REVIEW article

Front. Immunol., 29 March 2021

Sec. Viral Immunology

Volume 12 - 2021 | https://doi.org/10.3389/fimmu.2021.666983

How to Train Your Dragon: Harnessing Gamma Delta T Cells Antiviral Functions and Trained Immunity in a Pandemic Era

  • Infection and Immunity Research Institute, St. George’s University of London, London, United Kingdom

Abstract

The emergence of viruses with pandemic potential such as the SARS-CoV-2 coronavirus causing COVID-19 poses a global health challenge. There is remarkable progress in vaccine technology in response to this threat, but their design often overlooks the innate arm of immunity. Gamma Delta (γδ) T cells are a subset of T cells with unique features that gives them a key role in the innate immune response to a variety of homeostatic alterations, from cancer to microbial infections. In the context of viral infection, a growing body of evidence shows that γδ T cells are particularly equipped for early virus detection, which triggers their subsequent activation, expansion and the fast deployment of antiviral functions such as direct cytotoxic pathways, secretion of cytokines, recruitment and activation of other immune cells and mobilization of a trained immunity memory program. As such, γδ T cells represent an attractive target to stimulate for a rapid and effective resolution of viral infections. Here, we review the known aspects of γδ T cells that make them crucial component of the immune response to viruses, and the ways that their antiviral potential can be harnessed to prevent or treat viral infection.

Introduction

It’s estimated that on average, a human being will be infected with about 10 different viral species over a lifetime (), including influenza viruses, coronaviruses, noroviruses and rhinoviruses. Most of these viral infections result in either no disease or mild symptoms, and viral clearance in a matter of days or weeks. However, the increasing emergence of new viruses, to which human populations have no existing immunity, raises the potential for pandemics posing a threat to global human health that needs to be addressed.

During a viral infection, the successive and functional cooperation of the innate and adaptive immune systems is crucial in order to control the viral load and lead to a successful resolution of disease. The early detection and reaction by the immune system to viral infection is fundamental for the subsequent course of infection. This early response includes the production of cytokines and cytotoxic factors by first-line innate effector cells including macrophages, neutrophils, natural killer cells and Gamma Delta (γδ) T cells. This early ‘innate’ arm of the immune system also begins to recruit the adaptive arm to tailor the response and lead to immune memory. γδ T cells in particular are of the utmost importance as their large numbers in tissues, their pre-activated phenotype and rapidity of response make them a central player in the fight against viruses (). They represent 1-5% of blood lymphocytes and constitute between 10–100% of T cells in “barrier” sites such as lung, gut and skin (). γδ T cells migrate to these organs during early development and persist there as resident cells () with non-redundant features of surveillance compared to the other tissue-resident lymphocytes (, ). In addition, γδ T cells acquire a pre-activated phenotype early in their development that allows the rapid induction of effector functions upon detecting cellular stress and infection. Indeed, γδ T cells have been shown to be one of the first immune cells to react to viral entry (). The importance of γδ T cells for an efficient antiviral response is illustrated by γδ T cell-deficient mice which show severely impaired responses to both primary and secondary infection (, ). These mice also demonstrate substantial increases in viral titers immediately post-infection as well as increased mortality compared with control mice. The precise mechanisms deployed by human γδ T cells against viruses are still incompletely understood, but their ability in early sensing of infection, quick activation and cytotoxicity against a wide array of viruses, including cytomegalovirus (CMV), influenza A virus, hepatitis B (HBV) and C (HCV) virus, human immunodeficiency virus (HIV) and severe acute respiratory syndrome-related coronavirus (SARS-CoV), has triggered interest in a better definition of these under-studied lymphocytes and in ways of harnessing their potential for therapies (). This review aims to provide an insight into γδ T cells’ protective functions in human pathologies and to illustrate the necessity of including innate immunity in the design of antiviral strategies.

Sensing Viruses: γδ T-Cells as Early Responders

Despite their active roles in many human infectious diseases, the pathways used by γδ T cells to sense pathogens and initiate rapid responses remain largely unknown. In this section, we will explore some of the principal signals that are critical for γδ-T cell-mediated antiviral activity.

Toll-Like Receptors

In addition to their strategic position, γδ T cells express a diversity of receptors for sensing both viral particles directly and infected cells. Firstly, the presence on γδ T cells of both membrane expressed and intracellular pattern recognition receptors (PRRs), which bind conserved pathogen-associated molecular patterns (PAMPs), is a major tool for virus detection. Of particular importance are Toll-like receptors (TLRs) that respond independently of any other receptors to stimulation by virus-derived molecules.

TLRs are expressed on the cell membrane, where they can directly recognize PAMPs like viral glycoproteins and glycolipids (TLR2 & 4) (). They are also present on endosomes and lysosomes where they detect viral single-stranded (TLR7) and double-stranded (TLR3) RNA (), as well as CpG nucleotides (TLR9) present in the extracellular environment or produced during intracellular replication of many viruses. All TLRs (but TLR8) are expressed on γδ T cells in peripheral blood of human donors (), and they are quickly upregulated during activation (e.g. by TCR stimulation) ().

The binding of viral ligands to TLRs leads to the activation of several transcription factors such as interferon regulatory factor 3, 5, and 7 (IRFs) and nuclear factor-κB (NF-κB) (). This activation induces an antiviral program, including production of interferons, pro-inflammatory cytokines (IL-1, TNF-α) and other associated molecules. Through positive feedback processes, interferons are able to enhance many TLRs ().

Natural Killer Type Receptors

In addition to PRRs, γδ T cells also express several other receptors that mediate their optimal activation during viral infection, by directly triggering their own signaling effect, and/or modulating TCR signaling. Among these are NK type receptors (NKRs) including natural killer group 2-member D (NKG2D), DNAX Accessory Molecule-1 (DNAM1) and the Natural Cytotoxicity receptors (NCRs) NKp30, NKp44 and NKp46.

The activating NKG2D molecule is an important stimulatory receptor expressed on γδ T cells which provides a critical role in stress antigen recognition (). In humans, the ligands of NKG2D have been identified as stress‐inducible MHC class I related molecules A/B (MICA/MICB) and members of the UL16-binding protein family (ULBPs) (). These molecules have been shown to be upregulated in response to stress, including viral infection. For example, during CMV infection of fibroblasts, MICA and ULBP1-3 have been shown to be upregulated (). MICB is induced in macrophages infected by influenza A or Sendai virus (). CD4+ lymphocytes infected by HIV also display an upregulation in ULBP1-3 (). Furthermore, MICA, MICB and ULBP4 have been shown to be upregulated in response to Epstein-Barr virus (EBV) infection allowing activation of γδ T cells (, ). Recognition of these ligands induces signaling through NKG2D and rapid Ca2+ responses, triggering protein kinase C (PKC)-dependent co-stimulation of the TCR (), but can also signal independently of TCR signaling (). Blockade of NKG2D but not TCR resulted in decreased killing suggesting that recognition is principally mediated by NKG2D, and activation achieved through TCR (). Ligand recognition might actually involve the two receptors, as ULBPs have been suggested to engage both NKG2D and Vγ9Vδ2 TCR (). Alternatively, the binding of TCR and NKG2D to MICA has been reported to be mutually exclusive, with a dynamic influenced by the higher affinity for the latter ().

DNAM1 or CD226 is another NKR involved in γδ T cell activation. It is expressed at a low level constitutively and is upregulated following stimulation of the cell (). The ligands of this receptor include poliovirus receptor PVR (CD155) and nectin-2 (CD112), key receptors that play a role in viral entry and have been shown to be upregulated in response to cellular stress such as infection by viruses including CMV, HIV, EBV (). Interaction of DNAM1 with its ligands triggers γδ T cell effector functions, notably cytolytic granule exocytosis and interferon-gamma (IFN-γ) production against tumors (), but more studies are needed to establish if it has similar effects during a viral infection.

