Serotonin Reduction in Post-acute Sequelae of Viral Infection

Post-acute sequelae of COVID-19 (PASC, Long COVID ) pose a significant global health challenge. The pathophysiology is unknown, and no effective treatments have been found to date. Several hypotheses have been formulated to explain the etiology of PASC, including viral persistence, chronic inflammation, hypercoagulability, and autonomic dysfunction. Here, we propose a mechanism that links all four hypotheses in a single pathway and provides actionable insights for therapeutic interventions. We find that PASC are associated with serotonin reduction. Viral infection and type I interferon-driven inflammation reduce serotonin through three mechanisms: diminished intestinal absorption of the serotonin precursor tryptophan; platelet hyperactivation and thrombocytopenia, which impacts serotonin storage; and enhanced MAO-mediated serotonin turnover. Peripheral serotonin reduction, in turn, impedes the activity of the vagus nerve and thereby impairs hippocampal responses and memory. These findings provide a possible explanation for neurocognitive symptoms associated with viral persistence in Long COVID, which may extend to other post-viral syndromes

Implication of IL-2 and IL-15 in the exhaustion of CD8+ T cells during a chronic viral infection

L’épuisement des lymphocytes T CD8+ (LT CD8) est une voie de différentiation unique survenant lors de contextes pathologiques particuliers ayant en commun la persistance d’antigènes dans l’hôte, tel que les infections virales chroniques (expl : VIH, hépatites B et C) et différents types de cancers. Il apparait aujourd’hui très clairement que ce mécanisme est à l’origine de l’échec de l’immunité adaptative face à ces pathologies particulièrement néfastes pour l’homme. L’étude de ce processus a mené à la découverte de cible thérapeutiques d’un grand intérêt (« immune checkpoints ») pouvant être ciblées pour corriger et/ou reverser l’épuisement. Les essais thérapeutiques ayant découlés de ces découvertes ont donné des résultats extrêmement prometteurs dans le traitement de plusieurs cancers. Cependant, bien que ces thérapies ciblées permettent un regain temporaire de la fonction des LT CD8+, elles ne permettent pas d’inverser le processus d’épuisement. Il est donc crucial aujourd’hui de se tourner vers les agents causateurs de cet état d’épuisement qui restent très méconnues à ce jour. La famille de cytokines partageant la chaine commune gamma (cytokines gamma c) comprenant l’IL-2 -4 -7 -9 -15 et -21 sont des acteurs solubles clés de l’immunité adaptative. Ces cytokines sont intimement liées aux processus de développement, d’homéostasie, de différenciation et de maintenance des lymphocytes T. Parmi elles, l’IL-2 et l’IL-15 ont un rôle majeur dans le processus de différenciation des LT CD8+ au cours d’une infection virale aigue. Malgré cela, l’implication de ces cytokines dans l’épuisement des LT CD8+ dans un contexte d’infection virale chronique n’a jamais été investiguée. En se basant sur les connaissances actuelles des rôles de l’IL-2 et de l’IL-15 sur la différenciation des LT CD8+ au cours d’une infection virale aigue, nous avons émis l’hypothèse que ces cytokines pourraient promouvoir l’épuisement dans un contexte d’infection virale chronique. Dans un premier temps, nous avons démontré chez l’homme (patients atteints d’hépatite C chronique) et la souris (modèle LCMV Clone 13) que la chaîne beta du récepteur à l’IL-2 (IL2R beta[CD122]) qui se lie à l’IL-2 et l’IL-15 reste sélectivement exprimée à la surface des LT CD8+ épuisés au cours d’une infection virale chronique. De plus, une expression élevée de cette chaîne de récepteur corrèle avec un épuisement plus sévère des LT CD8+ chez l’homme et la souris. En développant un modèle murin dans lequel les LT CD8+ sont déficients pour cette chaîne, nous avons démontré que l’IL-2 et IL-15 contrôlent plusieurs aspects clés du processus d’épuisement. Ces cytokines augmentent l’expression de plusieurs récepteurs inhibiteurs (caractéristiques de l’épuisement) et contrôlent même directement l’expression de certains d’entre eux (notamment 2B4 et TIM-3). L’IL-2 et l’IL-15 dirigent également la différenciation terminale des LT CD8+ vers un état d’épuisement extrême et abrogent de manière irréversible leur potentiel de différenciation en cellules mémoires. Nous montrons donc pour la première fois un rôle clé de l’IL-2 et l’IL-15 dans l’épuisement des LT CD8+ au cours d’une infection virale chronique. Dans un deuxième temps nous avons investigué les fonctions individuelles et redondantes de l’IL-2 et l’IL-15 dans l’épuisement des LT CD8+. Nous avons également déterminé les fenêtres d’actions déterminantes de ces cytokines et les mécanismes intracellulaires clés par lesquels elles contrôlent le processus d’épuisement. L’IL-2 et l’IL-15 coopèrent pour promouvoir l’expression de 2B4 et TIM-3 à la surface des LT CD8+ et ces cytokines semblent collaborer pour