NFAT-dependent and -independent exhaustion circuits program maternal CD8 T cell hypofunction in pregnancy

• DOI: 10.1084/jem.20201599
• Publication Date: 2021-12-09T14:46:06Z
• Authors: Emma L. Lewis; Rong Xu; Jean-Christophe B...; Shin Foong Ngiow; Jordana Cohen; Rahul Telange; Alexander Crane; Deirdre Sawinski; E. John Wherry; Paige M. Porrett
• Keywords: Homeodomain Proteins; NFATC Transcription Factors; Gene Expression Profiling; Programmed Cell Death 1 Receptor; Mice, Transgenic; Kaplan-Meier Estimate; Skin Transplantation; CD8-Positive T-Lymphocytes; Lymphocytic Choriomeningitis; Lymphocyte Activation; Adoptive Transfer; Article; 3. Good health; Mice, Inbred C57BL; Pregnancy; Chlorocebus aethiops; Animals; Humans; Lymphocytic choriomeningitis virus; Female; Antigens; Spleen

Pregnancy is a common immunization event, but the molecular mechanisms and immunological consequences provoked by pregnancy remain largely unknown. We used mouse models and human transplant registry data to reveal that pregnancy induced exhausted CD8 T cells (Preg-TEX), which associated with prolonged allograft survival. Maternal CD8 T cells shared features of exhaustion with CD8 T cells from cancer and chronic infection, including transcriptional down-regulation of ribosomal proteins and up-regulation of TOX and inhibitory receptors. Similar to other models of T cell exhaustion, NFAT-dependent elements of the exhaustion program were induced by fetal antigen in pregnancy, whereas NFAT-independent elements did not require fetal antigen. Despite using conserved molecular circuitry, Preg-TEX cells differed from TEX cells in chronic viral infection with respect to magnitude and dependency of T cell hypofunction on NFAT-independent signals. Altogether, these data reveal the molecular mechanisms and clinical consequences of maternal CD8 T cell hypofunction and identify pregnancy as a previously unappreciated context in which T cell exhaustion may occur.