Finally, γδ T cells have been shown to express members of the NCR family, including NKp30, NKp44 and NKp46. These receptors were originally documented on NK cells and were shown to coordinate cytotoxic responses against tumor and infected cells. They play a key role in infection by CMV, as infected cells express NKp30 ligand B7-H6 (). NKp44 and NKp46 bind hemagglutinin (HA) present on influenza (, ) and vaccinia viruses () as well as hemagglutinin-neuraminidase (HN) on Newcastle disease virus (NDV) (). Numerous other pathogens such as West Nile and dengue viruses have also been shown to bind these receptors via unidentified proteins (). While not expressed constitutively on γδ T cells, studies have shown that the expression of NCRs can be induced following activation (). NCRs are instrumental for γδ T cells antiviral function, as shown for example in the case of HIV suppression via NKp30-dependent activation of γδ T cells (), or cytotoxicity inhibition by specific blockade of NKp44 (). These receptors have been shown to mediate granzyme B production and cytotoxicity in a TCR-independent manner ().

T-Cell Receptor

Gamma delta T cells are also capable of responding to infected cells via their T-Cell Receptor (TCR). The TCR recognition of γδ T cells is independent of MHC restrictions () and has been shown to bind to a variety of non-processed antigens () including MHC-like molecules (), HSPs () and HSP-regulated proteins (), several glycoproteins, lipoproteins and phosphoantigens (pAg) (). Many of these antigens are upregulated in an infectious context, as shown earlier for MICA and MICB, and γδ T cells rely on them for optimal activation and antiviral function, as exemplified by the correlation between pAg synthesis of EBV- or influenza A-infected cells and γδ T cells cytotoxicity against them (, ). The role of the γδ TCR is illustrated by blocking studies, resulting in the loss of recognition, for example in CMV-infected cells (). Conversely, transferring TCR from a CMV-reactive clone to a TCR-deficient cell line is sufficient to confer reactivity against CMV-infected targets ().

In humans, γδ T cells can be classified into two main populations according to their TCR expression: Vδ1 and Vδ2 γδ T cells (51). Vδ1 γδ T cells are generally resident lymphocytes, abundant in mucosal surfaces and epithelia of the digestive, respiratory and urogenital tracts; in contrast, Vδ2 γδ T cells are circulating lymphocytes and constitute the majority of peripheral blood γδ T cells (52). There is some evidence to suggests that the tissue specificity of γδ T cells is shaped by the selective activation resulting from the interaction between the TCR and a family of presenting molecules called butyrophilins (BTN) and butyrophilins-like proteins (BTNL) (53, 54).

Vδ1 γδ T cells proliferate during some chronic viral infections, including HCV and HIV (55, 56). They display antiviral potential with the production of T-helper cell type 1 cytokines (57) and direct cytotoxicity toward infected cells (58). Similarly, activation and proliferation of Vδ2 γδ T cells have also been shown to be increased early during the acute phase of many viral infections. These cells can display potent antiviral responses and mainly recognize pAg synthesized by infected cells via the interaction between their TCR and the BTN3A1 (CD277) presenting molecule (59, 60). This activating signal is capable of stimulating Vδ2 γδ T cells independently of the virus type ().

Activation of γδ T cells by the integrated signals from the PRRs, NKRs and TCRs induce an antiviral state characterized by proliferation and phenotypic specialization. Indeed, as seen for example in hepatitis C virus (HCV) patients (), during infection by herpes simplex virus (HSV) (61), or following an encounter with EBV (62, 63), there is a rapid proliferation of γδ T cells seen in the blood where they can expand from approximately 1% of circulating T cells in steady-state to over 50% following viral infection. These expanded γδ T cells express activation markers like CD69, CD38 and HLA-DR absent in healthy individuals (64, 65), but also effector molecules such as perforin, granzymes, granulysin contained in cytolytic granules and FasL or TRAIL.

WHODUNNIT: γδ T-Cells as Virus Killers

The strategic position of γδ T cells for immune surveillance, and their capacity to recognize a unique and wide array of danger signals allows them to rapidly detect viral infection. This activation generates a high number of functionally active cells, ready to deploy their full antiviral potential via multiple routes, either direct killing of infected cells or indirect inhibition through production of noncytolytic factors and interactions with other components of the immune system.

Direct Antiviral Action

γδ T cell-mediated direct cytotoxicity is executed by diverse pathways, including secretion of cytotoxic mediators stored in granules such as perforin (66), granzymes (67, 68) and granulysin (69) and expression of members of the death-inducing TNF family of ligands and receptors, including tumor-necrosis factor-related apoptosis-inducing ligand (TRAIL) (70) and FasL.

γδ T cells uniformly express abundant perforin, granzymes and granulysin in their cytoplasmic granules (7174) and are able to degranulate after specific recognition of virus-infected cells (75). Interestingly, the granules’ content varies with cell type and immunological context, influencing the outcome. For example, Granzyme M, which is highly expressed by γδ T cells, is regulated differently than Granzyme B and initiates a unique cell death pathway independent of caspase activation (76, 77). In addition to the induced apoptosis of infected cells, Granzyme M also directly inhibits viral replication by cleavage of essential virus proteins (78). Similarly, γδ T cell granules contain Granzyme H and K which have various antiviral activity against adenoviruses, Influenza virus, HBV and HCV (68, 7982).

Despite the central role of the cytolytic granules in immune-induced apoptosis, several observations of target cell death in the absence of Ca2+, perforin, or granule exocytosis suggests the existence of alternative pathways of cytotoxicity. The FasL-Fas pathway is such an alternative mechanism of direct killing used by γδ T cells (83). Fas is induced in the membrane of virally infected cells (84) and binds to FasL expressed on γδ T cells. This leads to caspases activation and apoptosis in a manner not dissimilar to the one triggered by Granzyme B (85). γδ T cells upregulate FasL as early as 1 hour after stimulation (via NF-kB), and are capable of keeping a high and sustained expression during an immune response (86).

Indirect Antiviral Actions

Mounting evidence indicates that γδ T cells also exert their protective function in the elimination of pathogens by producing cytokines, chemokines, and interacting with other components of the immune system.

During a viral infection, targeted cells can produce cytokines like TNF-α, IL-1, IL-6, IL-18 (87) which participate in the activation of γδ T cells both in situ and in the peripheral blood. During activation, these γδ T cells upregulate the chemokine receptors CXCR3/5, and CCR1/5, allowing additional recruitment to the site of inflammation, rich in CCL3/4/5 and CXCL9/10/11 [86–88].

Within a few hours of activation, γδ T cells release high amounts of cytokines, among which is IFN-γ, a key antiviral molecule capable of suppressing viral replication as well as recruiting and activating complementary immune cells like NK, macrophage or killer T cells. In vitro, the non-cytolytic antiviral activity of IFN-γ has been demonstrated in infections with hepatitis viruses (HBV & HCV), herpesviruses, orthopoxviruses, picornaviruses, retroviruses, influenza and others (88). IFN-γ induces the transcription of several genes called Interferon-Stimulated Genes (ISGs), which exhibit numerous functions such as targeting viral entry, RNA expression, protein synthesis, assembly or release through multiple mechanisms (8991). For example, members of the IFN-inducible transmembrane (IFITM) family have the capacity of limiting viral entry and replication (92, 93). Another noticeable effect of IFN-γ is the induction of the OAS (oligoadenylate synthetase)-RNase L (latent ribonuclease L) pathway which functions to detect foreign RNA and to cleave both host and viral RNA (94). At the other end of the viral life cycle, Viperin (virus inhibitory protein, endoplasmic reticulum-associated, IFN-inducible) inhibits the virus release by blocking budding at the plasma membrane (95). Interestingly, Viperin acts in a similar manner as bisphosphonates, a class of drugs known to activate γδ T cells. Indeed, it inhibits farnesyl diphosphate synthase (FPPS), altering membrane fluidity by disrupting lipid rafts and interfering with virus budding as a consequence (96). Thus, one can hypothesize that administration of bisphosphonates for in vivo γδ T cells activation, as routinely done clinically (Cf. Part 4), will have a beneficial synergistic antiviral action.

