Abstract

Abstract Exhausted immune responses to chronic diseases represent a major challenge to global health. To explore their cell fate and plasticity in exhaustion, we analyzed CD4+T cells in a mouse model with regulatable antigen presentation. When the cells are driven through the effector phase, and are then exposed to different levels of persistent antigen, they lose their Th1 functions, upregulate exhaustion markers, resemble naturally anergic cells and become unable to help B cells and, at the highest dose, undergo apoptosis. Mechanistically, TCR signaling pathways are modulated with increasing dose and time. Ca2+ fluxes were found to be more robust to persistent antigen presentation while the MAPK and Akt pathways are easily desensitized. Transcriptomic analyses show the dynamic adjustment of gene expression and the accumulation of TCR signals over a period of weeks. Upon antigen removal, the cells recover their functionality while losing exhaustion and anergy markers. Preliminary data indicate that antigen-exhausted CD4+T cells retain their plasticity for at least 30 days and are able to adjust to different levels of antigen. Our data suggest a dynamic response of CD4+ T cells to different levels of persisting antigen and contribute to a better understanding of chronic disease.

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