J Hepatol. 2023 Mar 07. pii: S0168-8278(23)00167-8. [Epub ahead of print]
Ilaria Montali,
Camilla Ceccatelli Berti,
Marco Morselli,
Greta Acerbi,
Valeria Barili,
Giuseppe Pedrazzi,
Barbara Montanini,
Carolina Boni,
Arianna Alfieri,
Marco Pesci,
Alessandro Loglio,
Elisabetta Degasperi,
Marta Borghi,
Riccardo Perbellini,
Amalia Penna,
Diletta Laccabue,
Marzia Rossi,
Andrea Vecchi,
Camilla Tiezzi,
Valentina Reverberi,
Chiara Boarini,
Gianluca Abbati,
Marco Massari,
Pietro Lampertico,
Gabriele Missale,
Carlo Ferrari,
Paola Fisicaro.
BACKGROUND AND AIMS: In chronic HBV infection elevated ROS levels derived from dysfunctional mitochondria can cause increased protein oxidation and DNA damage in exhausted virus-specific CD8 T cells. Aim of this study was to understand how these defects are mechanistically interconnected in order to further elucidate T cell exhaustion pathogenesis and, doing so, to devise novel T cell-based therapies.
METHODS: DNA damage and repair mechanisms, including parylation, CD38 expression and telomere length were studied in HBV-specific CD8 T cells from chronic HBV patients. Correction of intracellular signaling alterations and improvement of anti-viral T cell functions by the NAD precursor NMN and by CD38 inhibition was assessed.
RESULTS: Elevated DNA damage was associated with defective DNA repair processes, including NAD-dependent parylation, in HBV-specific CD8 cells of chronic HBV patients. NAD depletion was indicated by the overexpression of CD38, the major NAD consumer, and by the significant improvement of DNA repair mechanisms, mitochondrial and proteostasis functions by NAD supplementation, which could also improve the HBV-specific antiviral CD8 T cell function.
CONCLUSIONS: Our study delineates a model of CD8 T cell exhaustion whereby multiple interconnected intracellular defects, including telomere shortening, are causally related to NAD depletion suggesting similarities between T cell exhaustion and cell senescence. Correction of these deregulated intracellular functions by NAD supplementation can also restore anti-viral CD8 T cell activity and thus represents a promising potential therapeutic strategy for chronic HBV infection.
Keywords: DNA repair; NAD; immune-modulation; senescence