γδ T cells produce a high amount of IFN-γ upon stimulation (97100), commencing as early as 4 hours post-activation (101). Several studies show the central role of γδ T cell-secreted IFN-γ in the antiviral response (102104). As an additional immunostimulatory mechanism, the high concentration of IFNs produced by infected cells and immune cells including γδ T cells themselves in inflamed areas (105) will reinforce activation of the immune cell pool, therefore augmenting the antiviral response (106).

Due to the evolutionary pressure of the anti-viral effects of IFN-γ, numerous strategies have arisen in viruses to subvert this protective mechanism. Other complementary and non-redundant mechanisms, such as TNF-α, which is also produced by the γδ T cell, are required. TCR triggering induces massive production of TNF-α by γδ T cells, as early as 20 minutes after stimulation (107, 108). The protective effect of TNF-α for antiviral immunity has been shown in a number of cases, such as infection by CMV (109), HSV (110) and vaccinia virus (111). In addition to its effect on infected cells, TNF-α is necessary for inducing resistance in uninfected cells, and for optimal activation of γδ T cells and their cytokine production. In this regard, TNF-α can act as a co-stimulatory signal for a sustained response to TCR triggering (112) which implies a positive feedback loop not dissimilar to the one observed with IFN-γ.

After activation via the TCR, even if the majority of γδ T cells were expressing only IFN-γ, the appearance of cells producing both IFN-γ and TNF-α has been noted (113), suggesting that different subsets with diverging antiviral functions might appear during activation, depending on the context (114). It is known that TNF-α and IFN-γ have a synergistic effect, providing a heightened antiviral function to the γδ T cells with the capacity to produce both (115). A diverse range of other cytokines including GM-CSF, IL-4, IL-5 and IL-8 are produced by γδ T cells following viral infection (116, 117), participating in the systemic immune response. Similar to other sentinel cells, γδ T cells also secrete chemokines such as CCL2, CCL3, CCL4, CCL5, and CCL22 to recruit pro-inflammatory effectors, accelerating the elimination of pathogens and the repair of damaged tissues (116, 118).

In addition to their direct anti-infection activities and their recruitment of other immune cells, γδ T cells help to establish the adaptive response by contributing to dendritic cell maturation (119121) but also by acting as professional Antigen Presenting Cells (APC) themselves (122). Indeed, they can efficiently internalize, process and present pathogen-related antigens from both free viral particles (123) and infected cells (124) to other effector immune cells (125). These γδ-T APCs express approximately similar levels of the MHC-II antigen-presenting molecule HLA-DR and of the costimulatory molecules CD80/CD86 to conventional APCs such as dendritic cells, allowing an efficient induction of CD4+ αβ-T-cell responses (126). Moreover, γδ-T APCs’ ability for cross-presentation (a process describing the internalization of exogenous antigens and their degradation for peptide loading on MHC-I antigen-presenting molecules) allow them to equal or even exceed dendritic cells’ capacity to induce CD8+ αβ-T-cell proliferation and effector functions (126, 127). In addition to their capacity for antigen presentation, γδ-T APCs change their migratory properties during activation, including the expression of the chemokine receptor CCR7, allowing their homing to the draining lymph nodes where they can activate virus-specific αβ-T-cells (128).

Another role for γδ T cells in the initiation of adaptive immunity is their helper function for the B cell-mediated humoral immunity (129). Besides their role in antibody production, γδ T cells are also key players in antibody-dependent cell-mediated cytotoxicity (ADCC) via their expression of FcγRIII (CD16) (130, 131). Moreover, in the case of CMV infection, CD16 has been shown to be upregulated in γδ T cells (132) and implicated in viral inhibition via direct recognition of IgG-opsonized virions and stimulation of IFN-γ production (133). Interestingly, CD56 expression, upregulated upon stimulation (134) and associated with cytolytic effector functions in γδ T cells (135) might be only a marker of co-expression with CD16. Thus, the better observed antiviral activity of CD56+ γδ T cells would be essentially due to the CD16-mediated degranulation pathway (136).

The antiviral capacity of γδ T cells has been illustrated by different studies using a variety of in vitro infected cells. They highlight the relative importance of each pathway and their modulation depending on the infectious context. For example, in a model of influenza virus-infected A549 lung alveolar epithelial cell line, Li et al. have proven by targeted inhibition the reliance of γδ T cells on the perforin and Granzyme B pathway, as well as NKG2D, FasL, TRAIL and IFN-γ (116, 137). This cytotoxic profile was confirmed in different in vitro models, including EBV-infected B cell lines () and HIV-infected lymphocytes (58, 138).

In vivo, activated γδ T cells have also proven to efficiently clear human influenza virus in humanized mice models (139). In humans, a study in 205 renal allograft recipients showed that CMV infection directly precedes γδ T cell expansion, and is the only clinical parameter associated with this expansion (140). Importantly, CMV-infected patients who develop delayed γδ T cell expansion have a higher viral load, more symptoms and longer disease than patients with early expansion, showing another link between γδ T cells and viral infection (141). This resolution is likely to be dependent on TCR stimulation triggering the perforin-granzyme B pathway as well as the production of IFN-γ (142, 143). Both αβ and γδ T cells respond to viral infection, as in the case of EBV-induced mononucleosis, but only the latter keeps a high frequency during the convalescent phase, consistent with their immune surveillance role (65). In acute hepatitis B, peripheral γδ T cells are activated and exhibit increased cytotoxicity and capacity for viral clearance (144). There is a negative correlation between activated γδ T cells and clinical markers of hepatitis progression (145), and in chronically-infected patients there is a marked reduction in the proportion and cytotoxicity of circulating γδ T cells compared to healthy donors, this decreased antiviral function correlating with the persistence of HBV (146, 147). Early HIV infection is also associated with reduced number and function of γδ T cells in the blood and endocervix (148, 149). This loss is proportional to viremia (150, 151) and might be a contributing factor in the establishment of viral persistence in AIDS, notably by reducing the level of IFN-γ (152). Interestingly, this appears to precede the loss of CD4+ αβ T cells, the major target of HIV, suggesting that γδ T cell impairment is one of the very first immune failings during HIV infection (153). Moreover, HIV‐infected elite controllers have elevated levels of circulating γδ T cells compared with HIV‐negative controls or HIV‐infected individuals on antiretroviral therapy (154), highlighting again a link between γδ T cells and disease outcome. In this latter category of antiretroviral treated patients, a slow but steady reconstitution of the γδ T cell pool to near-normal levels is observed (155, 156). Combined treatment with zoledronate (a γδ T cell-stimulating drug) and Interleukin-2 (IL2) in HIV patients induced activation and expansion of their circulating γδ T cells, and a subsequent heightened immune response characterized by dendritic cell maturation and CD8+ T cells responses (157) showing the efficiency of such intervention.

A Case Study of γδ T Cell Antiviral Function: Coronaviruses

To illustrate the points discussed above, the next part of this review will focus on the case of the SARS-CoV-2 virus, responsible for the 2020 pandemic, which has generated a worldwide effort and an unprecedented amount of data for a better understanding of viral infection and the immune response to it.

