Ca
2+ ions play a pivotal role in cell proliferation and death by controlling a plethora of signaling pathways (
40). Although in vitro pharmacological studies suggest a direct role of Ca
2+ in cell death after TCR stimulation, the exact route of Ca
2+ entry and the detailed molecular mechanism have not been investigated due to a lack of the molecular identity and an appropriate animal model. Here we reaffirmed the important role of [Ca
2+]
i for T cell death using
Orai1−/− T cells and expression of the dominant negative mutants of ORAI1 in WT T cells. In addition, we demonstrated that ORAI1-NFAT pathway is crucial for activation of the downstream cell death programs in effector T cells, since overexpression of CA-NFAT could completely reconstitute cell death in ORAI1-deficient T cells. T cells lacking ORAI1 showed better survival than controls, in vitro upon TCR stimulations (), and in vivo after injection of anti-CD3 antibody and transfer to immunocompromised hosts (). Furthermore, thymocytes lacking ORAI1 showed increased resistance to cell death in vitro () and in vivo after anti-CD3 antibody injection (), indicating a possible role of ORAI1 in thymocyte death. In support of these data,
Orai1−/− thymocytes showed a significantly higher population of SP cells particularly in mice aged more than 12–16 weeks (). Only marginal differences were observed in the thymi from 6–8 week-old
Orai1−/− mice, consistent with the previous analyses of the same aged
Orai1−/− or
STIM1−/− mice () (
13,
14,
49). These results suggest that the increase in SP population in aged
Orai1−/− mice may be caused by accumulation of the survived thymocytes with age by escaping cell death, rather than a defect in T cell development. Our results showing a resistance of ORAI1-deficient thymocyte to cell death are consistent with earlier reports that the [Ca
2+]
i levels determine cell death or maturation of thymocytes, depending on avidity of antigen-TCR interactions and the strength of costimulation (e.g. CD28) (
42,
46–
48). Together, these results suggest that high [Ca
2+]
i through ORAI1 may be commonly used to control the negative selection process in the thymus and to maintain the size of the T cell pool by playing a negative role in T cell survival.
Our and other groups’ observations showed that CRAC channels are crucial for the function of effector T cells such as cytokine production (
Suppl. Fig. 4) (
13,
14). These data together with the SCID symptoms of human patients harboring mutations in
ORAI1 or
STIM1 genes demonstrate a positive role of CRAC channels in the immune response (
5,
12,
57). Here we showed that ORAI1 plays a bona fide role in stimulation-induced cell death further emphasizing the role of ORAI1 in the diverse functions of effector T cells in addition to cytokine production (). So far, none of the data from the patients and mice harboring deletion or mutations of Orai1 and STIM1 genes indicates any severe defect in development or homing of T cells in the peripheral lymphoid organs. However, these results do not rule out the role of Ca
2+ signaling in T cell development or homing because it is still possible that Ca
2+ plays a role via entering through alternate routes (e.g. ORAI2, ORAI3, or other non-store-operated Ca
2+ channels) instead of ORAI1. In support of this idea, reduction of SOCE in ORAI1-deficient naïve T cells was much less than that in effector T cells and ORAI2 instead of ORAI1 was abundantly expressed in naïve T cells as shown by mRNA expression analysis (
13,
14).
The role of CRAC channels in T cell proliferation is more complex than in cytokine production or cell death because it differs significantly in various mouse models. In the current work, we showed that
Orai1−/− T cells do not have a defect in proliferation (). Instead, the absence of ORAI1 enhanced the proliferation rate at the early stage of activation. A recent report examining T cell functions of knockin mice harboring a point mutation at position 93 (ORAI1
R93W) to recapitulate the phenotype observed in SCID patients (ORAI1
R91W), showed markedly reduced proliferation of
Orai1R93W/R93W effector T cells (
58). It is known that ORAI1 can form heteromultimers with other Orai family members (
6), and human ORAI1
R91W mutant has been shown to function in a dominant negative manner in an ORAI1-STIM1 overexpression system (
59). We also observed suppression of SOCE in WT and
Orai1−/− T cells upon expression of ORAI1
R91W (). Therefore, it is possible that the levels of SOCE in T cells isolated from
Orai1R93W/R93W mice are much lower than those of
Orai1−/− T cells, which may not reach the minimum requirement of [Ca
2+]
i to promote proliferation of T cells. Consistent with these observations, STIM1-deficient T cells showed normal proliferation with marginal differences in vitro and in vivo after immunization, while T cells lacking both STIM1 and STIM2 proliferate to a much lesser extent (
18,
19). Together, these results suggest that T cell proliferation does not require high [Ca
2+]
i levels and the threshold of [Ca
2+]
i necessary for T cell proliferation seems to be much lower than that for cytokine production or cell death.
