1 3373 129 HISTONE MODULATION BLOCKS TREG-INDUCED FOXP3 BINDING TO THE IL-2 PROMOTER OF VIRUS-SPECIFIC CD8(+) T CELLS FROM FELINE IMMUNODEFICIENCY VIRUS-INFECTED CATS. CD8(+) T CELLS ARE CRITICAL FOR CONTROLLING HIV INFECTION. DURING THE CHRONIC PHASE OF LENTIVIRAL INFECTION, CD8(+) T CELLS LOSE THEIR PROLIFERATIVE CAPACITY AND EXHIBIT IMPAIRED ANTIVIRAL FUNCTION. THIS LOSS OF CD8(+) T CELL FUNCTION IS DUE, IN PART, TO CD4(+)CD25(+) T REGULATORY (TREG) CELL-MEDIATED SUPPRESSION. OUR RESEARCH GROUP HAS DEMONSTRATED THAT LENTIVIRUS-ACTIVATED CD4(+)CD25(+) TREG CELLS INDUCE THE REPRESSIVE TRANSCRIPTION FACTOR FORKHEAD BOX P3 (FOXP3) IN AUTOLOGOUS CD8(+) T CELLS FOLLOWING CO-CULTURE. WE HAVE RECENTLY REPORTED THAT TREG-INDUCED FOXP3 BINDS THE INTERLEUKIN-2 (IL-2), INTERFERON-GAMMA (IFN- GAMMA), AND TUMOR NECROSIS FACTOR-ALPHA (TNF-ALPHA) PROMOTERS IN VIRUS-SPECIFIC CD8(+) T CELLS. THESE DATA SUGGEST AN IMPORTANT ROLE OF FOXP3-MEDIATED CD8(+) T CELL DYSFUNCTION IN LENTIVIRAL INFECTION. TO ELUCIDATE THE MECHANISM OF THIS SUPPRESSION, WE PREVIOUSLY REPORTED THAT DECREASED METHYLATION FACILITATES FOXP3 BINDING IN MITOGEN-ACTIVATED CD8(+) T CELLS FROM FELINE IMMUNODEFICIENCY VIRUS (FIV)-INFECTED CATS. WE DEMONSTRATED THE REDUCED BINDING OF FOXP3 TO THE IL-2 PROMOTER BY INCREASING METHYLATION OF CD8(+) T CELLS. IN THE STUDIES PRESENTED HERE, WE ASK IF ANOTHER FORM OF EPIGENETIC MODULATION MIGHT ALLEVIATE FOXP3-MEDIATED SUPPRESSION IN CD8(+) T CELLS. WE HYPOTHESIZED THAT DECREASING HISTONE ACETYLATION IN VIRUS-SPECIFIC CD8(+) T CELLS WOULD DECREASE TREG-INDUCED FOXP3 BINDING TO THE IL-2 PROMOTER. INDEED, USING ANACARDIC ACID (AA), A KNOWN HISTONE ACETYL TRANSFERASE (HAT) INHIBITOR, WE DEMONSTRATE A REDUCTION IN FOXP3 BINDING TO THE IL-2 PROMOTER IN VIRUS-SPECIFIC CD8(+) T CELLS CO-CULTURED WITH AUTOLOGOUS TREG CELLS. THESE DATA IDENTIFY A NOVEL MECHANISM OF FOXP3-MEDIATED CD8(+) T CELL DYSFUNCTION DURING LENTIVIRAL INFECTION. 2018 2 4567 33 MYELOID-DERIVED SUPPRESSOR CELL FUNCTION AND EPIGENETIC EXPRESSION EVOLVES OVER TIME AFTER SURGICAL SEPSIS. BACKGROUND: SEPSIS IS AN INCREASINGLY SIGNIFICANT CHALLENGE THROUGHOUT THE WORLD AS ONE OF THE MAJOR CAUSES OF PATIENT MORBIDITY AND MORTALITY. CENTRAL TO THE HOST IMMUNOLOGIC RESPONSE TO SEPSIS IS THE INCREASE IN CIRCULATING MYELOID-DERIVED SUPPRESSOR CELLS (MDSCS), WHICH HAVE BEEN DEMONSTRATED TO BE PRESENT AND INDEPENDENTLY ASSOCIATED WITH POOR LONG-TERM CLINICAL OUTCOMES. MDSCS ARE PLASTIC CELLS AND POTENTIALLY MODIFIABLE, PARTICULARLY THROUGH EPIGENETIC INTERVENTIONS. THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE HOW THE SUPPRESSIVE PHENOTYPE OF MDSCS EVOLVES AFTER SEPSIS IN SURGICAL ICU PATIENTS, AS WELL AS TO IDENTIFY EPIGENETIC DIFFERENCES IN MDSCS THAT MAY EXPLAIN THESE CHANGES. METHODS: CIRCULATING MDSCS FROM 267 SURVIVORS OF SURGICAL SEPSIS WERE PHENOTYPED AT VARIOUS INTERVALS OVER 6 WEEKS, AND HIGHLY ENRICHED MDSCS FROM 23 OF THESE SAMPLES WERE CO-CULTURED WITH CD3/CD28-STIMULATED AUTOLOGOUS T CELLS. MICRORNA EXPRESSION FROM ENRICHED MDSCS WAS ALSO IDENTIFIED. RESULTS: WE OBSERVED THAT MDSC NUMBERS REMAIN SIGNIFICANTLY ELEVATED IN HOSPITALIZED SEPSIS SURVIVORS FOR AT LEAST 6 WEEKS AFTER THEIR INFECTION. HOWEVER, ONLY MDSCS OBTAINED AT AND BEYOND 14 DAYS POST-SEPSIS SIGNIFICANTLY SUPPRESSED T LYMPHOCYTE PROLIFERATION AND IL-2 PRODUCTION. THESE SAME MDSCS DISPLAYED UNIQUE EPIGENETIC (MIRNA) EXPRESSION PATTERNS COMPARED TO EARLIER TIME POINTS. CONCLUSIONS: WE CONCLUDE THAT IN SEPSIS SURVIVORS, IMMATURE MYELOID CELL NUMBERS ARE INCREASED BUT THE IMMUNE SUPPRESSIVE FUNCTION SPECIFIC TO MDSCS DEVELOPS OVER TIME, AND THIS IS ASSOCIATED WITH A SPECIFIC EPIGENOME. THESE FINDINGS MAY EXPLAIN THE CHRONIC AND PERSISTENT IMMUNE SUPPRESSION SEEN IN THESE SUBJECTS. 