diriger leur différenciation terminale. En revanche, les signaux médiés par l’IL-2 pendant la phase de « priming » abrogent sélectivement leur potentiel de différenciation en cellules T centrales mémoires (Tcm) alors que l’IL-15 semble plutôt supprimer celle des T effecteurs mémoires (Tem) pendant la phase chronique. Pour finir, nous avons identifié la voie JAK3/STAT5 comme étant la principale voie intracellulaire par laquelle l’IL-2 et l’IL-15 dirigent l’épuisement des LT CD8+. Au cours de cette thèse, nous avons donc mis en évidence un nouveau rôle de l’IL-2 et l’IL-15 dans l’épuisement des LT CD8+ au cours d’une infection virale chronique. Nos résultats apportent une meilleure compréhension du processus d’épuisement des LT CD8+ et démontrent pour la première fois une implication des cytokines. Nous espérons que ces travaux contribueront à améliorer les stratégies thérapeutiques actuelles contre le cancer et les infections virales chroniques.CD8+ T cell exhaustion is a unique differentiation pathway which occurs during particular pathological contexts such as chronic viral infections (i.e. HIV, HCV and HBV) and cancers in which antigen (Ag) persists in the host. It appears clear now that this mechanism provokes the failure of adaptive responses against these pathologies and is particularly harmful to humans. The study of this process has led to the discovery of relevant molecules (“immune checkpoints”) that can be targeted to prevent and/or reverse exhaustion. Ensuing clinical trials have provided extremely promising results in the treatment of several cancers. However, although these targeted therapies allow a temporary regain of CD8+ T cell functions they still fail at reversing the exhaustion process. It is thus crucial to investigate the causative factors of such process that remain to be identified. The common gamma-chain (gamma c) family of cytokines which includes IL-2, -4, -7, -9, -15, and -21 are key soluble mediators involved in the development of adaptive immunity. These cytokines are intimately linked to T cell development, homeostasis, differentiation and maintenance. Among them, IL-2 and IL-15 display important functions on CD8+ T cell differentiation during an acute viral infection. However, impact of these cytokines on CD8+ T cell responses during a chronic viral infection remains to be investigated. Based on current knowledge of the functions of IL-2 and IL-15 on CD8+ T cell differentiation during an acute viral infection, we hypothesized that these cytokines promote CD8+ T cell exhaustion during a chronic viral infection. We first demonstrate in a mouse model of chronic viral infection (LCMV clone 13) and patients with chronic HCV that the IL-2-receptor beta chain (IL2R beta [CD122]) a cytokine receptor chain which binds to both IL-2 and IL-15 is selectively expressed on exhausted CD8+ T cells during a chronic viral infection. The intensity of CD122 expression positively correlates with severe exhaustion of CD8+ T cells in mice and humans. Using a mouse model in which CD8+ T cells lack the expression of the IL2R beta-chain, we demonstrate that IL-2 and IL-15 control several aspects of exhaustion. IL-2 and IL-15-dependent signals sustain the expression of several inhibitory receptors (characteristic of exhaustion) on CD8+ T cells and directly control the expression of some of them (e.g. 2B4 and TIM-3). IL-2 and IL-15 also direct the terminal exhaustion of CD8+ T cells and irreversibly abrogate their developmental plasticity toward memory T cell development. Together, we show for the first time key functions of IL-2 and IL-15 in directing CD8+ T cell exhaustion during a chronic viral infection. Next, we investigated the unique and redundant functions of IL-2 and IL-15 on CD8+ T cell exhaustion. We also determined individual time-frames of these cytokines and intracellular pathways by which they control CD8+ T cell exhaustion. IL-2 and IL-15 cooperate to promote 2B4 and TIM-3 expression on CD8+ T cells, and these cytokines likely collaborate to direct terminal exhaustion. In contrast, IL-2-dependent signals during priming preclude subsequent differentiation into central memory cells (Tcm) while prolonged exposure to IL-15 upon viral persistence likely suppresses effector memory cell (Tem) developmental potential. Finally, we demonstrate that the JAK3/STAT5 pathway is the dominant pathway by which IL-2 and IL-15 direct CD8+ T cell exhaustion. This thesis provides evidence of novel functions of IL-2 and IL-15 in directing CD8+ T cell exhaustion during a chronic viral infection. These results increase our understanding of the CD8+ T cell exhaustion process and demonstrate for the first time the involvement of cytokines. We hope that this work will contribute to the improvement of actual therapeutic strategies against chronic viral infections and cancers

IL2Rβ-dependent signals drive terminal exhaustion and suppress memory development during chronic viral infection.

