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Auto-aggressive CXCR6 + CD8 T cells cause liver immune pathology in NASH

Nature. 2021 Apr;592(7854):444-449. doi: 10.1038/s41586-021-03233-8. | PubMed

Michael Dudek1, Dominik Pfister2, Sainitin Donakonda1,3, Pamela Filpe4, Annika Schneider1, Melanie Laschinger5, Daniel Hartmann5, Norbert Hüser5, Philippa Meiser1, Felix Bayerl1, Donato Inverso6,7, Jennifer Wigger4, Marcial Sebode4, Rupert Öllinger8, Roland Rad8, Silke Hegenbarth1, Martina Anton1, Adrien Guillot9, Andrew Bowman10, Danijela Heide2, Florian Müller2, Pierluigi Ramadori2, Valentina Leone11,12, Cristina Garcia-Caceres13, Tim Gruber13, Gabriel Seifert14, Agnieszka M Kabat15, Jan-Philipp Mallm16, Simon Reider17,18, Maria Effenberger17, Susanne Roth19, Adrian T Billeter19, Beat Müller-Stich19, Edward J Pearce15, Friedrich Koch-Nolte20, Rafael Käser21, Herbert Tilg17, Robert Thimme21, Tobias Boettler21, Frank Tacke9, Jean-Francois Dufour22, Dirk Haller23, Peter J Murray1,24, Ron Heeren10, Dietmar Zehn25, Jan P Böttcher1, Mathias Heikenwälder2, Percy A Knolle26,27,28

  1. Institute of Molecular Immunology and Experimental Oncology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.
  2. Institute of Chronic Inflammation and Cancer, German Cancer Research Center, Heidelberg, Germany.
  3. German Center for Infection Research, Munich, Germany.
  4. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
  5. Department of Surgery, University Hospital München rechts der Isar, TUM, Munich, Germany.
  6. Division of Vascular Oncology and Metastasis, German Cancer ResearchCenter Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany.
  7. European Center of Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
  8. Institute of Molecular Oncology and Functional Genomics, TUM, Munich, Germany.
  9. Department of Hepatology and Gastroenterology, Charité Universitätsmedizin, Berlin, Germany.
  10. Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry, Maastricht University, Maastricht, the Netherlands.
  11. Institute of Virology, Technical University Munich and Helmholtz Zentrum Munich, Munich, Germany.
  12. Research Unit of Radiation Cytogenetics, Helmholtz Zentrum Munich, Neuherberg, Germany.
  13. Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Zentrum München, Neuherberg, Germany.
  14. Department of General and Visceral Surgery, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  15. Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany.
  16. Division of Chromatin Networks, Single-cell Open Lab, German Cancer Research Center, Heidelberg, Germany.
  17. Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University Innsbruck, Innsbruck, Austria.
  18. Christian Doppler Labor for Mucosal Immunology, Innsbruck, Austria.
  19. Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany.
  20. Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  21. Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  22. University Clinic for Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland.
  23. Chair of Nutrition and Immunology, School of Life Sciences Weihenstephan, TUM, Freising, Germany.
  24. Max Planck Institute for Biochemistry, Martinsried, Germany.
  25. Division of Animal Physiology and Immunology, School of Life Sciences Weihenstephan, TUM, Freising, Germany.
  26. Institute of Molecular Immunology and Experimental Oncology, School of Medicine, Technical University of Munich (TUM), Munich, Germany. percy.knolle@tum.de.
  27. German Center for Infection Research, Munich, Germany. percy.knolle@tum.de.
  28. Division of Animal Physiology and Immunology, School of Life Sciences Weihenstephan, TUM, Freising, Germany. percy.knolle@tum.de.

Abstract

Nonalcoholic steatohepatitis (NASH) is a manifestation of systemic metabolic disease related to obesity, and causes liver disease and cancer1,2. The accumulation of metabolites leads to cell stress and inflammation in the liver3, but mechanistic understandings of liver damage in NASH are incomplete. Here, using a preclinical mouse model that displays key features of human NASH (hereafter, NASH mice), we found an indispensable role for T cells in liver immunopathology. We detected the hepatic accumulation of CD8 T cells with phenotypes that combined tissue residency (CXCR6) with effector (granzyme) and exhaustion (PD1) characteristics. Liver CXCR6+ CD8 T cells were characterized by low activity of the FOXO1 transcription factor, and were abundant in NASH mice and in patients with NASH. Mechanistically, IL-15 induced FOXO1 downregulation and CXCR6 upregulation, which together rendered liver-resident CXCR6+ CD8 T cells susceptible to metabolic stimuli (including acetate and extracellular ATP) and collectively triggered auto-aggression. CXCR6+ CD8 T cells from the livers of NASH mice or of patients with NASH had similar transcriptional signatures, and showed auto-aggressive killing of cells in an MHC-class-I-independent fashion after signalling through P2X7 purinergic receptors. This killing by auto-aggressive CD8 T cells fundamentally differed from that by antigen-specific cells, which mechanistically distinguishes auto-aggressive and protective T cell immunity.

Presented By Michael Dudek | ORCID iD