A prevailing paradigm in immunology is that antigenic signal strength drives progressive T cell differentiation
3. To investigate this model regarding T
M, we studied CD8 T cell responses to bacterial infection in mice with a T cell-specific deletion of TRAF6 (TRAF6-ΔT), a negative regulator of antigen-specific T cell activation
4. Despite having fewer total CD8 T cells (SI Fig. 1), TRAF6-ΔT mice mounted normal Ova-specific T
E responses to attenuated
L. monocytogenes expressing Ova (LmOva) ( and SI Fig. 2). To examine CD8 T
M in TRAF6-ΔT mice, we immunized with LmOva and measured Ova-specific cells 60 days post-infection. Although Ova-specific T
E responses were intact, CD8 T
M generation in TRAF6-ΔT mice was severely compromised ( and SI Fig. 3), even with 10-fold higher or lower immunizing doses (not shown). In mice lacking
cbl-b 5, a different negative regulator of antigen-specific T cell activation, T
M developed normally (SI Fig. 4), indicating that failure of T
M generation in TRAF6-ΔT mice cannot be entirely explained by loss of a negative regulator.
A hallmark of TM is the ability to mount accelerated recall responses to challenge infection. To confirm the impaired generation of CD8 TM in TRAF6-ΔT mice, we challenged previously immunized CTRL and TRAF6-ΔT mice with LmOva and measured Ova-specific cells 7 days later. TRAF6-ΔT mice failed to respond robustly to re-infection, suggesting that TM may not have been generated and that the smaller Ova-specific population present in TRAF6-ΔT mice was a new primary response (). To determine if TRAF6-ΔT mice generate TM, we transferred equal numbers of Ova-specific cells from previously immunized CTRL and TRAF6-ΔT mice 28 days post-infection, at which time a small population of Ova-specific cells appeared to be present (SI Fig. 3), and compared functionality on a per cell basis in response to challenge. We reasoned that naïve donor cells transferred into immune-competent animals would not respond to infection because they would be vigorously outcompeted by endogenous naïve cells, and only TM donor cells would mount accelerated recall responses that could outcompete endogenous naïve cells. At day 7 post-challenge, donor-derived Ova-specific secondary TE cells from CTRL mice represented 11% of the engrafted population while TRAF6-ΔT donor cells were undetectable (SI Fig. 5), demonstrating a severe impairment in CD8 TM development in TRAF6-ΔT mice.
TRAF6-ΔT mice accumulate CD4 T cells and develop multi-organ inflammatory disease
4. Since CD4 T cells can influence CD8 T cells responses
6–8 we wanted to rule out effects from the TRAF6-deficient CD4 T cell compartment. To determine if defective CD8 T
M generation in TRAF6-ΔT mice was intrinsic to CD8 T cells, we crossed TRAF6-ΔT mice with MHCI-restricted Ova-specific TCR-transgenic OT-I mice. Since OT-I mice lack CD4 T cells, generating OTI-TRAF6-ΔT mice allowed us to assay a pure population of uniformly naïve TRAF6-deficient CD8 T cells (SI Figs. 6–8). We transferred OTI-TRAF6-WT and OTI-TRAF6-ΔT cells into congenic recipients, which possess a normal CD4 T cell compartment, and then immunized with LmOva (). By transferring only small numbers of transgenic cells we could measure endogenous Ova-specific cells at the same time as the engrafted donor response, allowing us to assume that the majority of donor cells were activated
9. In addition, following T cell responses by serially bleeding allowed us to compare the kinetics of responding CD8 T cells within individual animals. Although both OTI-TRAF6-WT and OTI-TRAF6-ΔT donor cells mounted strong T
E responses (days 4–6), OTI-TRAF6-ΔT cells were not maintained during contraction (days 10–21) and were undetectable by 3 weeks post-infection ( and SI Fig. 9). Donor T
E cells from both genotypes exhibited similar expression of classical activation markers following primary immunization (SI Figs. 10,11) however, consistent with published data regarding killer cell lectin-like receptor 1 (KLRG1) as a marker for short-lived T
E cells that do not form T
M, a greater percentage of the OTI-TRAF6-ΔT T
E population expressed higher levels of KLRG1 (SI Fig. 12)
10. Following challenge infection, only donor OTI-TRAF6-WT T
M cells responded robustly ( and SI Fig. 9). These results demonstrate that although TRAF6 is dispensable for CD8 T
E responses, TRAF6 signaling within CD8 T cells is crucial to T
M generation.