SARS-CoV-2 belongs to the betacoronavirus genus and causes a highly infectious respiratory disease called COVID-19. Its closest relative among human coronaviruses is SARS-CoV, with 79% genetic similarity (158). The pathophysiology of SARS-CoV-2 infection resembles that of SARS-CoV infection, with progression in some individuals to acute respiratory distress syndrome (ARDS) characterized by aggressive inflammatory responses in the lower airways and responsible for 28% of fatal COVID-19 cases. As such, severe COVID-19 is not only due to direct effects of the virus but also in part to a dysregulated immune response inflicting multi-organ damage, especially in the cardiac, hepatic and renal systems (159).

This immunopathology is defined by a suppression of the early pro-inflammatory response. Indeed, SARS-CoV-2 is able to inhibit several transcription factors pivotal for the antiviral response such as NF-kB and IRF3/7, resulting in limited IFN production and signaling, reduced recruitment of immune cells and viral evasion. This precipitates pathogenesis and mortality in susceptible individuals (160). Reports on severe COVID-19 patients also showed altered immune composition, with increased total neutrophils and reduced lymphocyte count in the peripheral blood (161), and a correlation between lymphocytopenia, serum IL-6 concentration (a hallmark of cytokine storm), and disease severity (162, 163). Moreover, as patients progress toward symptomatic stages, an increasing proportion of exhausted PD1+ and TIM3+ lymphocytes are seen, highlighting the failure of the adaptive system to control infection in these cases (164). COVID-19 is also characterized by its demographics, with a high susceptibility among older males (14.8% case fatality ratio after age 80 Vs 2.3% total; men roughly 1.5x more likely to die than women) (165, 166). Indeed, most children with COVID-19 are asymptomatic and have a normal lymphocyte count (167). One of the striking differences between young and elderly immunity is the strong innate responses observed in the former (168), leading to early control of infection at the site of entry. Multiple innate immunity aberrations have been reported in the elderly: desensitization of dendritic cells, reduced TLR responses, dysregulated IFN response, decreased macrophage and neutrophil function, reduced NK activity, and relevant to this discussion, decreased γδ T cell proliferation and number (169171). It has also been observed that there is altered function and phenotype among circulating γδ T cell in the elderly, notably a lower response and a lack of memory cells (172174). In women, this phenotypic change is not observed, and the γδ T cell reduction occurs later in life and is less pronounced than in men (175).

So innate immunity status and particularly γδ T cell function can shape the viral response and be a determinant of disease progression. Currently, only a few studies are available on the host innate immune response of COVID‐19 infected patients. It’s been shown that as the first line of defense, innate immunity must block the virus in the upper airways in the first 10-12 days from infection (5-7 from the disease onset) for an efficient resolution of the infection (176) and that it indeed performs with great efficiency in the majority of individuals (177). But in the case of the deleterious inflammation associated with severe COVID-19, a body of evidence suggest that it is due to a failure to activate the immune system during a critical early time window, and to a subsequent primary cytokine release syndrome triggered as a delayed emergency response to uncontrolled SARS-CoV-2 replication (178, 179). The priority therefore would be to promote an early and robust immune response for effective viral clearance and the prevention of symptomatic infection as well as viral transmission.

During the 2003 coronavirus outbreak, health care workers that survived SARS-CoV infection had a selective expansion of the blood Vδ2 γδ T cells, observed 3 months after the disease onset (180). No expansion of non-innate αβ T cells was detected at this timepoint. Interestingly, these γδ T cells were able to directly kill SARS-CoV infected target cells in an IFN-γ-dependent way, and their increase was proportional with anti-SARS-CoV IgG titers, suggesting their protective role during coronavirus infections.

There is currently a paucity of studies including the γδ T cells in their immune characterization of COVID-19, but the few studies that investigated this population gives us an interesting perspective on their role during the fight against SARS-CoV-2:

In accordance with the general lymphocytopenia, the percentage of γδ T cells in the blood of patients hospitalized for COVID-19 (on average 10 days after the onset of clinical symptoms) is lower than that of healthy controls (181, 182). Interestingly, there is a shift in γδ T cell phenotype during the 2 weeks of hospital admission, with a transition toward effector (memory) cells more capable of tissue infiltration, as confirmed by Odak et al. (183). The blood γδ T cell reduction is indeed associated with their recruitment in the airway tissues (184, 185). Moreover, γδ T cells’ level of stimulation (CD69 positivity) is increased in the blood compared to healthy controls and is even higher in the infected tissues than in the blood, showing their activation at the injury epicenter (186). Lei et al. (187) confirmed the γδ T cell activation in blood, with increasing expression of CD4 and CD25, and showed no sign of exhaustion as assessed by PD1 expression. The expansion of a CD16+ γδ T cell population in COVID-19 has been observed in single-cell transcriptional profiling of 13 patients. In the study, the presence of this CD16+ γδ T cells subset is strongly associated with moderate disease and almost absent in the severe condition (188). Another team comparing immune signatures between 63 COVID-19 patients and 55 Healthy Controls also confirmed the depletion of γδ T cells in the blood and showed that while the number of Vδ1 is not different from controls or between severity groups, the Vδ2 depletion is proportional to the disease severity (189). The authors then suggest that it could be used as a diagnostic or prognostic marker, a suggestion supported by Carissimo et al. who showed that a Neutrophil/Vδ2 ratio is a better prognostic marker of COVID-19 severity than the Neutrophil/CD8+ Lymphocytes ratio (190). They also showed that γδ T cells are generally activated, as seen by their upregulation of the activation marker CD38 and differentiate into central memory cells after recovery. Expansion of the γδ T cell pool has also been noted concomitantly of the remission phase in a single-cell analysis of 2 severe COVID-19 patients (191).

All the advantages highlighted above, including rapid activation, MHC independency, ability to traffic to infected tissues and potent antiviral function makes γδ T cells attractive candidates as therapeutic tools (192) (Figure 1). In the next section, we will focus on this therapeutic potential.

Figure 1

The Art of War: γδ T Cell-Based Therapeutic Strategies

There are 2 major modalities for taking advantage of γδ T cell capabilities in a clinical context: ex vivo activation with a subsequent adoptive transfer, or direct in vivo activation.

Ex Vivo Stimulation and Adoptive Cell Therapy

The ex vivo approach relies on γδ T cell isolation from Peripheral Blood Mononuclear Cells (PBMCs), in vitro stimulation with products such as bisphosphonates, pAg or monoclonal antibodies (193), and injection of the activated cells into patients (194). The safety and efficacy of this approach have long been proven in the treatment of cancers, with dozens of clinical trials involving isolation, expansion and adoptive transfer of up to 1x1010 γδ T cells (195).

This strategy is also implemented as antiviral therapy against various infections and has shown promising results. The first necessity for an optimal cell product is to stimulate γδ T cells in a way that maximizes their antiviral response. This has been achieved for example in a model of H1N1-infected macrophage, where γδ T cells expanded with isopentenyl pyrophosphate (IPP), a phosphoantigen, are able to effectively kill target cells and to inhibit viral replication, notably due to their high production of IFN-γ (116, 196). Similarly, when expanded with Pamidronate (PAM), a bisphosphonate, γδ T cells can also effectively kill influenza-infected lung alveolar epithelial cells in vitro thus inhibiting viral replication (137). These results have been confirmed in models of HCV as well as CMV infection (104, 197). Furthermore, Zoledronic Acid (ZA), another bisphosphonate, has been used ex vivo in PBMCs from HIV+ individuals and resulted in expansion of γδ T cells displaying cytotoxic capabilities and potent ADCC function, demonstrating that this protocol is able to reactivate effector functions in patient’s cells (198). PAM expanded cells from HIV-infected patients showed similar cytotoxicity against HIV-infected cells (199), illustrating that various avenues can be chosen to harness γδ T cells’ antiviral functions in a clinical setting.

