCT02049424 and #NCT02049580. (Blood. 2015;125(18):2855-2864
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