A direct correlation between the [Ca
2+]
i levels and activated T cell death was further verified by recovery experiments in ORAI1-deficient T cells. Expression of ORAI1 in ORAI1-deficient T cells almost completely recovered normal cell death levels in addition to SOCE (). Interestingly, we were able to suppress T cell death in WT T cells by expression of the dominant negative mutant of Orai1, ORAI1
E106Q and ORAI1
R91W ( and data not shown). Expression of ORAI1
R91W in ORAI1-deficient T cells further suppressed the residual levels of SOCE and cell death induced by stimulation (). Together, these results indicate that the degree of stimulation-induced T cell death is directly proportional to [Ca
2+]
i levels regulated via ORAI1. Furthermore, our data supports a model in which excessive Ca
2+ entry mediated by ORAI1 supports death programs mediated by multiple cell death pathways including a transcriptional event mediated by NFAT, and non-transcriptional events of mitochondrial Ca
2+ uptake. This conclusion is supported by the following observations. First,
Orai1−/− T cells showed reduced expression of proapoptotic molecule, FasL that is known to be regulated by Ca
2+-NFAT signaling. Second, our results showed [Ca
2+]
i-mediated regulation of the ratio of Noxa to Mcl-1, that is recently identified to set a threshold for T cell death () (
56). Finally,
Orai1−/− T cells showed severely reduced mitochondrial Ca
2+ uptake and thereby reduced mitochondria-mediated cell death (). Since the NFAT family of transcription factors are direct downstream targets of Ca
2+-CaM/calcineurin pathway, our results together with those of NFAT family-deficient mice suggest that excessive [Ca
2+]
i turns on cell death transcriptional programs, many of which are regulated by NFAT (
23,
55). It is also known that predominant accumulation of nuclear NFAT can turn on transcriptional programs of a status of T cell tolerance termed anergy (
23). ORAI1-deficient T cells were not anergic because proliferation and cell cycle progression were actively induced upon repetitive stimulations (). Therefore, the threshold levels of [Ca
2+]
i for anergy induction may be higher than that observed in
Orai1−/− T cells. Future studies in
Orai1−/− T cells examining the expression levels or activities of anergy-inducing factors including E3 ubiquitin ligases (Cbl-b, Itch, or GRAIL) and caspase 3 that cleaves/degrades TCR signaling molecules, and the zinc finger transcription factor Ikaros that suppresses IL-2 transcription, would validate the role of ORAI1 in anergy (
60,
61).
The rise in [Ca
2+]
i triggered by TCR stimulation plays a pivotal, positive role in T cell activation, cytokine production and proliferation. However, symptoms of the patients with nonfunctional CRAC channels, especially those with mutations in
STIM1 gene are perplexing because in addition to a defect in activation of immune cells as exemplified by SCID symptoms, they also display lymphoproliferative disorders demonstrated by lymphoadenopathy, splenomegaly, and elevated memory T cell population (
12). In addition to the proposed mechanism of reduced regulatory T cell population (
18), our observations of resistance to cell death can serve as an alternate explanation for the lymphoproliferative symptoms of SCID patients. Our findings demonstrate a crucial role of high [Ca
2+]
i in diverse immune tolerance mechanisms such as negative selection, induction of cell death, and T cell survival. Our and other groups’ results point towards different threshold levels of [Ca
2+]
i to trigger various functions of T cells including proliferation, anergy, or death. A comprehensive study of animal models with various levels of CRAC channel activity can facilitate further understanding of how different amplitudes of Ca
2+ entry influence diverse activities of T cells.