Antigen-specific CD8 T cells responding to infection are not a homogenous population, but consist of small numbers of T
M precursors that express IL-7Rα
11. In conjunction with this idea, numerous studies have delineated roles for the γ
c cytokines IL-7 and IL-15 as critical factors for CD8 T cell homeostasis and T
M development
12–15. Impaired γ
c cytokine signaling in TRAF6-deficient CD8 T cells could explain the defect in their ability to form T
M. We tested the ability of CD8 T
E cells to respond to IL-15 and found that both OTI-TRAF6-WT and OTI-TRAF6-ΔT cells exhibit similar responsiveness to this cytokine (SI Fig. 13,14). To be sure that the lack of T
M development by TRAF-6-deficient CD8 T cells is not secondary to a defect in survival, and to further investigate a possible defect in γ
c cytokine signaling, we crossed OTI-TRAF6-ΔT mice to mice constitutively expressing an active form of Stat-5 (CA-St5)
16, a critical γ
c cytokine receptor downstream signaling molecule
16. CD8 T cells expressing CA-St5 show augmented survival, proliferation, and Bcl-2 expression
17, and CA-St5 mice exhibit selective expansion of memory-like CD8 T cells
16. We transferred CA-St5-OTI-TRAF6-WT and CA-St5-OTI-TRAF6-ΔT cells into congenic mice, immunized, and followed the donor and host Ova-specific responses ( and SI Fig. 15). Contraction of CA-St5-OTI-TRAF6-WT populations was reduced compared to control OT-I populations (). Surprisingly however, CA-St5-OTI-TRAF6-ΔT cells were not rescued from contracting to undetectable levels 3 weeks post-infection ( and SI Fig. 15). Importantly, we confirmed that CA-St5 expression in TRAF6-deficient CD8 T cells enhanced survival in an
ex vivo survival assay (SI Fig. 16), suggesting that the severe contraction exhibited by the TRAF6-deficient OT-I population ( and SI Fig. 15) and the ensuing lack of T
M development is not secondary to a general survival defect. Animals primed with the challenge dose of bacteria 3 weeks post-transfer showed no differences in the T
E response between the genotypes ( and SI Fig. 15), indicating that the loss of TRAF6-deficient CD8 T cells is exaggerated in response to signals following infection, and not simply due to defects in homeostatic signals following transfer.
We used a systems biology approach to identify unique gene expression signatures between OTI-TRAF6-WT and OTI-TRAF6-ΔT CD8 T cells that could account for their differences in survival following infection. We performed microarray analyses for both genotypes 6 and 10 days post-transfer and infection (SI Fig. 17). Due to similar survival rates between OTI-TRAF6-WT and OTI-TRAF6-ΔT CD8 T cells during the peak of the TE response, but striking differences in survival during contraction, we reasoned that expression of genes related to survival might begin to diverge between genotypes at d10 post-infection. We used the NIAID DAVID website to look for pathways in the KEGG database that have significant overlaps with differentially expressed genes in our microarray experiment. We discovered that TRAF6-deficient cells from d10 post-infection displayed defects in the expression of genes which function in several metabolic pathways, including fatty acid metabolism ().
FAO is an important survival pathway in metabolically stressed cells
18 and the removal of signals associated with infection, such as growth factor cytokines including IL-2, induces metabolic stress in hematopoietic cells
19, 20. Therefore, we tested the ability of OTI-TRAF6-WT and OTI-TRAF6-ΔT CD8 T cells to oxidize fatty acids following withdrawal of the pro-proliferative growth factor cytokine IL-2
in vitro. After IL-2 withdrawal, only control OTI-TRAF6-WT CD8 T cells increased FAO to a high degree (). Consistent with normal activation (SI Fig. 18), activated control and TRAF6-deficient CD8 T cells increased glycolysis in response to IL-2 (data not shown). Also, TRAF6-deficient CD8 T cells displayed normal upregulation of FAO in response to glucose withdrawal, indicating that cells are not completely unfit in the absence of TRAF6, but rather their inability to regulate catabolic fatty acid metabolism is due to the lack of a specific signal from growth factor (SI Fig. 19). Importantly, although transgenic-expression of CA-St5 did enhance T cell survival following infection (SI Fig. 16), it did not rescue the defect in FAO in TRAF6-deficient cells following growth factor withdrawal (SI Fig. 20), suggesting that FAO defects are not secondary to survival defects.
Proliferating T cells use glycolytic metabolism rather than FAO for energy generation
21–23, and growth factors enable this bias
24. In the absence of glucose, cells can survive in part by ceasing proliferation and switching to catabolic metabolism like FAO and autophagy
18, 20. OTI-TRAF6-ΔT CD8 T cells were notably less capable of effecting this metabolic switch than OTI-TRAF6-WT CD8 T cells following IL-2 withdrawal (). This suggested that TRAF6-deficient CD8 T cells responding to infection are unable to survive contraction and persist as long-lived T
M due to an inability to properly engage pathways of FAO when growth factors like IL-2 become limiting after the peak of the immune response.
