Gut Liver.  2024 May;18(3):520-530. 10.5009/gnl220449.

Single-Cell RNA Sequencing Shows T-Cell Exhaustion Landscape in the Peripheral Blood of Patients with Hepatitis B Virus-Associated Acute-on-Chronic Liver Failure

• Yao J
• Ji Y
• Liu T
• Bai J
• Wang H
• Yao R
• Wang J
• Zhou X

• KMID: 2555849
• DOI: http://doi.org/10.5009/gnl220449

Abstract

Background/Aims
The occurrence and development of hepatitis B virus-associated acute-onchronic liver failure (HBV-ACLF) is closely related to the immune pathway. We explored the heterogeneity of peripheral blood T cell subsets and the characteristics of exhausted T lymphocytes, in an attempt to identify potential therapeutic target molecules for immune dysfunction in ACLF patients.
Methods
A total of 83,577 T cells from HBV-ACLF patients and healthy controls were screened for heterogeneity by single-cell RNA sequencing. In addition, exhausted T-lymphocyte subsets were screened to analyze their gene expression profiles, and their developmental trajectories were investigated. Subsequently, the expression of exhausted T cells and their capacity in secreting cytokines (interleukin 2, interferon γ, and tumor necrosis factor α) were validated by flow cytometry.
Results
A total of eight stable clusters were identified, among which CD4 ⁺ TIGIT ⁺ subset and CD8 ⁺ LAG-3 ⁺ subset, with high expression of exhaust genes, were significantly higher in the HBV-ACLF patients than in normal controls. As shown by pseudotime analysis, T cells experienced a transition from naïve T cells to effector T cells and then exhausted T cells. Flow cytometry confirmed that the CD4 ⁺ TIGIT ⁺ subset and CD8 ⁺ LAG-3 ⁺ subset in the peripheral blood of the ACLF patients were significantly higher than those in the healthy controls. Moreover, in vitro cultured CD8 ⁺ LAG-3 ⁺ T cells were significantly fewer capable of secreting cytokines than CD8 ⁺ LAG-3^- subset.
Conclusions
Peripheral blood T cells are heterogeneous in HBV-ACLF. The exhausted T cells markedly increase during the pathogenesis of ACLF, suggesting that T-cell exhaustion is involved in the immune dysfunction of HBV-ACLF patients.

Keyword

Acute-on-chronic liver failure; T lymphocyte; Single-cell RNA sequencing; T cell exhaustion; Lymphocyte activation gene 3 protein