2019 3 5908 32 TARGETED DE-METHYLATION OF THE FOXP3-TSDR IS SUFFICIENT TO INDUCE PHYSIOLOGICAL FOXP3 EXPRESSION BUT NOT A FUNCTIONAL TREG PHENOTYPE. CD4+ REGULATORY T CELLS (TREGS) ARE KEY MEDIATORS OF IMMUNOLOGICAL TOLERANCE AND PROMISING EFFECTOR CELLS FOR IMMUNO-SUPPRESSIVE ADOPTIVE CELLULAR THERAPY TO FIGHT AUTOIMMUNITY AND CHRONIC INFLAMMATION. THEIR FUNCTIONAL STABILITY IS CRITICAL FOR THEIR CLINICAL UTILITY AND HAS BEEN CORRELATED TO THE DEMETHYLATED STATE OF THE TSDR/CNS2 ENHANCER ELEMENT IN THE TREG LINEAGE TRANSCRIPTION FACTOR FOXP3. HOWEVER, PROOF FOR A CAUSAL CONTRIBUTION OF THE TSDR DE-METHYLATION TO FOXP3 STABILITY AND TREG INDUCTION IS SO FAR LACKING. WE HERE ESTABLISHED A POWERFUL TRANSIENT-TRANSFECTION CRISPR-CAS9-BASED EPIGENETIC EDITING METHOD FOR THE SELECTIVE DE-METHYLATION OF THE TSDR WITHIN THE ENDOGENOUS CHROMATIN ENVIRONMENT OF A LIVING CELL. THE INDUCED DE-METHYLATED STATE WAS STABLE OVER WEEKS IN CLONAL T CELL PROLIFERATION CULTURES EVEN AFTER EXPRESSION OF THE EDITING COMPLEX HAD CEASED. EPIGENETIC EDITING OF THE TSDR RESULTED IN FOXP3 EXPRESSION, EVEN IN ITS PHYSIOLOGICAL ISOFORM DISTRIBUTION, PROVING A CAUSAL ROLE FOR THE DE-METHYLATED TSDR IN FOXP3 REGULATION. HOWEVER, SUCCESSFUL FOXP3 INDUCTION WAS NOT ASSOCIATED WITH A SWITCH TOWARDS A FUNCTIONAL TREG PHENOTYPE, IN CONTRAST TO WHAT HAS BEEN REPORTED FROM FOXP3 OVEREXPRESSION APPROACHES. THUS, TSDR DE-METHYLATION IS REQUIRED, BUT NOT SUFFICIENT FOR A STABLE TREG PHENOTYPE INDUCTION. THEREFORE, TARGETED DEMETHYLATION OF THE TSDR MAY BE A CRITICAL ADDITION TO PUBLISHED IN VITRO TREG INDUCTION PROTOCOLS WHICH SO FAR LACK FOXP3 STABILITY. 2020 4 4664 31 NEW IMMUNE HORIZONS IN THERAPEUTICS AND DIAGNOSTIC APPROACHES TO PREECLAMPSIA. HYPERTENSIVE DISORDERS OF PREGNANCY (HDP) ARE ONE OF THE COMMONEST MALADIES, AFFECTING 5%-10% OF PREGNANCIES WORLDWIDE. THE AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS (ACOG) IDENTIFIES FOUR CATEGORIES OF HDP, NAMELY GESTATIONAL HYPERTENSION (GH), PREECLAMPSIA (PE), CHRONIC HYPERTENSION (CH), AND CH WITH SUPERIMPOSED PE. PE IS A MULTISYSTEM, HETEROGENEOUS DISORDER THAT ENCOMPASSES 2%-8% OF ALL PREGNANCY-RELATED COMPLICATIONS, CONTRIBUTING TO ABOUT 9% TO 26% OF MATERNAL DEATHS IN LOW-INCOME COUNTRIES AND 16% IN HIGH-INCOME COUNTRIES. THESE TRANSLATE TO 50 000 MATERNAL DEATHS AND OVER 500 000 FETAL DEATHS WORLDWIDE, THEREFORE DEMANDING HIGH PRIORITY IN UNDERSTANDING CLINICAL PRESENTATION, SCREENING, DIAGNOSTIC CRITERIA, AND EFFECTIVE MANAGEMENT. PE IS ACCOMPANIED BY UTEROPLACENTAL INSUFFICIENCY LEADING TO VASCULAR AND METABOLIC CHANGES, VASOCONSTRICTION, AND END-ORGAN ISCHEMIA. PE IS DIAGNOSED AFTER 20 WEEKS OF PREGNANCY IN WOMEN WHO WERE PREVIOUSLY NORMOTENSIVE OR HYPERTENSIVE. BESIDES SHALLOW TROPHOBLAST INVASION AND INADEQUATE REMODELING OF UTERINE ARTERIES, DYSREGULATION OF THE NONIMMUNE SYSTEM HAS BEEN THE FOCAL POINT IN PE. THIS RESULTS FROM ABERRANT IMMUNE SYSTEM ACTIVATION AND IMBALANCED DIFFERENTIATION OF T CELLS. FURTHER, A FAILURE OF TOLERANCE TOWARD THE SEMI-ALLOGENIC FETUS RESULTS DUE TO ALTERED DISTRIBUTION OF TREGS SUCH AS CD4+FOXP3+ OR CD4+CD25+CD127(LOW) FOXP3+ CELLS, THEREBY CREATING A CYTOTOXIC ENVIRONMENT BY SUBOPTIMAL PRODUCTION OF IMMUNOSUPPRESSIVE CYTOKINES LIKE IL-10, IL-4, AND IL-13. ALSO, INTRACELLULAR PRODUCTION OF COMPLEMENT PROTEIN C5A MAY RESULT IN DECREASED FOXP3+ REGULATORY T CELLS. WITH IMMUNE SYSTEM DYSFUNCTION AS A MAJOR DRIVER IN PE PATHOGENESIS, IT IS LOGICAL THAT THERAPEUTIC TARGETING OF COMPONENTS OF THE IMMUNE SYSTEM WITH PHARMACOLOGIC AGENTS LIKE ANTI-INFLAMMATORY AND IMMUNE-MODULATING MOLECULES ARE EITHER BEING USED OR UNDER CLINICAL TRIAL. CHOLESTEROL SYNTHESIS INHIBITORS LIKE PRAVASTATIN MAY IMPROVE PLACENTAL PERFUSION IN PE, WHILE ECULIZUMAB (MONOCLONAL ANTIBODY INHIBITING C5) AND SMALL MOLECULAR INHIBITOR OF C5A, ZILUCOPLAN ARE UNDER INVESTIGATION. MONOCLONAL ANTIBODY AGAINST IL-17(SECUKINUMAB) HAS BEEN PROPOSED TO ALTER THE TH IMBALANCE IN PE. AUTOLOGOUS TREG THERAPY AND IMMUNE CHECKPOINT INHIBITORS LIKE ANTI-CTLA-4 ARE EMERGING AS NEW CANDIDATES IN IMMUNE HORIZONS FOR PE MANAGEMENT IN THE FUTURE. 