Abstract

AimsInflammation has important roles in atherosclerosis. CD4+CD28null (CD28null) T cells are a specialized T lymphocyte subset that produce inflammatory cytokines and cytotoxic molecules. CD28null T cells expand preferentially in patients with acute coronary syndrome (ACS) rather than stable angina and are barely detectable in healthy subjects. Importantly, ACS patients with CD28null T-cell expansion have increased risk for recurrent acute coronary events and poor prognosis, compared to ACS patients in whom this cell subset does not expand. The mechanisms regulating CD28null T-cell expansion in ACS remain elusive. We therefore investigated the role of cytokines in CD28null T-cell expansion in ACS.Methods and resultsHigh-purity sorted CD4+ T cells from ACS patients were treated with a panel of cytokines (TNF-α, IL-1β, IL-6, IL-7, and IL-15), and effects on the number, phenotype, and function of CD28null T cells were analysed and compared to the control counterpart CD28+ T-cell subset. IL-7- and IL-15-induced expansion of CD28null T cells from ACS patients, while inflammatory cytokines TNF-α, IL-1β, and IL-6 did not. The mechanisms underlying CD28null T-cell expansion by IL-7/IL-15 were preferential activation and proliferation of CD28null T cells compared to control CD28+ T cells. Additionally, IL-7/IL-15 markedly augmented CD28null T-cell cytotoxic function and interferon-γ production. Further mechanistic analyses revealed differences in baseline expression of component chains of IL-7/IL-15 receptors (CD127 and CD122) and increased baseline STAT5 phosphorylation in CD28null T cells from ACS patients compared to the control CD28+ T-cell subset. Notably, we demonstrate that CD28null T-cell expansion was significantly inhibited by Tofacitinib, a selective JAK1/JAK3 inhibitor that blocks IL-7/IL-15 signalling.ConclusionOur novel data show that IL-7 and IL-15 drive the expansion and function of CD28null T cells from ACS patients suggesting that IL-7/IL-15 blockade may prevent expansion of these cells and improve patient outcomes.

Highlights

  • 8" We examined whether IL-7 and IL-15 expand CD28null T cells from ACS patients with 9"

  • IL-7 and IL-15 induce proliferation of CD28null T cells from ACS patients 4" As IL-7 and IL-15 preferentially activate CD28null T cells (Figure 2), we investigated 5" whether this resulted in proliferation of this cell subset, which may explain CD28null T cell 6" expansion in ACS

  • We investigated 23" whether IL-7 and IL-15 affect the cytotoxic function of CD28null T cells using a degranulation 24" assay based on CD107a expression as previously described10

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Summary

1" 2. Introduction

2" Coronary artery disease (CAD) and acute coronary syndrome (ACS) remain a major cause of 3" death and morbidity worldwide despite considerable advances in diagnosis, prevention and 4" treatment. T lymphocytes have pivotal roles in atherosclerosis and pathogenesis of CAD.2, 3 5" CD4+CD28null (CD28null) T cells are an inflammatory subset of T lymphocytes defined by the 6" lack of the co-stimulatory receptor CD28. Other cytokines that are deregulated in chronic inflammatory diseases (e.g. 3" rheumatoid arthritis, RA) and are currently targeted in patients are IL-7 and IL-15 that belong 4" to the common gamma chain cytokine family.. Other cytokines that are deregulated in chronic inflammatory diseases (e.g. 3" rheumatoid arthritis, RA) and are currently targeted in patients are IL-7 and IL-15 that belong 4" to the common gamma chain cytokine family.17-19 Whether these cytokines are involved in 5" the expansion and function of CD28null T cells in ACS patients is unknown. We dissect the mechanistic basis of IL-7 and IL10" 15 effects on CD28null T cells from ACS patients and demonstrate that Tofacitinib, a selective 11" JAK1/JAK3 inhibitor that blocks IL-7/IL-15 signalling, significantly inhibits CD28null T cell 12" expansion. These new data suggest that targeting IL-7 and IL-15 could potentially provide a 13" therapeutic strategy to prevent expansion of CD28null T cells in ACS patients. 14"

1" 3. Methods
1" 4. Results
1" 5. Discussion
Conclusions
1" 7. References
Findings
! Supplementary Data
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