Modulation of tissue resident memory T cells by glucocorticoids after acute cellular rejection in lung transplantation

J Exp Med. 2022 Apr 4;219(4):e20212059. doi: 10.1084/jem.20212059. Epub 2022 Mar 14.

Abstract

Acute cellular rejection is common after lung transplantation and is associated with an increased risk of early chronic rejection. We present combined single-cell RNA and TCR sequencing on recipient-derived T cells obtained from the bronchoalveolar lavage of three lung transplant recipients with rejection and compare them with T cells obtained from the same patients after treatment of rejection with high-dose systemic glucocorticoids. At the time of rejection, we found an oligoclonal expansion of cytotoxic CD8+ T cells that all persisted as tissue resident memory T cells after successful treatment. Persisting CD8+ allograft-resident T cells have reduced gene expression for cytotoxic mediators after therapy with glucocorticoids but accumulate around airways. This clonal expansion is discordant with circulating T cell clonal expansion at the time of rejection, suggesting in situ expansion. We thus highlight the accumulation of cytotoxic, recipient-derived tissue resident memory T cells within the lung allograft that persist despite the administration of high-dose systemic glucocorticoids. The long-term clinical consequences of this persistence have yet to be characterized.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • CD8-Positive T-Lymphocytes / metabolism
  • Glucocorticoids* / metabolism
  • Graft Rejection / genetics
  • Graft Rejection / metabolism
  • Humans
  • Lung Transplantation*
  • Memory T Cells

Substances

  • Glucocorticoids