2023 5 6481 32 TOX IS EXPRESSED BY EXHAUSTED AND POLYFUNCTIONAL HUMAN EFFECTOR MEMORY CD8(+) T CELLS. CD8(+) T CELL EXHAUSTION IS A HALLMARK OF MANY CANCERS AND CHRONIC INFECTIONS. IN MICE, T CELL FACTOR 1 (TCF-1) MAINTAINS EXHAUSTED CD8(+) T CELL RESPONSES, WHEREAS THYMOCYTE SELECTION-ASSOCIATED HMG BOX (TOX) IS REQUIRED FOR THE EPIGENETIC REMODELING AND SURVIVAL OF EXHAUSTED CD8(+) T CELLS. HOWEVER, IT HAS REMAINED UNCLEAR TO WHAT EXTENT THESE TRANSCRIPTION FACTORS PLAY ANALOGOUS ROLES IN HUMANS. IN THIS STUDY, WE MAPPED THE EXPRESSION OF TOX AND TCF-1 AS A FUNCTION OF DIFFERENTIATION AND SPECIFICITY IN THE HUMAN CD8(+) T CELL LANDSCAPE. HERE, WE DEMONSTRATE THAT CIRCULATING TOX(+) CD8(+) T CELLS EXIST IN MOST HUMANS, BUT THAT TOX IS NOT EXCLUSIVELY ASSOCIATED WITH EXHAUSTION. EFFECTOR MEMORY CD8(+) T CELLS GENERALLY EXPRESSED TOX, WHEREAS NAIVE AND EARLY-DIFFERENTIATED MEMORY CD8(+) T CELLS GENERALLY EXPRESSED TCF-1. CYTOLYTIC GENE AND PROTEIN EXPRESSION SIGNATURES WERE ALSO DEFINED BY THE EXPRESSION OF TOX. IN THE CONTEXT OF A RELENTLESS IMMUNE CHALLENGE, EXHAUSTED HIV-SPECIFIC CD8(+) T CELLS COMMONLY EXPRESSED TOX, OFTEN IN CLUSTERS WITH VARIOUS ACTIVATION MARKERS AND INHIBITORY RECEPTORS, AND EXPRESSED LESS TCF-1. HOWEVER, POLYFUNCTIONAL MEMORY CD8(+) T CELLS SPECIFIC FOR CYTOMEGALOVIRUS (CMV) OR EPSTEIN-BARR VIRUS (EBV) ALSO EXPRESSED TOX, EITHER WITH OR WITHOUT TCF-1. A SIMILAR PHENOTYPE WAS OBSERVED AMONG HIV-SPECIFIC CD8(+) T CELLS FROM INDIVIDUALS WHO MAINTAINED EXCEPTIONAL IMMUNE CONTROL OF VIRAL REPLICATION. COLLECTIVELY, THESE DATA DEMONSTRATE THAT TOX IS EXPRESSED BY MOST CIRCULATING EFFECTOR MEMORY CD8(+) T CELL SUBSETS AND NOT EXCLUSIVELY LINKED TO EXHAUSTION. 2020 6 4166 30 MEDICAL, ETHICAL, AND LEGAL ASPECTS OF HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR CROHN'S DISEASE IN BRAZIL. CROHN'S DISEASE (CD) IS A CHRONIC INFLAMMATORY BOWEL DISEASE THAT CAN AFFECT ANY PART OF THE GASTROINTESTINAL TRACT. THE ETIOLOGY OF CD IS UNKNOWN; HOWEVER, GENETIC, EPIGENETIC, ENVIRONMENTAL, AND LIFESTYLE FACTORS COULD PLAY AN ESSENTIAL ROLE IN THE ONSET AND ESTABLISHMENT OF THE DISEASE. CD RESULTS FROM IMMUNE DYSREGULATION DUE TO LOSS OF THE HEALTHY SYMBIOTIC RELATIONSHIP BETWEEN HOST AND INTESTINAL FLORA AND OR ITS ANTIGENS. IT AFFECTS BOTH SEXES EQUALLY WITH A MALE TO FEMALE RATIO OF 1.0, AND ITS ONSET CAN OCCUR AT ANY AGE, BUT THE DIAGNOSIS IS MOST COMMONLY OBSERVED IN THE RANGE OF 20 TO 40 YEARS OF AGE. CD DIMINISHES QUALITY OF LIFE, INTERFERES WITH SOCIAL ACTIVITIES, TRAUMATIZES DUE TO THE STIGMA OF INCONTINENCE, FISTULAE, STRICTURES, AND COLOSTOMIES, AND IN SEVERE CASES, AFFECTS SURVIVAL WHEN COMPARED TO THE GENERAL POPULATION. SYMPTOMS FLUCTUATE BETWEEN PERIODS OF REMISSION AND ACTIVITY IN WHICH COMPLICATIONS SUCH AS FISTULAS, STRICTURES, AND THE NEED FOR BOWEL RESECTION, SURGERY, AND COLOSTOMY IMPLANTATION MAKE UP THE MOST SEVERE ASPECTS OF THE DISEASE. CD CAN BE PROGRESSIVE AND THE COMPLICATIONS RECURRENT DESPITE TREATMENT WITH ANTI-INFLAMMATORY DRUGS, CORTICOSTEROIDS, IMMUNOSUPPRESSANTS, AND BIOLOGICAL AGENTS. HOWEVER, OVER TIME MANY PATIENTS BECOME REFRACTORY WITHOUT TREATMENT ALTERNATIVES, AND IN THIS SCENARIO, HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) HAS EMERGED AS A POTENTIAL TREATMENT OPTION. THE RATIONALE FOR THE USE OF HSCT FOR CD IS ANCHORED IN ANIMAL STUDIES AND HUMAN CLINICAL TRIALS WHERE HSCT COULD RESET A PATIENT'S IMMUNE SYSTEM BY ELIMINATING DISEASE-CAUSING EFFECTOR CELLS AND UPON IMMUNE RECOVERY INCREASE REGULATORY AND SUPPRESSIVE IMMUNE CELLS. AUTOLOGOUS HSCT USING A NON-MYELOABLATIVE REGIMEN OF CYCLOPHOSPHAMIDE AND ANTI-THYMOCYTE GLOBULIN WITHOUT CD34+ SELECTION HAS BEEN TO DATE THE MOST COMMON TRANSPLANT CONDITIONING REGIMEN ADOPTED. IN THIS REVIEW WE WILL ADDRESS THE CURRENT SITUATION REGARDING CD TREATMENT WITH HSCT AND EMPHASIZE THE MEDICAL, ETHICAL, AND LEGAL ASPECTS THAT PERMEATE THE PROCEDURE IN BRAZIL. 2020 7 559 27 BACH2 ENFORCES THE TRANSCRIPTIONAL AND EPIGENETIC PROGRAMS OF STEM-LIKE CD8(+) T CELLS. DURING CHRONIC INFECTION AND CANCER, A SELF-RENEWING CD8(+) T CELL SUBSET MAINTAINS LONG-TERM IMMUNITY AND IS CRITICAL TO THE EFFECTIVENESS OF IMMUNOTHERAPY. THESE STEM-LIKE CD8(+) T CELLS DIVERGE FROM OTHER CD8(+) SUBSETS EARLY AFTER CHRONIC VIRAL INFECTION. HOWEVER, PATHWAYS GUARDING STEM-LIKE CD8(+) T CELLS AGAINST TERMINAL EXHAUSTION REMAIN UNCLEAR. HERE, WE SHOW THAT THE GENE ENCODING TRANSCRIPTIONAL REPRESSOR BACH2 IS TRANSCRIPTIONALLY AND EPIGENETICALLY ACTIVE IN STEM-LIKE CD8(+) T CELLS BUT NOT TERMINALLY EXHAUSTED CELLS EARLY AFTER INFECTION. BACH2 OVEREXPRESSION ENFORCED STEM-LIKE CELL FATE, WHEREAS BACH2 DEFICIENCY IMPAIRED STEM-LIKE CD8(+) T CELL DIFFERENTIATION. SINGLE-CELL TRANSCRIPTOMIC AND EPIGENOMIC APPROACHES REVEALED THAT