PD-L1 blockade synergizes with IL-2 therapy in reinvigorating exhausted T cells

J Clin Invest. 2013 Jun;123(6):2604-15. doi: 10.1172/JCI67008. Epub 2013 May 15.

Abstract

The inhibitory receptor programmed cell death 1 (PD-1) plays a major role in functional exhaustion of T cells during chronic infections and cancer, and recent clinical data suggest that blockade of the PD-1 pathway is an effective immunotherapy in treating certain cancers. Thus, it is important to define combinatorial approaches that increase the efficacy of PD-1 blockade. To address this issue, we examined the effect of IL-2 and PD-1 ligand 1 (PD-L1) blockade in the mouse model of chronic lymphocytic choriomeningitis virus (LCMV) infection. We found that low-dose IL-2 administration alone enhanced CD8+ T cell responses in chronically infected mice. IL-2 treatment also decreased inhibitory receptor levels on virus-specific CD8+ T cells and increased expression of CD127 and CD44, resulting in a phenotype resembling that of memory T cells. Surprisingly, IL-2 therapy had only a minimal effect on reducing viral load. However, combining IL-2 treatment with blockade of the PD-1 inhibitory pathway had striking synergistic effects in enhancing virus-specific CD8+ T cell responses and decreasing viral load. Interestingly, this reduction in viral load occurred despite increased numbers of Tregs. These results suggest that combined IL-2 therapy and PD-L1 blockade merits consideration as a regimen for treating human chronic infections and cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies / administration & dosage
  • Antibodies / pharmacology
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / pharmacology
  • Arenaviridae Infections / drug therapy*
  • Arenaviridae Infections / immunology
  • Arenaviridae Infections / virology
  • B7-H1 Antigen / antagonists & inhibitors*
  • B7-H1 Antigen / immunology
  • CD8-Positive T-Lymphocytes / drug effects
  • CD8-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / virology
  • Chronic Disease
  • Drug Synergism
  • Female
  • Humans
  • Hyaluronan Receptors / metabolism
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / pharmacology
  • Immunotherapy
  • Interleukin-2 / administration & dosage*
  • Interleukin-2 / pharmacology
  • Interleukin-7 Receptor alpha Subunit / metabolism
  • Lymphocyte Activation
  • Lymphocytic choriomeningitis virus / drug effects
  • Lymphocytic choriomeningitis virus / immunology*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Transgenic
  • Programmed Cell Death 1 Receptor / metabolism
  • T-Lymphocytes, Regulatory / drug effects
  • T-Lymphocytes, Regulatory / immunology
  • Viral Load / drug effects
  • Viremia / drug therapy
  • Viremia / immunology
  • Viremia / virology

Substances

  • Antibodies
  • Antiviral Agents
  • B7-H1 Antigen
  • Cd274 protein, mouse
  • Cd44 protein, mouse
  • Hyaluronan Receptors
  • Immunologic Factors
  • Interleukin-2
  • Interleukin-7 Receptor alpha Subunit
  • Programmed Cell Death 1 Receptor