Abstract

CD8 T-cells contribute to control of Mycobacterium tuberculosis infection, but little is known about the quality of the CD8 T-cell response in subjects with latent infection and in patients with active tuberculosis disease. CD8 T-cells recognizing epitopes from 6 different proteins of Mycobacterium tuberculosis were detected by tetramer staining. Intracellular cytokines staining for specific production of IFN-γ and IL-2 was performed, complemented by phenotyping of memory markers on antigen-specific CD8 T-cells. The ex-vivo frequencies of tetramer-specific CD8 T-cells in tuberculous patients before therapy were lower than in subjects with latent infection, but increased at four months after therapy to comparable percentages detected in subjects with latent infection. The majority of CD8 T-cells from subjects with latent infection expressed a terminally-differentiated phenotype (CD45RA+CCR7−). In contrast, tuberculous patients had only 35% of antigen-specific CD8 T-cells expressing this phenotype, while containing higher proportions of cells with an effector memory- and a central memory-like phenotype, and which did not change significantly after therapy. CD8 T-cells from subjects with latent infection showed a codominance of IL-2+/IFN-γ+ and IL-2−/IFN-γ+ T-cell populations; interestingly, only the IL-2+/IFN-γ+ population was reduced or absent in tuberculous patients, highly suggestive of a restricted functional profile of Mycobacterium tuberculosis-specific CD8 T-cells during active disease. These results suggest distinct Mycobacterium tuberculosis specific CD8 T-cell phenotypic and functional signatures between subjects which control infection (subjects with latent infection) and those who do not (patients with active disease).

Highlights

  • Tuberculosis (TB) accounts for approximately nine million new cases of disease and around two million deaths every year [1]

  • Data are presented as median values while interquartile range is shown in brackets. ap,0.01 and bp,0.05 when compared to values in LTBI subjects. cp,0.05 and dp,0.02 when compared to values in TB patients before therapy (T0)

  • The limited number of patients after therapy did not allow statistical analysis of data. These results indicate for the first time that the percentage of double IFNc+/IL-2+ producing CD8 T-cells is significantly higher in LTBI subjects than in TB patients before therapy, suggesting a protective role of the two cytokines jointly in association with antigen specific CD8+ T-cell responses towards Mycobacterium tuberculosis (Mtb) in latently infected healthy subjects

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Summary

Introduction

Tuberculosis (TB) accounts for approximately nine million new cases of disease and around two million deaths every year [1]. TB is transmitted directly from human to human and the control of the infection depends on early identification and proper treatment of individuals with active disease. A role for CD4 T-cells in protection against Mtb is well documented, there is a large body of evidence derived from human and non human models that suggests an involvement of CD8 T-cells [2,3,4,5]. CD8 T-cells contribute to control of Mtb infection by mediating specific effector functions, including IFN-c and TNF-a production upon recognition of mycobacterial antigens [6,7,8], lysis of infected host cells [6,7,8,9], and direct killing of mycobacteria [5,10,11]. CD8 T-cells specific for numerous mycobacterial antigens can be isolated at high frequency from human and mouse

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