BACH2 ESTABLISHED THE TRANSCRIPTIONAL AND EPIGENETIC PROGRAMS OF STEM-LIKE CD8(+) T CELLS. IN ADDITION, BACH2 SUPPRESSED THE MOLECULAR PROGRAM DRIVING TERMINAL EXHAUSTION THROUGH TRANSCRIPTIONAL REPRESSION AND EPIGENETIC SILENCING. THUS, OUR STUDY REVEALS A NEW PATHWAY THAT ENFORCES COMMITMENT TO STEM-LIKE CD8(+) LINEAGE AND PREVENTS AN ALTERNATIVE TERMINALLY EXHAUSTED CELL FATE. 2021 8 991 34 CHRONIC STIMULATION DRIVES HUMAN NK CELL DYSFUNCTION AND EPIGENETIC REPROGRAMING. A POPULATION OF NATURAL KILLER (NK) CELLS EXPRESSING THE ACTIVATING RECEPTOR NKG2C AND THE MATURATION MARKER CD57 EXPANDS IN RESPONSE TO HUMAN CYTOMEGALOVIRUS (HCMV) INFECTION. CD3-CD56DIMCD57+NKG2C+ NK CELLS ARE SIMILAR TO CD8+ MEMORY T CELLS WITH RAPID AND ROBUST EFFECTOR FUNCTION UPON RE-STIMULATION, PERSISTENCE, AND EPIGENETIC REMODELING OF THE IFNG LOCUS. CHRONIC ANTIGEN STIMULATION DRIVES CD8+ MEMORY T CELL PROLIFERATION WHILE ALSO INDUCING GENOME-WIDE EPIGENETIC REPROGRAMING AND DYSFUNCTION. WE HYPOTHESIZED THAT CHRONIC STIMULATION COULD SIMILARLY INDUCE EPIGENETIC REPROGRAMING AND DYSFUNCTION IN NK CELLS. HERE WE SHOW THAT CHRONIC STIMULATION OF ADAPTIVE NK CELLS THROUGH NKG2C USING PLATE-BOUND AGONISTIC ANTIBODIES IN COMBINATION WITH IL-15 DROVE ROBUST PROLIFERATION AND ACTIVATION OF CD3-CD56DIMCD57+NKG2C+ NK CELLS WHILE SIMULTANEOUSLY INDUCING HIGH EXPRESSION OF THE CHECKPOINT INHIBITORY RECEPTORS LAG-3 AND PD-1. MARKED INDUCTION OF CHECKPOINT INHIBITORY RECEPTORS WAS ALSO OBSERVED ON THE SURFACE OF ADAPTIVE NK CELLS CO-CULTURED WITH HCMV-INFECTED ENDOTHELIAL CELLS. CHRONICALLY STIMULATED ADAPTIVE NK CELLS WERE DYSFUNCTIONAL WHEN CHALLENGED WITH TUMOR TARGETS. THESE CELLS EXHIBITED A PATTERN OF EPIGENETIC REPROGRAMING, WITH GENOME-WIDE ALTERATIONS IN DNA METHYLATION. OUR STUDY HAS IMPORTANT IMPLICATIONS FOR CANCER IMMUNOTHERAPY AND SUGGEST THAT EXHAUSTED NK CELLS COULD BE TARGETED WITH INHIBITORY CHECKPOINT RECEPTOR BLOCKADE. 2019 9 942 28 CHRONIC LYMPHOCYTIC LEUKEMIA PRESENCE IMPAIRS ANTIGEN-SPECIFIC CD8(+) T-CELL RESPONSES THROUGH EPIGENETIC REPROGRAMMING TOWARDS SHORT-LIVED EFFECTORS. T-CELL DYSREGULATION IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) ASSOCIATES WITH LOW RESPONSE RATES TO AUTOLOGOUS T CELL-BASED THERAPIES. HOW CLL AFFECTS ANTIGEN-SPECIFIC T-CELL RESPONSES REMAINS LARGELY UNKNOWN. WE INVESTIGATED (EPI)GENETIC AND FUNCTIONAL CONSEQUENCES OF ANTIGEN-SPECIFIC T-CELL RESPONSES IN PRESENCE OF CLL IN VITRO AND IN AN ADOPTIVE-TRANSFER MURINE MODEL. ALREADY AT STEADY-STATE, ANTIGEN-EXPERIENCED PATIENT-DERIVED T CELLS WERE SKEWED TOWARDS SHORT-LIVED EFFECTOR CELLS (SLEC) AT THE EXPENSE OF MEMORY-PRECURSOR EFFECTOR CELLS (MPEC). STIMULATION OF THESE T CELLS IN VITRO SHOWED RAPID INDUCTION OF EFFECTOR GENES AND SUPPRESSION OF KEY MEMORY TRANSCRIPTION FACTORS ONLY IN PRESENCE OF CLL CELLS, INDICATING EPIGENETIC REGULATION. THIS WAS INVESTIGATED IN VIVO BY FOLLOWING ANTIGEN-SPECIFIC RESPONSES OF NAIVE OT-I CD8(+) CELLS TO MCMV-OVA IN PRESENCE/ABSENCE OF TCL1 B-CELL LEUKEMIA. PRESENCE OF LEUKEMIA RESULTED IN INCREASED SLEC FORMATION, WITH DISTURBED INFLAMMATORY CYTOKINE PRODUCTION. CHROMATIN AND TRANSCRIPTOME PROFILING REVEALED STRONG EPIGENETIC MODIFICATIONS, LEADING TO ACTIVATION OF AN EFFECTOR AND SILENCING OF A MEMORY PROFILE THROUGH PRESENCE OF CLL CELLS. SECONDARY CHALLENGE IN VIVO CONFIRMED DYSFUNCTIONAL MEMORY RESPONSES BY ANTIGEN-EXPERIENCED OT-I CELLS GENERATED IN PRESENCE OF CLL. ALTOGETHER, WE SHOW THAT PRESENCE OF CLL INDUCES A SHORT-LIVED EFFECTOR PHENOTYPE AND IMPAIRED MEMORY RESPONSES BY EPIGENETIC REPROGRAMMING DURING PRIMARY RESPONSES. 