The second step of this strategy involves the adoptive transfer of activated γδ T cells, which have been shown to be safe and effective in pre-clinical models of infectious disease. In mice infected with enterovirus or CMV, the adoptive transfer of γδ T cells was able to provoke a Th1-type response associated with viral control and better survival (200202). In humanized mice infected by the influenza virus, injection of PAM-activated γδ T cells resulted in controlled viral replication and reduced disease severity and mortality (203).

Thus, γδ T cell-based adoptive cell therapies have the potential to be used as an allogeneic “off-the-shelf” antiviral product, akin to the strategies used for example with NK cells (https://clinicaltrials.gov/ct2/show/NCT04365101). Despite this potential, clinical efficacy has yet to be proven, and the logistical challenges that come with an ex vivo cell product may hinder the development of this specific strategy. Hence, directly stimulating a patient’s γδ T cells in vivo could appear more desirable.

In Vivo Activation

The in vivo approach involves systemic stimulation and expansion of γδ T cells, usually by administration of bisphosphonates or pAg. It’s also used routinely for cancer treatment, with no severe adverse effects and an efficient in vivo expansion of IFN-γ+ Perforin+ effector γδ T cells (204, 205) associated with stable disease or partial remission (206).

The use of humanized mouse models has generated interesting data in influenza infection. In vivo activation with PAM resulted in accumulation of γδ T cells in lungs and fewer symptoms, associated with reduced lung inflammation, fewer cell infiltrates and decreased levels of mediators such as IL-6, TNF-α or IP-10 (203). This finding has been supported by others, who also describe a 3-fold increase of γδ T cells 2 days after treatment, and lower viral replication and mortality (139). Non-human primate models provide an alternative to humanized mice in the interrogation of in vivo γδ T cells responses. The pAg HMBPP ((E)-4-Hydroxy-3-Methyl-But-2-enyl Pyrophosphate), in combination with IL2, has been shown to cause expansion of circulating IFN-γ+ Perforin+ γδ T cells in vivo, and accumulation in the lungs lasting at least 3-4 months, long after circulating levels had returned to normal (207). In a similar study, γδ T cells accumulated in the lungs were able to protect from pulmonary lesions caused by Yersinia pestis infection (208). Finally, in a model of tuberculosis, IFN-γ+ Perforin+ γδ T cells accumulating in the lungs attenuated the lesions and stimulated a CD8+ T cell adaptive immune response (209). These findings are consistent with the paradigm that circulating γδ T cells can traffic to the lungs for homeostatic protection against tissue damage during infection, suggesting their potential as immunotherapeutics against a variety of pulmonary pathogens. In humans, administration of ZA with IL2 has been carried out in HIV‐infected, antiretroviral naïve patients and was associated with γδ T cell expansion, dendritic cell activation and increased HIV‐specific CD8+ T‐cell responses (210), suggesting that this strategy can be used to restore impaired immune response observed in AIDS (211).

The advantage of bisphosphonates such as ZA and PAM is that they are already clinically approved, inexpensive and relatively safe drugs (212). Moreover, in the context of viral infection, they might have an additive clinical benefit, as they’ve been shown not only to stimulate γδ T cells but also inhibit the protein prenylation pathway and the cholesterol synthesis, both required for virus assembly (113, 213). Taken together, these effects strengthen the argument for their use as antiviral agents.

Another known mechanism of in vivo γδ T cell activation is by microbial products like listeria, mycobacteria or salmonella-derived vaccines (214216). Indeed, there is accumulating evidence that innate immunity, including γδ T cells, is boosted by specific vaccination in addition to targeted adaptive immunity (217). For example, the influenza vaccine is able to induce virus-specific γδ T cell expansion along with CD4+ and CD8+ T cells stimulation (218), and the differentiation of these γδ T cells into an effector/memory phenotype, with increased perforin expression (219). Vaccination in a model of Simian Immunodeficiency Virus (SIV) in macaques has been shown to block infection early at mucosal sites, and this protection was associated with expansion of γδ T cells and maturation of dendritic cells (220). In addition to their designed effects, vaccines have long been shown to protect beyond their target antigen through induction of innate immune mechanisms termed non-specific heterologous effects and trained immunity (221). Thus, certain adjuvants such as TLR agonists (222), as well as live vaccines like polio (223) or measles (224, 225) induce long-term cross-protection against various infections through epigenetic, transcriptional, and functional reprogramming of innate immune cells such as macrophages, NK cells or γδ T cells (226). This reprogramming results in enhanced activation, and ultimately protection against secondary infection, resembling immune memory (227, 228). The most well-studied inducer of trained immunity is the Bacillus Calmette–Guérin (BCG) vaccine (229). It is composed of a live attenuated strain of Mycobacterium bovis originally given to young children to protect against tuberculosis, but recent studies demonstrated that its administration more broadly reduced mortalities from infectious diseases over the neonatal period (230, 231). It has then been postulated that the relative protection from COVID-19 reported in children might be attributed to their frequent vaccinations, and indeed some correlations between BCG vaccination policies and reduced infection and mortality rates due to SARS-CoV-2 have been reported (232235). Indeed, even after correcting for many socioeconomic and pandemic-related confounders, data shows that for every 10% increase in the BCG index (degree of national universal vaccination), there is a 10.4% reduction in COVID-19 mortality (236). These results are still under debate (237) but have initiated numerous studies and clinical trials investigating the effect of BCG on nonspecific protection against SARS-CoV-2 infection or its severity (238240) (https://clinicaltrials.gov/ct2/show/NCT04369794, NCT04362124, NCT04379336, NCT04350931, NCT04327206, NCT04373291, NCT04328441, NCT04348370). This non-specific protection could be harnessed independently of age, as a randomized controlled trial in elderly (60–75 years old) who received BCG vaccinations, showed a reduction of the incidence of acute upper respiratory tract infection (241). It has also been proven to protect against a variety of viruses like yellow fever, influenza, papillomavirus (HPV), Respiratory syncytial virus (RSV) or HSV (242, 243).

As a key cell type in the innate immune response, it is clear γδ T cells also play a role in contributing to trained immunity. Many studies have documented expansion of the γδ T cell population following vaccination with BCG, with these cells being one of the key producers of IFN-y in immunized children (244246). Mycobacteria stimulation also induces γδ T cell cytotoxicity toward virus-infected cells (HSV and vaccinia), typical of the heterologous effect observed in trained immunity (247). Moreover, γδ T cells expanded after viral infection or BCG stimulation, differentiate into effector memory cells capable of a faster and more efficient response to a second infection (248251). So BCG can be used to expand cytotoxic γδ T cells capable of eventually differentiating in long-lived memory cells allowing enhanced protection against subsequent infections.

The contribution of γδ T cells to the regression of BCG-treated melanoma patients has already been proven (252), and highlights the clinical potential suggested above for a similar setting in treatments of viral infections. Thus, BCG or its derivatives (253, 254) are attractive candidates for establishing trained immunity and stimulating early clearance of subsequent viral infection (255). Integrating innate immunity stimulation in the design of vaccines would also be a way of harnessing this under-considered potential (256). Indeed, by the choice of delivery route (257, 258) or adjuvant (259), one could balance the immune response to allow for complementary protection in instances where the adaptive immunity is failing. BCG itself could be used as an adjuvant or in a prime-boost strategy, as it has been shown to orient toward an antiviral Th1-type response and to enhance vaccine efficiency (260).

Discussion

As highlighted here, the varied characteristics of γδ T cells support their role in controlling viral diseases in general and COVID-19 in particular. Considering the accumulating evidence on their multiple antiviral functions and their capacity to react early and to quickly prevent viral spread, we’re advocating for better inclusion of γδ T cells in the therapeutic armamentarium against viral infections. For example, a cheap and effective way of harnessing anti-viral innate immunity such as that mediated by γδ T cells would be to vaccinate the population with BCG in cases where there is no access to a specific vaccine, or as a supplementary boost to it, and the ongoing clinical trials using these strategies will be of tremendous importance for the optimization of γδ T cell-based therapies against viruses.

