OX40-and CD27-mediated costimulation synergizes with anti–PD-L1 blockade by forcing exhausted CD8+ T cells to exit quiescence

SL Buchan, T Manzo, B Flutter, A Rogel… - The Journal of …, 2015 - journals.aai.org
SL Buchan, T Manzo, B Flutter, A Rogel, N Edwards, L Zhang, S Sivakumaran…
The Journal of Immunology, 2015journals.aai.org
Exhaustion of chronically stimulated CD8+ T cells is a significant obstacle to immune control
of chronic infections or tumors. Although coinhibitory checkpoint blockade with anti–
programmed death ligand 1 (PD-L1) Ab can restore functions to exhausted T cell
populations, recovery is often incomplete and dependent upon the pool size of a quiescent T-
bet high subset that expresses lower levels of PD-1. In a model in which unhelped, HY-
specific CD8+ T cells gradually lose function following transfer to male bone marrow …
Abstract
Exhaustion of chronically stimulated CD8+ T cells is a significant obstacle to immune control of chronic infections or tumors. Although coinhibitory checkpoint blockade with anti–programmed death ligand 1 (PD-L1) Ab can restore functions to exhausted T cell populations, recovery is often incomplete and dependent upon the pool size of a quiescent T-bet high subset that expresses lower levels of PD-1. In a model in which unhelped, HY-specific CD8+ T cells gradually lose function following transfer to male bone marrow transplantation recipients, we have explored the effect of shifting the balance away from coinhibition and toward costimulation by combining anti–PD-L1 with agonistic Abs to the TNFR superfamily members, OX40 and CD27. Several weeks following T cell transfer, both agonistic Abs, but especially anti-CD27, demonstrated synergy with anti–PD-L1 by enhancing CD8+ T cell proliferation and effector cytokine generation. Anti-CD27 and anti–PD-L1 synergized by downregulating the expression of multiple quiescence-related genes concomitant with a reduced frequency of T-bet high cells within the exhausted population. However, in the presence of persistent Ag, the CD8+ T cell response was not sustained and the overall size of the effector cytokine-producing pool eventually contracted to levels below that of controls. Thus, CD27-mediated costimulation can synergize with coinhibitory checkpoint blockade to switch off molecular programs for quiescence in exhausted T cell populations, but at the expense of losing precursor cells required to maintain a response.
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