AMP-activated kinase (AMPK) and Akt are central regulators of FAO and glycolyis, respectively
23. Consistent with reduced FAO, TRAF6-deficient CD8 T cells have lower active AMPK levels following IL-2 withdrawal (). To investigate whether AMPK defects could underlie decreased FAO in TRAF6-deficient CD8 T cells, we measured the effect of the anti-diabetic drug metformin, which promotes AMPK activation
25, on FAO following IL-2 withdrawal. Metformin increased AMPK activation () and rescued FAO in TRAF6-deficient CD8 T cells (). In contrast, FAO in TRAF6-deficient cells was unaffected by the Akt inhibitor triciribine (), suggesting that Akt may not regulate this metabolic pathway. These data support that FAO initiation following the peak of infection, accompanied by the reduction in T cell survival signals, underlies T
M development, and that commitment to this metabolic pathway is affected when TRAF6 is absent. In such a case, stimulating FAO in TRAF6-deficient CD8 T cells would rescue the observed defects and promote T
M. Consistent with this hypothesis, OTI-TRAF6-ΔT CD8 T cells had lower levels of active AMPK at the peak of the T
E response ().
To explore if inducing FAO
in vivo would rescue the observed defects in TRAF6-deficient CD8 T cells and promote T
M, we administered metformin daily following T cell transfer and infection. Remarkably, metformin not only promoted survival of OTI-TRAF6-ΔT CD8 T cells throughout contraction, but also of endogenous Ova-specific cells, resulting in enhanced T
M with the capacity to respond to re-infection ( and SI Fig. 21). Metformin also promoted OTI-TRAF6-WT CD8 T cell survival (). Treatment with a second FAO-inducing drug
26–28, the mTOR (mammalian target of rapamycin) inhibitor rapamycin, resulted in strikingly increased T
M development and ensuing recall response for both OTI-TRAF6-ΔT and OTI-TRAF6-WT CD8 T cells ( and SI Fig. 21). Together these data strongly point towards the commitment to FAO as a key requirement for T
M development, and the pharmacological modulation of this metabolic pathway as a potential target for vaccine design.
Promoting CD8 T
M development is a major goal of vaccination. Our data showing increased CD8 T
M for donor OT-I and endogenous Ova-specific cells following metformin treatment suggested that commitment to FAO is generally important for CD8 T
M development, and not only in settings of TRAF6-deficiency. This led us to the idea that pharmacological modulation of T cell metabolism could enhance vaccine efficacy. To test this we utilized an experimental vaccine against an aggressive tumor
29. We immunized control mice with LmOva and then began daily injections of PBS or metformin following the peak of the T
E response. After three weeks, drug treatment ceased and mice were inoculated with EL4-Ova tumor cells (). Metformin was administered after T
E cell expansion to avoid the possibility of altering the T
E response. To rule out direct effects of metformin on tumor growth, treatment was stopped 24 hours before tumor injection. Following EL4-Ova inoculation, 6/9 metformin-treated mice survived >33 days compared to only 1/8 PBS-treated mice (). This increase in survival following metformin treatment correlated with an increase in T
M cells prior to tumor inoculation (SI Fig. 22), suggesting that metformin treatment enhanced T
M cell generation resulting in greater protective anti-tumor immunity.
Proliferating T cells utilize glucose as their main energy source and suppress fatty acid metabolism, while quiescent cells (i.e. naïve and T
M) break down fatty acids, amino acids, and glucose interchangeably for energy
23. As such, proliferating T
E cells display an anabolic signature typified by increased glycolytic metabolism, while T
M cells display a catabolic signature. This implies that during contraction there is an active conversion of cellular energy metabolism in order to generate T
M. Current models suggest that during contraction T cells compete for growth factors such as IL-2, and we speculate that as these growth factors become limiting, cells become stressed and undergo a metabolic transformation essential for T
M generation. We propose a model where TRAF6 plays a critical role following infection by regulating a metabolic switch in CD8 T cells that promotes survival and development into long-lived T
M.
Investigating the role of TRAF6 in T
M development led us to the surprising finding that energy metabolism can be pharmacologically manipulated during an immune response to promote CD8 T
M generation and protective immunity. Although the exact mechanism of metformin-mediated CD8 T
M enhancement remains unclear, our work suggests that metabolism-altering drugs hold promise as immunotherapeutics and command further study as modulators of T cell responses. Metformin has been shown to inhibit tumor progression
25, 30, although given our results it is unclear how metformin-regulated changes in T
M contribute to its anti-tumor properties. Our findings highlight a critical link between metabolic transitions and cell fate determination, and may have important implications for therapeutic and prophylactic vaccine development.