2023 10 1759 29 EARLY PRECURSOR T CELLS ESTABLISH AND PROPAGATE T CELL EXHAUSTION IN CHRONIC INFECTION. CD8(+) T CELLS RESPONDING TO CHRONIC INFECTIONS OR TUMORS ACQUIRE AN 'EXHAUSTED' STATE ASSOCIATED WITH ELEVATED EXPRESSION OF INHIBITORY RECEPTORS, INCLUDING PD-1, AND IMPAIRED CYTOKINE PRODUCTION. EXHAUSTED T CELLS ARE CONTINUOUSLY REPLENISHED BY T CELLS WITH PRECURSOR CHARACTERISTICS THAT SELF-RENEW AND DEPEND ON THE TRANSCRIPTION FACTOR TCF1; HOWEVER, THEIR DEVELOPMENTAL REQUIREMENTS ARE POORLY UNDERSTOOD. IN THE PRESENT STUDY, WE DEMONSTRATE THAT HIGH ANTIGEN LOAD PROMOTED THE DIFFERENTIATION OF PRECURSOR T CELLS, WHICH ACQUIRED HALLMARKS OF EXHAUSTION WITHIN DAYS OF INFECTION, WHEREAS EARLY EFFECTOR CELLS RETAINED POLYFUNCTIONAL FEATURES. EARLY PRECURSOR T CELLS SHOWED EPIGENETIC IMPRINTING CHARACTERISTIC OF T CELL RECEPTOR-DEPENDENT TRANSCRIPTION FACTOR BINDING AND WERE RESTRICTED TO THE GENERATION OF CELLS DISPLAYING EXHAUSTION CHARACTERISTICS. TRANSCRIPTION FACTORS BACH2 AND BATF WERE KEY REGULATORS WITH OPPOSING FUNCTIONS IN THE GENERATION OF EARLY PRECURSOR T CELLS. OVERALL, WE DEMONSTRATE THAT EXHAUSTION MANIFESTS FIRST IN TCF1(+) PRECURSOR T CELLS AND IS PROPAGATED SUBSEQUENTLY TO THE POOL OF ANTIGEN-SPECIFIC T CELLS. 2020 11 2421 31 EPIGENETIC SIGNATURE OF PD-1+ TCF1+ CD8 T CELLS THAT ACT AS RESOURCE CELLS DURING CHRONIC VIRAL INFECTION AND RESPOND TO PD-1 BLOCKADE. WE HAVE RECENTLY DEFINED A NOVEL POPULATION OF PD-1 (PROGRAMMED CELL DEATH 1)+ TCF1 (T CELL FACTOR 1)+ VIRUS-SPECIFIC CD8 T CELLS THAT FUNCTION AS RESOURCE CELLS DURING CHRONIC LCMV INFECTION AND PROVIDE THE PROLIFERATIVE BURST SEEN AFTER PD-1 BLOCKADE. SUCH CD8 T CELLS HAVE BEEN FOUND IN OTHER CHRONIC INFECTIONS AND ALSO IN CANCER IN MICE AND HUMANS. THESE CD8 T CELLS EXHIBIT STEM-LIKE PROPERTIES UNDERGOING SELF-RENEWAL AND ALSO DIFFERENTIATING INTO THE TERMINALLY EXHAUSTED CD8 T CELLS. HERE WE COMPARED THE EPIGENETIC SIGNATURE OF STEM-LIKE CD8 T CELLS WITH EXHAUSTED CD8 T CELLS. ATAC-SEQ ANALYSIS SHOWED THAT STEM-LIKE CD8 T CELLS HAD A UNIQUE SIGNATURE IMPLICATING ACTIVITY OF HMG (TCF) AND RHD (NF-KAPPAB) TRANSCRIPTION FACTOR FAMILY MEMBERS IN CONTRAST TO HIGHER ACCESSIBILITY TO ETS AND RUNX MOTIFS IN EXHAUSTED CD8 T CELLS. IN ADDITION, REGULATORY REGIONS OF THE TRANSCRIPTION FACTORS TCF7 AND ID3 WERE MORE ACCESSIBLE IN STEM-LIKE CELLS WHEREAS PRDM1 AND ID2 WERE MORE ACCESSIBLE IN EXHAUSTED CD8 T CELLS. WE ALSO COMPARED THE EPIGENETIC SIGNATURES OF THE 2 CD8 T CELL SUBSETS FROM CHRONICALLY INFECTED MICE WITH EFFECTOR AND MEMORY CD8 T CELLS GENERATED AFTER AN ACUTE LCMV INFECTION. BOTH CD8 T CELL SUBSETS GENERATED DURING CHRONIC INFECTION WERE STRIKINGLY DIFFERENT FROM CD8 T CELL SUBSETS FROM ACUTE INFECTION. INTERESTINGLY, THE STEM-LIKE CD8 T CELL SUBSET FROM CHRONIC INFECTION, DESPITE SHARING KEY FUNCTIONAL PROPERTIES WITH MEMORY CD8 T CELLS, HAD A VERY DISTINCT EPIGENETIC PROGRAM. THESE RESULTS SHOW THAT THE CHRONIC STEM-LIKE CD8 T CELL PROGRAM REPRESENTS A SPECIFIC ADAPTATION OF THE T CELL RESPONSE TO PERSISTENT ANTIGENIC STIMULATION. 2019 12 1313 38 DELETING DNMT3A IN CAR T CELLS PREVENTS EXHAUSTION AND ENHANCES ANTITUMOR ACTIVITY. CHIMERIC ANTIGEN RECEPTOR (CAR) T CELL THERAPY IS REVOLUTIONIZING CANCER IMMUNOTHERAPY FOR PATIENTS WITH B CELL MALIGNANCIES AND IS NOW BEING DEVELOPED FOR SOLID TUMORS AND CHRONIC VIRAL INFECTIONS. ALTHOUGH CLINICAL TRIALS HAVE DEMONSTRATED THE CURATIVE POTENTIAL OF CAR T CELL THERAPY, A SUBSTANTIAL AND WELL-ESTABLISHED LIMITATION IS THE HEIGHTENED CONTRACTION AND TRANSIENT PERSISTENCE OF CAR T CELLS DURING PROLONGED ANTIGEN EXPOSURE. THE UNDERLYING MECHANISM(S) FOR THIS DYSFUNCTIONAL STATE, OFTEN TERMED CAR T CELL EXHAUSTION, REMAINS POORLY DEFINED. HERE, WE REPORT THAT EXHAUSTION OF HUMAN CAR T CELLS OCCURS THROUGH AN EPIGENETIC REPRESSION OF THE T CELL'S MULTIPOTENT DEVELOPMENTAL POTENTIAL. DELETION OF THE DE NOVO DNA METHYLTRANSFERASE 3 ALPHA (DNMT3A) IN T CELLS EXPRESSING FIRST- OR SECOND-GENERATION CARS UNIVERSALLY PRESERVED THE CELLS' ABILITY TO PROLIFERATE AND MOUNT AN ANTITUMOR RESPONSE DURING PROLONGED TUMOR EXPOSURE. THE INCREASED FUNCTIONALITY OF THE EXHAUSTION-RESISTANT DNMT3A KNOCKOUT CAR T CELLS WAS COUPLED TO AN UP-REGULATION OF INTERLEUKIN-10, AND GENOME-WIDE DNA METHYLATION PROFILING DEFINED AN ATLAS OF GENES TARGETED FOR EPIGENETIC SILENCING. THIS ATLAS PROVIDES A MOLECULAR DEFINITION OF CAR T CELL EXHAUSTION, WHICH INCLUDES MANY TRANSCRIPTIONAL REGULATORS THAT LIMIT THE "STEMNESS" OF IMMUNE CELLS, INCLUDING CD28, CCR7, TCF7, AND LEF1. LAST, WE DEMONSTRATE THAT THIS EPIGENETICALLY REGULATED MULTIPOTENCY PROGRAM IS FIRMLY COUPLED TO THE CLINICAL OUTCOME OF PRIOR CAR T CELL THERAPIES. THESE DATA DOCUMENT THE CRITICAL ROLE EPIGENETIC MECHANISMS PLAY IN LIMITING THE FATE POTENTIAL OF HUMAN T CELLS AND PROVIDE A ROAD MAP FOR LEVERAGING THIS INFORMATION FOR IMPROVING CAR T CELL EFFICACY. 