Funding

This work was supported by the Institute for Cancer Vaccines and Immunotherapy (Registered Charity Number 1080343).

Statements

Author contributions

JC designed, wrote, and revised the manuscript. LR wrote and revised the manuscript. MB-S revised and edited the manuscript. All authors contributed to the article and approved the submitted version.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

  • 1

    XuGJKulaTXuQLiMZVernonSDNdung’uTet al. Viral immunology. Comprehensive serological profiling of human populations using a synthetic human virome. Science (2015) 348:aaa0698. doi: 10.1126/science.aaa0698

  • 2

    PocciaFAgratiCMartiniFCapobianchiMRWallaceMMalkovskyM. Antiviral reactivities of gammadelta T cells. Microbes Infect (2005) 7:518–28. doi: 10.1016/j.micinf.2004.12.009

  • 3

    NielsenMMWitherdenDAHavranWL. γδ T cells in homeostasis and host defence of epithelial barrier tissues. Nat Rev Immunol (2017) 17:733–45. doi: 10.1038/nri.2017.101

  • 4

    BonnevilleMO’BrienRLBornWK. Gammadelta T cell effector functions: a blend of innate programming and acquired plasticity. Nat Rev Immunol (2010) 10:467–78. doi: 10.1038/nri2781

  • 5

    HaydayATheodoridisERamsburgEShiresJ. Intraepithelial lymphocytes: exploring the Third Way in immunology. Nat Immunol (2001) 2:9971003. doi: 10.1038/ni1101-997

  • 6

    CruzMSDiamondARussellAJamesonJM. Human αβ and γδ T Cells in Skin Immunity and Disease. Front Immunol (2018) 9:1304. doi: 10.3389/fimmu.2018.01304

  • 7

    ChienYMeyerCBonnevilleM. γδ T cells: first line of defense and beyond. Annu Rev Immunol (2014) 32:121–55. doi: 10.1146/annurev-immunol-032713-120216

  • 8

    SelinLKSantolucitoPAPintoAKSzomolanyi-TsudaEWelshRM. Innate immunity to viruses: control of vaccinia virus infection by gamma delta T cells. J Immunol (2001) 166:6784–94. doi: 10.4049/jimmunol.166.11.6784

  • 9

    WangTGaoYScullyEDavisCTAndersonJFWelteTet al. Gamma delta T cells facilitate adaptive immunity against West Nile virus infection in mice. J Immunol (2006) 177:1825–32. doi: 10.4049/jimmunol.177.3.1825

  • 10

    DeetzCOHebbelerAMProppNACairoCTikhonovIPauzaCD. Gamma interferon secretion by human Vgamma2Vdelta2 T cells after stimulation with antibody against the T-cell receptor plus the Toll-Like receptor 2 agonist Pam3Cys. Infect Immun (2006) 74:4505–11. doi: 10.1128/IAI.00088-06

  • 11

    CuiYKangLCuiLHeW. Human gammadelta T cell recognition of lipid A is predominately presented by CD1b or CD1c on dendritic cells. Biol Direct (2009) 4:47. doi: 10.1186/1745-6150-4-47

  • 12

    LesterSNLiK. Toll-like receptors in antiviral innate immunity. J Mol Biol (2014) 426:1246–64. doi: 10.1016/j.jmb.2013.11.024

  • 13

    WeschDBeetzSObergH-HMargetMKrengelKKabelitzD. Direct costimulatory effect of TLR3 ligand poly(I:C) on human gamma delta T lymphocytes. J Immunol (2006) 176:1348–54. doi: 10.4049/jimmunol.176.3.1348

  • 14

    PietschmannKBeetzSWelteSMartensIGruenJObergH-Het al. Toll-like receptor expression and function in subsets of human gammadelta T lymphocytes. Scand J Immunol (2009) 70:245–55. doi: 10.1111/j.1365-3083.2009.02290.x

  • 15

    WeschDPetersCObergH-HPietschmannKKabelitzD. Modulation of γδ T cell responses by TLR ligands. Cell Mol Life Sci (2011) 68:2357–70. doi: 10.1007/s00018-011-0699-1

  • 16

    KawaiTAkiraS. TLR signaling. Cell Death Differ (2006) 13:816–25. doi: 10.1038/sj.cdd.4401850

  • 17

    SirénJPirhonenJJulkunenIMatikainenS. IFN-alpha regulates TLR-dependent gene expression of IFN-alpha, IFN-beta, IL-28, and IL-29. J Immunol (2005) 174:1932–7. doi: 10.4049/jimmunol.174.4.1932

  • 18

    Rincon-OrozcoBKunzmannVWrobelPKabelitzDSteinleAHerrmannT. Activation of V gamma 9V delta 2 T cells by NKG2D. J Immunol (2005) 175:2144–51. doi: 10.4049/jimmunol.175.4.2144

  • 19

    GonzálezSLópez-SotoASuarez-AlvarezBLópez-VázquezALópez-LarreaC. NKG2D ligands: key targets of the immune response. Trends Immunol (2008) 29:397403. doi: 10.1016/j.it.2008.04.007

  • 20

    RölleAMousavi-JaziMErikssonMOdebergJSöderberg-NauclérCCosmanDet al. Effects of human cytomegalovirus infection on ligands for the activating NKG2D receptor of NK cells: up-regulation of UL16-binding protein (ULBP)1 and ULBP2 is counteracted by the viral UL16 protein. J Immunol (2003) 171:902–8. doi: 10.4049/jimmunol.171.2.902

  • 21

    SirénJSarenevaTPirhonenJStrengellMVeckmanVJulkunenIet al. Cytokine and contact-dependent activation of natural killer cells by influenza A or Sendai virus-infected macrophages. J Gen Virol (2004) 85:2357–64. doi: 10.1099/vir.0.80105-0

  • 22

    WardJBonaparteMSacksJGutermanJFogliMMavilioDet al. HIV modulates the expression of ligands important in triggering natural killer cell cytotoxic responses on infected primary T-cell blasts. Blood (2007) 110:1207–14. doi: 10.1182/blood-2006-06-028175

  • 23

    XiangZLiuYZhengJLiuMLvAGaoYet al. Targeted activation of human Vγ9Vδ2-T cells controls epstein-barr virus-induced B cell lymphoproliferative disease. Cancer Cell (2014) 26:565–76. doi: 10.1016/j.ccr.2014.07.026

  • 24

    KongYCaoWXiXMaCCuiLHeW. The NKG2D ligand ULBP4 binds to TCRgamma9/delta2 and induces cytotoxicity to tumor cells through both TCRgammadelta and NKG2D. Blood (2009) 114:310–7. doi: 10.1182/blood-2008-12-196287

  • 25

    NedellecSSabourinCBonnevilleMScotetE. NKG2D Costimulates Human Vγ9Vδ2 T Cell Antitumor Cytotoxicity through Protein Kinase Cθ-Dependent Modulation of Early TCR-Induced Calcium and Transduction Signals. J Immunol (2010) 185:5563. doi: 10.4049/jimmunol.1000373

  • 26

    LançaTCorreiaDVMoitaCFRaquelHNeves-CostaAFerreiraCet al. The MHC class Ib protein ULBP1 is a nonredundant determinant of leukemia/lymphoma susceptibility to gammadelta T-cell cytotoxicity. Blood (2010) 115:2407–11. doi: 10.1182/blood-2009-08-237123

  • 27

    XuBPizarroJCHolmesMAMcBethCGrohVSpiesTet al. Crystal structure of a gammadelta T-cell receptor specific for the human MHC class I homolog MICA. Proc Natl Acad Sci USA (2011) 108:2414–9. doi: 10.1073/pnas.1015433108

