PD-L1 Checkpoint Inhibition Narrows the Antigen-Specific T Cell Receptor Repertoire in Chronic Lymphocytic Choriomeningitis Virus Infection

Abstract

Checkpoint inhibitors are effective in restoring exhausted CD8⁺ T cell responses in persistent viral infections or tumors. Several compounds are in clinical use for different malignancies but also trials in patients with chronic viral infections were conducted. In the mouse model of persistent lymphocytic choriomeningitis virus (LCMV) infection, it was shown that checkpoint inhibitor treatment increased T cell proliferation and functionality but its influence on the antigen-specific T cell receptor (TCR) repertoire is unknown. NP396-specific CD8⁺ T cells dominate during acute LCMV infection and are predominantly exhausted during chronic infection. Next generation sequencing of NP396-specific TCRs showed that exhaustion corresponds with a significantly reduced NP396-specific TCR repertoire diversity: Shannon Index of 4 in immunized to 2.6 in persistently infected mice. Anti-PD-L1 treatment during persistent LCMV infection restored NP396-specific T cell responses and reduced viral titers. Nevertheless, “αPD-L1-treated” mice showed an even more narrowed TCR repertoire, with reduced TCR diversity compared to persistently infected control mice (Shannon Index of 2.1 and 2.6, respectively). Interestingly, αPD-L1 treatment induced narrowing of the TCR repertoire negatively correlates with functional and physical restoration of the antigen-specific T cell response. Further, we found that private, hyper-expanded TCR clonotypes dominated the T cell response after αPD-L1 treatment. Although being private, these top clonotypes from „αPD-L1-treated“ mice revealed a more „closely-related“ CDR3 motif pattern, compared to top clonotypes from persistently infected control mice. In conclusion, although targeting the PD-1/PD-L1 pathway re-invigorates exhausted CD8+ T cells, it fails to restore T-cell repertoire diversity. IMPORTANCE Checkpoint inhibitors are effective immunotherapeutics to restore cancer- and virus-induced exhausted CD8⁺ T cells, by enhancing the quality and survival of immune responses. Although checkpoint inhibitors are already used as therapy against various cancers, not much is known about their multifaceted impact on the exhausted CD8⁺ T cell receptor (TCR) repertoire. This study describes for the first time the evolvement of an exhausted antigen-specific CD8⁺ TCR repertoire under checkpoint inhibitor treatment. By using a well-established virus model, we were able to show major shifts towards oligoclonality of the CD8⁺ TCR repertoire response against a massively exhausted lymphocytic choriomeningitis virus (LCMV) epitope. While supporting viral control in the LCMV model, oligoclonality and more private of TCR repertoires may impact future pathogenic challenges and may promote viral escape. Our results may explain the ongoing problems of viral escapes, unpredictable autoimmunity and heterogeneous responses appearing as adverse effects of checkpoint inhibitor treatments.