2021 13 2242 62 EPIGENETIC MODULATION OF CD8(+) T CELL FUNCTION IN LENTIVIRUS INFECTIONS: A REVIEW. CD8(+) T CELLS ARE CRITICAL FOR CONTROLLING VIREMIA DURING HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION. THESE CELLS PRODUCE CYTOLYTIC FACTORS AND ANTIVIRAL CYTOKINES THAT ELIMINATE VIRALLY- INFECTED CELLS. DURING THE CHRONIC PHASE OF HIV INFECTION, CD8(+) T CELLS PROGRESSIVELY LOSE THEIR PROLIFERATIVE CAPACITY AND ANTIVIRAL FUNCTIONS. THESE DYSFUNCTIONAL CELLS ARE UNABLE TO CLEAR THE PRODUCTIVELY INFECTED AND REACTIVATED CELLS, REPRESENTING A ROADBLOCK IN HIV CURE. THEREFORE, MECHANISMS TO UNDERSTAND CD8(+) T CELL DYSFUNCTION AND STRATEGIES TO BOOST CD8(+) T CELL FUNCTION NEED TO BE INVESTIGATED. USING THE FELINE IMMUNODEFICIENCY VIRUS (FIV) MODEL FOR LENTIVIRAL PERSISTENCE, WE HAVE DEMONSTRATED THAT CD8(+) T CELLS EXHIBIT EPIGENETIC CHANGES SUCH AS DNA DEMETHYLATION DURING THE COURSE OF INFECTION AS COMPARED TO UNINFECTED CATS. WE HAVE ALSO DEMONSTRATED THAT LENTIVIRUS-ACTIVATED CD4(+)CD25(+) T REGULATORY CELLS INDUCE FORKHEAD BOX P3 (FOXP3) EXPRESSION IN VIRUS-SPECIFIC CD8(+) T CELL TARGETS, WHICH BINDS THE INTERLEUKIN (IL)-2, TUMOR NECROSIS FACTOR (TNF)-Α, AND INTERFERON (IFN)-Γ PROMOTERS IN THESE CD8(+) T CELLS. FINALLY, WE HAVE REPORTED THAT EPIGENETIC MODULATION REDUCES FOXP3 BINDING TO THESE PROMOTER REGIONS. THIS REVIEW COMPARES AND CONTRASTS OUR CURRENT UNDERSTANDING OF CD8(+) T CELL EPIGENETICS AND MECHANISMS OF LYMPHOCYTE SUPPRESSION DURING THE COURSE OF LENTIVIRAL INFECTION FOR TWO ANIMAL MODELS, FIV AND SIMIAN IMMUNODEFICIENCY VIRUS (SIV). 2018 14 5223 35 PRIMARY MURINE CD4+ T CELLS FAIL TO ACQUIRE THE ABILITY TO PRODUCE EFFECTOR CYTOKINES WHEN ACTIVE RAS IS PRESENT DURING TH1/TH2 DIFFERENTIATION. CONSTITUTIVE RAS SIGNALING HAS BEEN SHOWN TO AUGMENT IL-2 PRODUCTION, REVERSE ANERGY, AND FUNCTIONALLY REPLACE MANY ASPECTS OF CD28 CO-STIMULATION IN CD4+ T CELLS. THESE DATA RAISE THE POSSIBILITY THAT INTRODUCTION OF ACTIVE RAS INTO PRIMARY T CELLS MIGHT RESULT IN IMPROVED FUNCTIONALITY IN PATHOLOGIC SITUATIONS OF T CELL DYSFUNCTION, SUCH AS CANCER OR CHRONIC VIRAL INFECTION. TO TEST THE BIOLOGIC EFFECTS OF ACTIVE RAS IN PRIMARY T CELLS, CD4+ T CELLS FROM COXSACKIE-ADENOVIRUS RECEPTOR TRANSGENIC MICE WERE TRANSDUCED WITH AN ADENOVIRUS ENCODING ACTIVE RAS. AS EXPECTED, ACTIVE RAS AUGMENTED IL-2 PRODUCTION IN NAIVE CD4+ T CELLS. HOWEVER, WHEN CELLS WERE CULTURED FOR 4 DAYS UNDER CONDITIONS TO PROMOTE EFFECTOR CELL DIFFERENTIATION, ACTIVE RAS INHIBITED THE ABILITY OF CD4+ T CELLS TO ACQUIRE A TH1 OR TH2 EFFECTOR CYTOKINE PROFILE. THIS DIFFERENTIATION DEFECT WAS NOT DUE TO DEFICIENT STAT4 OR STAT6 ACTIVATION BY IL-12 OR IL-4, RESPECTIVELY, NOR WAS IT ASSOCIATED WITH DEFICIENT INDUCTION OF T-BET AND GATA-3 EXPRESSION. IMPAIRED EFFECTOR CYTOKINE PRODUCTION IN ACTIVE RAS-TRANSDUCED CELLS WAS ASSOCIATED WITH DEFICIENT DEMETHYLATION OF THE IL-4 GENE LOCUS. OUR RESULTS INDICATE THAT, DESPITE AUGMENTING ACUTE ACTIVATION OF NAIVE T CELLS, CONSTITUTIVE RAS SIGNALING INHIBITS THE ABILITY OF CD4+ T CELLS TO PROPERLY DIFFERENTIATE INTO TH1/TH2 EFFECTOR CYTOKINE-PRODUCING CELLS, IN PART BY INTERFERING WITH EPIGENETIC MODIFICATION OF EFFECTOR GENE LOCI. ALTERNATIVE STRATEGIES TO POTENTIATE RAS PATHWAY SIGNALING IN T CELLS IN A MORE REGULATED FASHION SHOULD BE CONSIDERED AS A THERAPEUTIC APPROACH TO IMPROVE IMMUNE RESPONSES IN VIVO. 2014 15 2072 29 EPIGENETIC CONVERSION OF HUMAN ADULT BONE MESODERMAL STROMAL CELLS INTO NEUROECTODERMAL CELL TYPES FOR REPLACEMENT THERAPY OF NEURODEGENERATIVE DISORDERS. TISSUE-SPECIFIC STEM CELLS, SUCH AS BONE MARROW-DERIVED MESODERMAL STROMAL CELLS (MSCS), ARE THOUGHT TO BE LINEAGE RESTRICTED AND, THEREFORE, COULD ONLY BE DIFFERENTIATED INTO CELL TYPES OF THE TISSUE OF ORIGIN. SEVERAL RECENT STUDIES, HOWEVER, SUGGEST THAT THESE TYPES OF STEM CELLS MIGHT BE ABLE TO BREAK BARRIERS OF GERM LAYER COMMITMENT AND DIFFERENTIATE IN VITRO AND/OR IN VIVO INTO CELLS OF DIFFERENT TISSUES, SUCH AS NEUROECTODERMAL CELL TYPES. RECENTLY, PROTOCOLS FOR HIGH-YIELD GENERATION OF UNDIFFERENTIATED NEURAL STEM CELL (NSC)-LIKE CELLS FROM MSCS OF PRIMATE AND HUMAN ORIGIN WERE REPORTED. UNDIFFERENTIATED