  • 28

    ToutiraisOCabillicFLe FriecGSalotSLoyerPLe GalloMet al. DNAX accessory molecule-1 (CD226) promotes human hepatocellular carcinoma cell lysis by Vgamma9Vdelta2 T cells. Eur J Immunol (2009) 39:1361–8. doi: 10.1002/eji.200838409

  • 29

    PignoloniBFiondaCDell’OsteVLuganiniACippitelliMZingoniAet al. Distinct Roles for Human Cytomegalovirus Immediate Early Proteins IE1 and IE2 in the Transcriptional Regulation of MICA and PVR/CD155 Expression. J Immunol (2016) 197:4066–78. doi: 10.4049/jimmunol.1502527

  • 30

    VassenaLGiulianiEMatusaliGCohenÉADoriaM. The human immunodeficiency virus type 1 Vpr protein upregulates PVR via activation of the ATR-mediated DNA damage response pathway. J Gen Virol (2013) 94:2664–9. doi: 10.1099/vir.0.055541-0

  • 31

    PappworthIYWangECRoweM. The switch from latent to productive infection in epstein-barr virus-infected B cells is associated with sensitization to NK cell killing. J Virol (2007) 81:474–82. doi: 10.1128/JVI.01777-06

  • 32

    Charpak-AmikamYKubschTSeidelEOiknine-DjianECavalettoNYaminRet al. Human cytomegalovirus escapes immune recognition by NK cells through the downregulation of B7-H6 by the viral genes US18 and US20. Sci Rep (2017) 7:8661. doi: 10.1038/s41598-017-08866-2

  • 33

    MandelboimOLiebermanNLevMPaulLArnonTIBushkinYet al. Recognition of haemagglutinins on virus-infected cells by NKp46 activates lysis by human NK cells. Nature (2001) 409:1055–60. doi: 10.1038/35059110

  • 34

    HoJWHershkovitzOPeirisMZilkaABar-IlanANalBet al. H5-type influenza virus hemagglutinin is functionally recognized by the natural killer-activating receptor NKp44. J Virol (2008) 82:2028–32. doi: 10.1128/JVI.02065-07

  • 35

    JarahianMFiedlerMCohnenADjandjiDHämmerlingGJGatiCet al. Modulation of NKp30- and NKp46-mediated natural killer cell responses by poxviral hemagglutinin. PloS Pathog (2011) 7:e1002195. doi: 10.1371/journal.ppat.1002195

  • 36

    JarahianMWatzlCFournierPArnoldADjandjiDZahediSet al. Activation of natural killer cells by newcastle disease virus hemagglutinin-neuraminidase. J Virol (2009) 83:8108–21. doi: 10.1128/JVI.00211-09

  • 37

    HershkovitzORosentalBRosenbergLANavarro-SanchezMEJivovSZilkaAet al. NKp44 receptor mediates interaction of the envelope glycoproteins from the West Nile and dengue viruses with NK cells. J Immunol (2009) 183:2610–21. doi: 10.4049/jimmunol.0802806

  • 38

    CorreiaDVFogliMHudspethKda SilvaMGMavilioDSilva-SantosB. Differentiation of human peripheral blood Vδ1+ T cells expressing the natural cytotoxicity receptor NKp30 for recognition of lymphoid leukemia cells. Blood (2011) 118:9921001. doi: 10.1182/blood-2011-02-339135

  • 39

    HudspethKFogliMCorreiaDVMikulakJRobertoADella BellaSet al. Engagement of NKp30 on Vδ1 T cells induces the production of CCL3, CCL4, and CCL5 and suppresses HIV-1 replication. Blood (2012) 119:4013–6. doi: 10.1182/blood-2011-11-390153

  • 40

    von Lilienfeld-ToalMNattermannJFeldmannGSieversEFrankSStrehlJet al. Activated gammadelta T cells express the natural cytotoxicity receptor natural killer p 44 and show cytotoxic activity against myeloma cells. Clin Exp Immunol (2006) 144:528–33. doi: 10.1111/j.1365-2249.2006.03078.x

  • 41

    UrbanEMChapovalAIPauzaCD. Repertoire development and the control of cytotoxic/effector function in human gammadelta T cells. Clin Dev Immunol (2010) 2010:732893. doi: 10.1155/2010/732893

  • 42

    BornWKKemal AydintugMO’BrienRL. Diversity of γδ T-cell antigens. Cell Mol Immunol (2013) 10:1320. doi: 10.1038/cmi.2012.45

  • 43

    SpadaFMGrantEPPetersPJSugitaMMeliánALeslieDSet al. Self-recognition of CD1 by gamma/delta T cells: implications for innate immunity. J Exp Med (2000) 191:937–48. doi: 10.1084/jem.191.6.937

  • 44

    HirshMIJungerWG. Roles of heat shock proteins and gamma delta T cells in inflammation. Am J Respir Cell Mol Biol (2008) 39:509–13. doi: 10.1165/rcmb.2008-0090TR

  • 45

    DasHGrohVKuijlCSugitaMMoritaCTSpiesTet al. MICA engagement by human Vgamma2Vdelta2 T cells enhances their antigen-dependent effector function. Immunity (2001) 15:8393. doi: 10.1016/s1074-7613(01)00168-6

  • 46

    FourniéJJBonnevilleM. Stimulation of gamma delta T cells by phosphoantigens. Res Immunol (1996) 147:338–47. doi: 10.1016/0923-2494(96)89648-9

  • 47

    DjaoudZGuethleinLAHorowitzAAzziTNemat-GorganiNOliveDet al. Two alternate strategies for innate immunity to Epstein-Barr virus: One using NK cells and the other NK cells and γδ T cells. J Exp Med (2017) 214:1827–41. doi: 10.1084/jem.20161017

  • 48

    JamesonJMCruzJCostanzoATerajimaMEnnisFA. A role for the mevalonate pathway in the induction of subtype cross-reactive immunity to influenza A virus by human gammadelta T lymphocytes. Cell Immunol (2010) 264:71–7. doi: 10.1016/j.cellimm.2010.04.013

  • 49

    DéchanetJMervillePLimARetièreCPitardVLafargeXet al. Implication of gammadelta T cells in the human immune response to cytomegalovirus. J Clin Invest (1999) 103:1437–49. doi: 10.1172/JCI5409

  • 50

    KaminskiHMarsèresGCosentinoAGuervilleFPitardVFourniéJ-Jet al. Understanding human γδ T cell biology toward a better management of cytomegalovirus infection. Immunol Rev (2020) 298:264–88. doi: 10.1111/imr.12922

  • 51

    JinYXiaMSaylorCMNarayanKKangJWiestDLet al. Cutting edge: Intrinsic programming of thymic γδT cells for specific peripheral tissue localization. J Immunol (2010) 185:7156–60. doi: 10.4049/jimmunol.1002781

  • 52

    ChennupatiVWorbsTLiuXMalinarichFHSchmitzSHaasJDet al. Intra- and intercompartmental movement of gammadelta T cells: intestinal intraepithelial and peripheral gammadelta T cells represent exclusive nonoverlapping populations with distinct migration characteristics. J Immunol (2010) 185:5160–8. doi: 10.4049/jimmunol.1001652

  • 53

    Di Marco BarrosRRobertsNADartRJVantouroutPJandkeANussbaumerOet al. Epithelia Use Butyrophilin-like Molecules to Shape Organ-Specific γδ T Cell Compartments. Cell (2016) 167:20318.e17. doi: 10.1016/j.cell.2016.08.030

  • 54

    JandkeAMelandriDMoninLUshakovDSLaingAGVantouroutPet al. Butyrophilin-like proteins display combinatorial diversity in selecting and maintaining signature intraepithelial γδ T cell compartments. Nat Commun (2020) 11:3769. doi: 10.1038/s41467-020-17557-y

