The current studies provide convincing evidence that the CD8
+ T cell response to FV infection is not only vigorous and effective, but is critical for virus control. As in the Takamura et al. study, we found that expression was increased in a large proportion of effector CD8
+ T cells during acute FV infection. However, in contrast to their results from
in vitro re-stimulation experiments, which they interpreted as premature exhaustion of the PD-1
hi CD8
+ T cells, our
in vivo and direct
ex vivo studies showed high cytolytic potential of PD-1 expressing CD8
+ T cells and rapid
in vivo killing of viral peptide-loaded targets. Interestingly, the function of the activated CD8
+ T cells in terms of cytokine production versus cytotoxic potential corresponded to relative PD-1 expression levels. For example, shows that approximately half of the activated PD-1
lo cells made one or more cytokines, while approximately half of the PD-1
hi cells expressed granzymes and the degranulation marker CD107a. These results and the phenotypic analysis shown in strongly suggest that the minor PD-1
lo subset was a potent producer of cytokines and contained a significant proportion of effector memory precursors, whereas the PD-1
hi CD8
+ T cells were terminally differentiated effector cells that were the main mediators of cytotoxic activity during acute FV infection. This lytic activity was clearly demonstrated in
in vivo CTL assays using target cells labeled with the same FV epitope peptide that we and Takamura et al. used to detect virus-specific CD8
+ T cells. Rapid and efficient FV-specific killing was detected in both FV-resistant C57BL/6 and FV-susceptible Y10.A mice indicating that CD8
+ T cell cytotoxicity was not influenced by the Fv-2 genetic background of mice, as had been discussed in two letters to the Journal of Immunology (
34). The results from the
in vivo CTL assays also indicate that high expression of granzyme B is not, as suggested by Takamura et al., an indicator of excessive T cell activation and exhaustion, but an indicator of cytolytic potential. In fact, it is the loss of granzyme expression that has been defined as a hallmark of CD8
+ T cell exhaustion (reviewed in (
3,
35)).
Although PD-1 has been defined as a major inhibitory molecule on exhausted CD8
+ T cells during chronic infections, and blockade of the PD-1 signaling pathway can revitalize exhausted cells, the mere up-regulation of PD-1 and other inhibitory receptors on CD8
+ T cells did not correlate with an exhausted phenotype during acute infection. This finding is consistent with recent studies supporting the notion that the effect of PD-1 signalling varies between acute immunological responses and situations of chronic antigen exposure (
36). Although PD-1 signalling may indeed provide an inhibitory signal, the biological effect is dependent on the overall strength of that signal in the context of other signals in the cell, both positive and negative. A comparable system of activating and inhibitory receptors controls the function of NK cells (
37). During acute infections the combination of strong TCR signalling, co-stimulation, and cytokine signalling may outweigh the inhibitory effects of PD-1 on CD8
+ T cells. As the infection is brought under control the signalling milieu changes from overall positive to negative such that the response contracts to prevent overwhelming cytotoxic CD8
+ T cell activity that could cause severe immunopathology. This is in line with our current results showing that blockade of either PD-1 and TIM3 alone did not improve CD8
+ T cell function, but blocking both at the same time resulted in a significant reduction in acute FV viral loads (). Similar findings have been made by other groups (
6) suggesting a requirement for an orchestrated inhibitory signaling machinery composed of multiple receptors to suppress T cell responses. Such a system should ensure that effector CD8
+ T cells have enough time to control pathogens before they are shut down in their activity. However, our PD-1 and TIM3 blocking experiments indicate that although CD8
+ T cells expressing these receptors mediate vigorous virus-specific cytotoxic responses during acute FV infection, some degree of inhibition is already initiated during this phase.
For some viruses the immune system is not able to completely clear the infection and transition to chronic infection occurs. After chronic infection has been established, signaling through inhibitory receptors sustains and contributes to the progressive functional exhaustion of the remaining effector CD8
+ T cells (
38). Thus, inhibitory receptors, like PD-1, are excellent markers for the identification and tracking of exhausted T cells during the course of many chronic infections (
3,
12,
39) but do not indentify dysfunctional T cells during acute infections (
7,
8,
14,
15). In addition, in healthy adult humans most PD-1
hi CD8
+ T cells are effector memory cells rather than exhausted cells (
40). During chronic FV infection virus-specific CD8
+ T cells do develop functional exhaustion, which is associated with loss of granzymes, CD107a surface expression, and undetectable target cell killing in the
in vivo CTL assay (
41). We previously showed that this exhaustion is in large part mediated by regulatory T cells, which suppress the proliferation and function of virus-specific CD8
+ T cells. Taken together, our current results from
ex vivo and
in vivo experiments preclude premature exhaustion of CD8
+ T cells during acute FV infection. This is also strongly supported by several CD8
+ T cell depletion studies, which show that CD8
+ T cells are absolutely critical to control initial FV replication and disease progression in FV-resistant as well as FV-susceptible mouse strains ( and (
42)).
To our knowledge this is the first study delineating PD-1
hi and PD-1
lo effector CD8
+ T cell subsets with different functions during acute infection. We show several lines of evidence indicating that activated PD-1
hi CD8
+ T cells are terminally differentiated cytotoxic cells. In contrast, few activated PD-1
lo CD8
+ T cells produced cytotoxic molecules but most were efficient producers of cytokines, with significant proportions producing multiple cytokines, a characteristic demonstrated to mediate potent antiviral effects in several virus infections (
43). Interestingly, activated PD-1
lo CD8
+ T cells were low in expression of inhibitory receptors indicating that this suppressive pathway does not seem to play a major role in their control. Hence, inhibitory receptors may be predominantly associated with the control of the cytotoxic function of effector CD8
+ T cells. Also of import, a significant proportion of the activated PD-1
lo CD8
+ T cells did not have the phenotype of short-lived terminally differentiated effector cells, but had phenotypic markers indicative of effector memory precurser cells, a population of long-lived effector cells that develop into central or effector memory T cells (
29). This finding implies that memory precurser T cells do not up-regulate inhibitory receptors during acute infections, most likely because their effector functions are not associated with severe immunopathology and their survival is critical for the establishment of an immunological memory. This is in line with a recent report showing that defects in PD-1 signaling results in enhanced central memory CD8
+ T cell responses after an acute vaccinia virus infection (
44). Thus, blocking the PD-1/PD-L1 pathway during vaccination against pathogens can increase protective memory responses (
45). Understanding the role of inhibitory receptors on effector T cells may therefore be important for the design of effective vaccines against virus infections as well as new treatments for acute infections.