NSCS ARE COMMONLY USED AND ARE MORE SUITABLE FOR NEUROTRANSPLANTATION COMPARED WITH FULLY DIFFERENTIATED NEURAL CELLS, AS DIFFERENTIATED NEURAL CELLS ARE WELL KNOWN TO POORLY SURVIVE DETACHMENT AND SUBSEQUENT TRANSPLANTATION PROCEDURES. THESE HUMAN MSC-DERIVED NSC-LIKE CELLS (MSC-NSCS) GROW IN NEUROSPHERE-LIKE STRUCTURES AND EXPRESS HIGH LEVELS OF EARLY NEUROECTODERMAL MARKERS, BUT LOSE CHARACTERISTICS OF MSCS. IN THE PRESENCE OF SELECTED GROWTH FACTORS, HUMAN MSC-NSCS CAN BE DIFFERENTIATED INTO THE THREE MAIN NEURAL PHENOTYPES: ASTROGLIA, OLIGODENDROGLIA AND NEURONS. COMPARED WITH DIRECT DIFFERENTIATION OF HUMAN MSCS INTO MATURE NEURAL CELLS, THE CONVERSION STEP SEEMS TO BE ESSENTIAL TO GENERATE MATURE FUNCTIONAL NEUROECTODERMAL CELLS. THIS REVIEW DESCRIBES THE TECHNIQUES FOR THE CONVERSION OF HUMAN MSCS INTO NSCS AND SUMMARISES THE DATA ON EPIGENETIC CONVERSION OF HUMAN MSCS INTO IMMATURE NEUROECTODERMAL CELLS. THESE CELLS PROVIDE A POWERFUL TOOL FOR INVESTIGATING THE MOLECULAR MECHANISMS OF NEURAL DIFFERENTIATION, AND MIGHT SERVE AS AN AUTOLOGOUS CELL SOURCE TO TREAT ACUTE AND CHRONIC NEURODEGENERATIVE DISEASES. 2006 16 590 33 BET BROMODOMAIN PROTEIN INHIBITION REVERSES CHIMERIC ANTIGEN RECEPTOR EXTINCTION AND REINVIGORATES EXHAUSTED T CELLS IN CHRONIC LYMPHOCYTIC LEUKEMIA. CHIMERIC ANTIGEN RECEPTOR (CAR) T CELLS HAVE INDUCED REMARKABLE ANTITUMOR RESPONSES IN B CELL MALIGNANCIES. SOME PATIENTS DO NOT RESPOND BECAUSE OF T CELL DEFICIENCIES THAT HAMPER THE EXPANSION, PERSISTENCE, AND EFFECTOR FUNCTION OF THESE CELLS. WE USED LONGITUDINAL IMMUNE PROFILING TO IDENTIFY PHENOTYPIC AND PHARMACODYNAMIC CHANGES IN CD19-DIRECTED CAR T CELLS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). CAR EXPRESSION MAINTENANCE WAS ALSO INVESTIGATED BECAUSE THIS CAN AFFECT RESPONSE DURABILITY. CAR T CELL FAILURE WAS ACCOMPANIED BY PREEXISTING T CELL-INTRINSIC DEFECTS OR DYSFUNCTION ACQUIRED AFTER INFUSION. IN A SMALL SUBSET OF PATIENTS, CAR SILENCING WAS OBSERVED COINCIDENT WITH LEUKEMIA RELAPSE. USING A SMALL MOLECULE INHIBITOR, WE DEMONSTRATED THAT THE BROMODOMAIN AND EXTRA-TERMINAL (BET) FAMILY OF CHROMATIN ADAPTERS PLAYS A ROLE IN DOWNREGULATING CAR EXPRESSION. BET PROTEIN BLOCKADE ALSO AMELIORATED CAR T CELL EXHAUSTION AS MANIFESTED BY INHIBITORY RECEPTOR REDUCTION, ENHANCED METABOLIC FITNESS, INCREASED PROLIFERATIVE CAPACITY, AND ENRICHED TRANSCRIPTOMIC SIGNATURES OF T CELL REINVIGORATION. BET INHIBITION DECREASED LEVELS OF THE TET2 METHYLCYTOSINE DIOXYGENASE, AND FORCED EXPRESSION OF THE TET2 CATALYTIC DOMAIN ELIMINATED THE POTENCY-ENHANCING EFFECTS OF BET PROTEIN TARGETING IN CAR T CELLS, PROVIDING A MECHANISM LINKING BET PROTEINS AND T CELL DYSFUNCTION. THUS, MODULATING BET EPIGENETIC READERS MAY IMPROVE THE EFFICACY OF CELL-BASED IMMUNOTHERAPIES. 2021 17 5704 29 SINGLE-CELL RNA-SEQ REVEALS TOX AS A KEY REGULATOR OF CD8(+) T CELL PERSISTENCE IN CHRONIC INFECTION. PROGENITOR-LIKE CD8(+) T CELLS MEDIATE LONG-TERM IMMUNITY TO CHRONIC INFECTION AND CANCER AND RESPOND POTENTLY TO IMMUNE CHECKPOINT BLOCKADE. THESE CELLS SHARE TRANSCRIPTIONAL REGULATORS WITH MEMORY PRECURSOR CELLS, INCLUDING T CELL-SPECIFIC TRANSCRIPTION FACTOR 1 (TCF1), BUT IT IS UNCLEAR WHETHER THEY ADOPT DISTINCT PROGRAMS TO ADAPT TO THE IMMUNOSUPPRESSIVE ENVIRONMENT. BY COMPARING THE SINGLE-CELL TRANSCRIPTOMES AND EPIGENETIC PROFILES OF CD8(+) T CELLS RESPONDING TO ACUTE AND CHRONIC VIRAL INFECTIONS, WE FOUND THAT PROGENITOR-LIKE CD8(+) T CELLS BECAME DISTINCT FROM MEMORY PRECURSOR CELLS BEFORE THE PEAK OF THE T CELL RESPONSE. WE DISCOVERED A COEXPRESSION GENE MODULE CONTAINING TOX THAT EXHIBITED HIGHER TRANSCRIPTIONAL ACTIVITY ASSOCIATED WITH MORE ABUNDANT ACTIVE HISTONE MARKS IN PROGENITOR-LIKE CELLS THAN MEMORY PRECURSOR CELLS. MOREOVER, THYMOCYTE SELECTION-ASSOCIATED HIGH MOBILITY GROUP BOX PROTEIN TOX (TOX) PROMOTED THE PERSISTENCE OF ANTIVIRAL CD8(+) T CELLS AND WAS REQUIRED FOR THE PROGRAMMING OF PROGENITOR-LIKE CD8(+) T CELLS. THUS, LONG-TERM CD8(+) T CELL IMMUNITY TO CHRONIC VIRAL INFECTION REQUIRES UNIQUE TRANSCRIPTIONAL AND EPIGENETIC PROGRAMS ASSOCIATED WITH THE TRANSCRIPTION FACTOR TOX. 2019 18 1007 31 CHRONIC VIRUS INFECTION ENFORCES DEMETHYLATION OF THE LOCUS THAT