Impact of chronic viral infection on the CD8 preimmune repertoire : when do we lose our naivety ?

The CD8 preimmune repertoire is defined as the set of circulating antigen-specific T CD8 lymphocytes that have not been activated yet by their cognate antigen. Because those cells are very rare, they have not been evaluated in humans. We developed a tetramer-based enrichment protocol that allowed for the first time direct detection and enumeration of those rare naive antigen-specific CD8 T cells in healthys. We then used this tool to characterize the CD8 preimmune repertoire in patients with chronic hepatitis C viral infection. We found that their naive CD8 T cells are dysregulated, being hypersensitive to TCR signals, and with increased proportions of memory-phenotype (MP) cells in inexperienced populations. These perturbations are reversible after viral clearance, highlighting the added benefit of early antiviral treatment. Finally, using a transgenic model (OTI), we observed high proportions of MP inexperienced T cells in the blood of cxcr3-deficient unimmunized mice. This suggests that CXCR3-dependent lymphocyte trafficking could account for some preimmune repertoire alterations. Altogether, our work demonstrates that inexperienced T cells can lose their naivete in several pathological situations. The impact of these findings will need to be considered when designing future immunotherapeutic strategies - especially when « inflammatory » patients are being targeted. Additionally, we highlight the challenge of interpreting T-cell immunophenotyping studies without getting knowledge into antigen-specific populations.