PD-1 regulates CD4 T cell differentiation and trafficking in response to hyperlipidemia in mice and humans 2260972

S Sydney Blimbaum (University of Virginia) H Hema Kothari (University of Virginia) K Katherine Root (University of Virginia) M Melissa Marshall (University of Virginia, Charlottesville , Virginia, United States) C Corey Williams (University of Virginia) C Chantel McSkimming (University of Virginia, Charlottesville, Virginia, United States) C Coleen McNamara (UNIVERSITY VIRGINIA, Charlottesville, Virginia, United States)

Abstract

Abstract Introduction Programmed cell death protein 1 (PD-1) is a well-studied regulator of T cell activation. It is also highly expressed on T follicular helper cells, and global deletion of PD-1 or its ligands, PD-L1 and PD-L2, has been shown to diminish antigen-specific B cell responses and formation of memory B cells. Given that PD-1 blockade immunotherapy has recently been associated with accelerated progression of atherosclerosis, we have developed a murine model with CD4-specific inducible loss of PD-1 to further investigate how PD-1 regulates the CD4 T cell, and consequently, the B cell response, both at baseline and in response to hyperlipidemia. We have also probed two cohorts of patients with coronary artery disease (CAD) to investigate the prevalence and phenotype of PD-1-expressing CD4 T cells among PBMCs. Methods To study loss-of-function in mice, we have generated CD4CreERT2Pdcd1fl/fl mice, with tamoxifen-inducible CD4-specific knockout of PD-1. In our human studies, we assembled a matched cohort of patients with low and high severity CAD, determined by coronary angiography, and performed CITE-Seq on PBMCs collected at the time of imaging. Results During hyperlipidemia, CD4-specific loss of PD-1 results in increased CD4 T cell activation and differentiation into Th subtypes, with corresponding decreases in the frequency of naïve CD4 T cells. We also observe increases in CXCR3 and CCR5 in CD4 T cells, both associated with trafficking to atherosclerotic lesions. In CAD patients, PD-1+ CD4s express these same markers. In the B cells, we observe major changes to B cell surface markers without PD-1 signaling, suggesting disruptions in T-dependent B cell activation. Conclusion Altogether, these data suggest that PD-1 is not only an important regulator of T cell activation, but also a regulator of T cell trafficking during atherosclerosis. Furthermore, the PD-1 signaling axis between CD4s and B cells may maintain B cell homeostasis. Funding Source Leducq Foundation, NIH T32AI007496-29, NIH R01 AI17211 Topic Categories Immune Response Regulation: Cellular Mechanisms (IRC)

Article Details

Volume / Issue Vol. 215, Issue Supplement_1
Published August 01, 2026
ISSN 0022-1767
Publisher American Association of Immunologists

Authors (7)

S

Sydney Blimbaum

University of Virginia

H

Hema Kothari

University of Virginia

K

Katherine Root

University of Virginia

M

Melissa Marshall

University of Virginia, Charlottesville , Virginia, United States

C

Corey Williams

University of Virginia

C

Chantel McSkimming

University of Virginia, Charlottesville, Virginia, United States

C

Coleen McNamara

UNIVERSITY VIRGINIA, Charlottesville, Virginia, United States