ENCODES PD-1 IN ANTIGEN-SPECIFIC CD8(+) T CELLS. FUNCTIONALLY EXHAUSTED T CELLS HAVE HIGH EXPRESSION OF THE PD-1 INHIBITORY RECEPTOR, AND THERAPIES THAT BLOCK PD-1 SIGNALING SHOW PROMISE FOR RESOLVING CHRONIC VIRAL INFECTIONS AND CANCER. BY USING HUMAN AND MURINE SYSTEMS OF ACUTE AND CHRONIC VIRAL INFECTIONS, WE ANALYZED EPIGENETIC REGULATION OF PD-1 EXPRESSION DURING CD8(+) T CELL DIFFERENTIATION. DURING ACUTE INFECTION, NAIVE TO EFFECTOR CD8(+) T CELL DIFFERENTIATION WAS ACCOMPANIED BY A TRANSIENT LOSS OF DNA METHYLATION OF THE PDCD1 LOCUS THAT WAS DIRECTLY COUPLED TO THE DURATION AND STRENGTH OF T CELL RECEPTOR SIGNALING. FURTHER DIFFERENTIATION INTO FUNCTIONAL MEMORY CELLS COINCIDED WITH PDCD1 REMETHYLATION, PROVIDING AN ADAPTED PROGRAM FOR REGULATION OF PD-1 EXPRESSION. IN CONTRAST, THE PDCD1 REGULATORY REGION WAS COMPLETELY DEMETHYLATED IN EXHAUSTED CD8(+) T CELLS AND REMAINED UNMETHYLATED EVEN WHEN VIRUS TITERS DECREASED. THIS LACK OF DNA REMETHYLATION LEAVES THE PDCD1 LOCUS POISED FOR RAPID EXPRESSION, POTENTIALLY PROVIDING A SIGNAL FOR PREMATURE TERMINATION OF ANTIVIRAL FUNCTIONS. 2011 19 3454 38 HYPOMETHYLATION AT THE REGULATORY T CELL-SPECIFIC DEMETHYLATED REGION IN CD25HI T CELLS IS DECOUPLED FROM FOXP3 EXPRESSION AT THE INFLAMED SITE IN CHILDHOOD ARTHRITIS. THE MAINTENANCE OF FOXP3 EXPRESSION IN CD25(HI) REGULATORY T CELLS (TREGS) IS CRUCIAL TO THE CONTROL OF INFLAMMATION AND ESSENTIAL FOR SUCCESSFUL TREG TRANSFER THERAPIES. COEXPRESSION OF CD25 AND FOXP3 IN COMBINATION WITH A HYPOMETHYLATED REGION WITHIN THE FOXP3 GENE, CALLED THE TREG-SPECIFIC DEMETHYLATED REGION (TSDR), IS CONSIDERED THE HALLMARK OF STABLE TREGS. THE TSDR IS AN EPIGENETIC MOTIF THAT IS IMPORTANT FOR STABLE FOXP3 EXPRESSION AND IS USED AS A BIOMARKER TO MEASURE TREG LINEAGE COMMITMENT. IN THIS STUDY, WE REPORT THAT, UNLIKE IN PERIPHERAL BLOOD, CD4(+) T CELL EXPRESSION OF CD25 AND FOXP3 IS FREQUENTLY DISSOCIATED AT THE INFLAMED SITE IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS, WHICH LED US TO QUESTION THE STABILITY OF HUMAN TREGS IN CHRONIC INFLAMMATORY ENVIRONMENTS. WE DESCRIBE A NOVEL CD4(+)CD127(LO)CD25(HI) HUMAN T CELL POPULATION THAT EXHIBITS EXTENSIVE TSDR AND PROMOTER DEMETHYLATION IN THE ABSENCE OF STABLE FOXP3 EXPRESSION. THIS POPULATION EXPRESSES HIGH LEVELS OF CTLA-4 AND CAN SUPPRESS T CONVENTIONAL CELL PROLIFERATION IN VITRO. THESE DATA COLLECTIVELY SUGGEST THAT THIS POPULATION MAY REPRESENT A CHRONICALLY ACTIVATED FOXP3(LO) TREG POPULATION. WE SHOW THAT THESE CELLS HAVE DEFECTS IN IL-2 SIGNALING AND REDUCED EXPRESSION OF A DEUBIQUITINASE IMPORTANT FOR FOXP3 STABILITY. CLINICALLY, THE PROPORTIONS OF THESE CELLS WITHIN THE CD25(HI) T CELL SUBSET ARE INCREASED IN PATIENTS WITH THE MORE SEVERE COURSES OF DISEASE. OUR STUDY DEMONSTRATES, THEREFORE, THAT HYPOMETHYLATION AT THE TSDR CAN BE DECOUPLED FROM FOXP3 EXPRESSION IN HUMAN T CELLS AND THAT ENVIRONMENT-SPECIFIC BREAKDOWN IN FOXP3 STABILITY MAY COMPROMISE THE RESOLUTION OF INFLAMMATION IN JUVENILE IDIOPATHIC ARTHRITIS. 2014 20 3182 26 HALLMARKS OF CD8(+) T CELL DYSFUNCTION ARE ESTABLISHED WITHIN HOURS OF TUMOR ANTIGEN ENCOUNTER BEFORE CELL DIVISION. TUMOR-SPECIFIC CD8+ T CELLS (TST) IN PATIENTS WITH CANCER ARE DYSFUNCTIONAL AND UNABLE TO HALT CANCER PROGRESSION. TST DYSFUNCTION, ALSO KNOWN AS EXHAUSTION, IS THOUGHT TO BE DRIVEN BY CHRONIC T CELL ANTIGEN RECEPTOR (TCR) STIMULATION OVER DAYS TO WEEKS. HOWEVER, WE KNOW LITTLE ABOUT THE INTERPLAY BETWEEN CD8(+) T CELL FUNCTION, CELL DIVISION AND EPIGENETIC REMODELING WITHIN HOURS OF ACTIVATION. HERE, WE ASSESSED EARLY CD8(+) T CELL DIFFERENTIATION, CELL DIVISION, CHROMATIN ACCESSIBILITY AND TRANSCRIPTION IN TUMOR-BEARING MICE AND ACUTELY INFECTED MICE. SURPRISINGLY, DESPITE ROBUST ACTIVATION AND PROLIFERATION, TST HAD NEAR COMPLETE EFFECTOR FUNCTION IMPAIRMENT EVEN BEFORE UNDERGOING CELL DIVISION AND HAD ACQUIRED HALLMARK CHROMATIN ACCESSIBILITY FEATURES PREVIOUSLY ASSOCIATED WITH LATER DYSFUNCTION/EXHAUSTION. MOREOVER, CONTINUED TUMOR/ANTIGEN EXPOSURE DROVE PROGRESSIVE EPIGENETIC REMODELING, 'IMPRINTING' THE DYSFUNCTIONAL STATE. OUR STUDY REVEALS THE RAPID DIVERGENCE OF T CELL FATE CHOICE BEFORE CELL DIVISION IN THE CONTEXT OF TUMORS VERSUS INFECTION. 2023