International audienceExhaustion of CD8(+) T cells severely impedes the adaptive immune response to chronic viral infections. Despite major advances in our understanding of the molecular regulation of exhaustion, the cytokines that directly control this process during chronicity remain unknown. We demonstrate a direct impact of IL-2 and IL-15, two common gamma-chain-dependent cytokines, on CD8(+) T-cell exhaustion. Common to both cytokine receptors, the IL-2 receptor β (IL2Rβ) chain is selectively maintained on CD8(+) T cells during chronic lymphocytic choriomeningitis virus and hepatitis C virus infections. Its expression correlates with exhaustion severity and identifies terminally exhausted CD8(+) T cells both in mice and humans. Genetic ablation of the IL2Rβ chain on CD8(+) T cells restrains inhibitory receptor induction, in particular 2B4 and Tim-3; precludes terminal differentiation of highly defective PD-1(hi) effectors; and rescues memory T-cell development and responsiveness to IL-7-dependent signals. Together, we ascribe a previously unexpected role to IL-2 and IL-15 as instigators of CD8(+) T-cell exhaustion during chronic viral infection

Inhibitory signaling sustains a distinct early memory CD8 + T cell precursor that is resistant to DNA damage

International audienceThe developmental origins of memory T cells remain incompletely understood. During the expansion phase of acute viral infection, we identified a distinct subset of virus-specific CD8 + T cells that possessed distinct characteristics including expression of CD62L, T cell factor 1 (TCF-1), and Eomesodermin; relative quiescence; expression of activation markers; and features of limited effector differentiation. These cells were a quantitatively minor subpopulation of the TCF-1 + pool and exhibited self-renewal, heightened DNA damage surveillance activity, and preferential long-term recall capacity. Despite features of memory and somewhat restrained proliferation during the expansion phase, this subset displayed evidence of stronger TCR signaling than other responding CD8 + T cells, coupled with elevated expression of multiple inhibitory receptors including programmed cell death 1 (PD-1), lymphocyte activating gene 3 (LAG-3), cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), CD5, and CD160. Genetic ablation of PD-1 and LAG-3 compromised the formation of this CD62L hi TCF-1 + subset and subsequent CD8 + T cell memory. Although central memory phenotype CD8 + T cells were formed in the absence of these cells, subsequent memory CD8 + T cell recall responses were compromised. Together, these results identify an impor tant link between genome integrity maintenance and CD8 + T cell memory. Moreover, the data indicate a role for inhibitory receptors in preserving key memory CD8 + T cell precursors during initial activation and differentiation. Identification of this rare subpopulation within the memory CD8 + T cell precursor pool may help reconcile models of the developmental origin of long-term CD8 + T cell memory

MicroRNA-29a attenuates CD8 T cell exhaustion and induces memory-like CD8 T cells during chronic infection.

CD8 T cells mediate protection against intracellular pathogens and tumors. However, persistent antigen during chronic infections or cancer leads to T cell exhaustion, suboptimal functionality, and reduced protective capacity. Despite considerable work interrogating the transcriptional regulation of exhausted CD8 T cells (TEX), the posttranscriptional control of TEX remains poorly understood. Here, we interrogated the role of microRNAs (miRs) in CD8 T cells responding to acutely resolved or chronic viral infection and identified miR-29a as a key regulator of TEX. Enforced expression of miR-29a improved CD8 T cell responses during chronic viral infection and antagonized exhaustion. miR-29a inhibited exhaustion-driving transcriptional pathways, including inflammatory and T cell receptor signaling, and regulated ribosomal biogenesis. As a result, miR-29a fostered a memory-like CD8 T cell differentiation state during chronic infection. Thus, we identify miR-29a as a key regulator of TEX and define mechanisms by which miR-29a can divert exhaustion toward a more beneficial memory-like CD8 T cell differentiation state

TCF-1-Centered Transcriptional Network Drives an Effector versus Exhausted CD8 T Cell-Fate Decision

TCF-1 is a key transcription factor in progenitor exhausted CD8 T cells (Tex). Moreover, this Tex cell subset mediates responses to PD-1 checkpoint pathway blockade. However, the role of the transcription factor TCF-1 in early fate decisions and initial generation of Tex cells is unclear. Single-cell RNA sequencing (scRNA-seq) and lineage tracing identified a TCF-1+Ly108+PD-1+ CD8 T cell population that seeds development of mature Tex cells early during chronic infection. TCF-1 mediated the bifurcation between divergent fates, repressing development of terminal KLRG1Hi effectors while fostering KLRG1Lo Tex precursor cells, and PD-1 stabilized this TCF-1+ Tex precursor cell pool. TCF-1 mediated a T-bet-to-Eomes transcription factor transition in Tex precursors by promoting Eomes expression and drove c-Myb expression that controlled Bcl-2 and survival. These data define a role for TCF-1 in early-fate-bifurcation-driving Tex precursor cells and also identify PD-1 as a protector of this early TCF-1 subset. [Display omitted] •scRNA-seq defines an effector versus exhausted Tex cell-fate decision•TCF-1 plays a central role in initially establishing Tex precursor cells•PD-1 supports the TCF-1+ Tex precursor cells at early phase of chronic infection•Eomes and c-Myb play key roles in Tex cell persistence downstream of TCF-1 The initiation of the T cell exhaustion program remains poorly understood. In this study, Chen et al. define an effector (Teff) versus exhausted (Tex) CD8 T cell binary-fate decision during chronic infection and find that TCF-1 supports the Tex precursor development by antagonizing Teff-like cell differentiation through multiple transcription factors