  • 55

    AgratiCD’OffiziGNarcisoPAbrignaniSIppolitoGColizziVet al. Vdelta1 T lymphocytes expressing a Th1 phenotype are the major gammadelta T cell subset infiltrating the liver of HCV-infected persons. Mol Med (2001) 7:11–9. doi: 10.1016/j.arr.2018.11.003

  • 56

    De PaoliPGennariDMartelliPBasagliaGCrovattoMBattistinSet al. A subset of gamma delta lymphocytes is increased during HIV-1 infection. Clin Exp Immunol (1991) 83:187–91. doi: 10.1111/j.1365-2249.1991.tb05612.x

  • 57

    AgratiCD’OffiziGNarcisoPSelvaCPucilloLPIppolitoGet al. Gammadelta T cell activation by chronic HIV infection may contribute to intrahepatic vdelta1 compartmentalization and hepatitis C virus disease progression independent of highly active antiretroviral therapy. AIDS Res Hum Retroviruses (2001) 17:1357–63. doi: 10.1089/08892220152596614

  • 58

    Fausther-BovendoHWauquierNCherfils-ViciniJCremerIDebréPVieillardV. NKG2C is a major triggering receptor involved in the V[delta]1 T cell-mediated cytotoxicity against HIV-infected CD4 T cells. AIDS (2008) 22:217–26. doi: 10.1097/QAD.0b013e3282f46e7c

  • 59

    VavassoriSKumarAWanGSRamanjaneyuluGSCavallariMEl DakerSet al. Butyrophilin 3A1 binds phosphorylated antigens and stimulates human γδ T cells. Nat Immunol (2013) 14:908–16. doi: 10.1038/ni.2665

  • 60

    BoutinLScotetE. Towards Deciphering the Hidden Mechanisms That Contribute to the Antigenic Activation Process of Human Vγ9Vδ2 T Cells. Front Immunol (2018) 9:828. doi: 10.3389/fimmu.2018.00828

  • 61

    VerjansGMGMRoestRWvan der KooiAvan DijkGvan der MeijdenWIOsterhaus A ‘DME. Isopentenyl pyrophosphate-reactive Vgamma9Vdelta 2 T helper 1-like cells are the major gammadelta T cell subset recovered from lesions of patients with genital herpes. J Infect Dis (2004) 190:489–93. doi: 10.1086/422393

  • 62

    ZhongHHuXJanowskiABStorchGASuLCaoLet al. Whole transcriptome profiling reveals major cell types in the cellular immune response against acute and chronic active Epstein-Barr virus infection. Sci Rep (2017) 7:17775. doi: 10.1038/s41598-017-18195-z

  • 63

    HassanJFeigheryCBresnihanBWhelanA. Elevated T cell receptor gamma delta + T cells in patients with infectious mononucleosis. Br J Haematol (1991) 77:255–6. doi: 10.1111/j.1365-2141.1991.tb07990.x

  • 64

    YinWTongSZhangQShaoJLiuQPengHet al. Functional dichotomy of Vδ2 γδ T cells in chronic hepatitis C virus infections: role in cytotoxicity but not for IFN-γ production. Sci Rep (2016) 6:26296. doi: 10.1038/srep26296

  • 65

    De PaoliPGennariDMartelliPCavarzeraniVComorettoRSantiniG. Gamma delta T cell receptor-bearing lymphocytes during Epstein-Barr virus infection. J Infect Dis (1990) 161:1013–6. doi: 10.1093/infdis/161.5.1013

  • 66

    KoizumiHLiuCCZhengLMJoagSVBayneNKHoloshitzJet al. Expression of perforin and serine esterases by human gamma/delta T cells. J Exp Med (1991) 173:499502. doi: 10.1084/jem.173.2.499

  • 67

    LiebermanJ. The ABCs of granule-mediated cytotoxicity: new weapons in the arsenal. Nat Rev Immunol (2003) 3:361–70. doi: 10.1038/nri1083

  • 68

    BadeBBoettcherHELohrmannJHink-SchauerCBratkeKJenneDEet al. Differential expression of the granzymes A, K and M and perforin in human peripheral blood lymphocytes. Int Immunol (2005) 17:1419–28. doi: 10.1093/intimm/dxh320

  • 69

    SparrowEBodman-SmithMD. Granulysin: The attractive side of a natural born killer. Immunol Lett (2020) 217:126–32. doi: 10.1016/j.imlet.2019.11.005

  • 70

    SchneiderPThomeMBurnsKBodmerJLHofmannKKataokaTet al. TRAIL receptors 1 (DR4) and 2 (DR5) signal FADD-dependent apoptosis and activate NF-kappaB. Immunity (1997) 7:831–6. doi: 10.1016/s1074-7613(00)80401-x

  • 71

    NakataMSmythMJNorihisaYKawasakiAShinkaiYOkumuraKet al. Constitutive expression of pore-forming protein in peripheral blood gamma/delta T cells: implication for their cytotoxic role in vivo. J Exp Med (1990) 172:1877–80. doi: 10.1084/jem.172.6.1877

  • 72

    De RosaSCAndrusJPPerfettoSPMantovaniJJHerzenbergLAHerzenbergLAet al. Ontogeny of gamma delta T cells in humans. J Immunol (2004) 172:1637–45. doi: 10.4049/jimmunol.172.3.1637

  • 73

    NakataMKawasakiAAzumaMTsujiKMatsudaHShinkaiYet al. Expression of perforin and cytolytic potential of human peripheral blood lymphocyte subpopulations. Int Immunol (1992) 4:1049–54. doi: 10.1093/intimm/4.9.1049

  • 74

    DieliFTroye-BlombergMIvanyiJFourniéJJKrenskyAMBonnevilleMet al. Granulysin-dependent killing of intracellular and extracellular Mycobacterium tuberculosis by Vgamma9/Vdelta2 T lymphocytes. J Infect Dis (2001) 184:1082–5. doi: 10.1086/323600

  • 75

    FarnaultLGertner-DardenneJGondois-ReyFMichelGChambostHHirschIet al. Clinical evidence implicating gamma-delta T cells in EBV control following cord blood transplantation. Bone Marrow Transplant (2013) 48:1478–9. doi: 10.1038/bmt.2013.75

  • 76

    de KoningPJATesselaarKBovenschenNColakSQuadirRVolmanTJHet al. The cytotoxic protease granzyme M is expressed by lymphocytes of both the innate and adaptive immune system. Mol Immunol (2010) 47:903–11. doi: 10.1016/j.molimm.2009.10.001

  • 77

    de KoningPJAKummerJABovenschenN. Biology of granzyme M: a serine protease with unique features. Crit Rev Immunol (2009) 29:307–15. doi: 10.1615/critrevimmunol.v29.i4.20

  • 78

    van DomselaarRPhilippenLEQuadirRWiertzEJHJKummerJABovenschenN. Noncytotoxic inhibition of cytomegalovirus replication through NK cell protease granzyme M-mediated cleavage of viral phosphoprotein 71. J Immunol (2010) 185:7605–13. doi: 10.4049/jimmunol.1001503

  • 79

    AndradeFFellowsEJenneDERosenAYoungCSH. Granzyme H destroys the function of critical adenoviral proteins required for viral DNA replication and granzyme B inhibition. EMBO J (2007) 26:2148–57. doi: 10.1038/sj.emboj.7601650

  • 80

    ZhongCLiCWangXToyodaTGaoGFanZ. Granzyme K inhibits replication of influenza virus through cleaving the nuclear transport complex importin α1/β dimer of infected host cells. Cell Death Differ (2012) 19:882–90. doi: 10.1038/cdd.2011.178

  • 81

    TangHLiCWangLZhangHFanZ. Granzyme H of cytotoxic lymphocytes is required for clearance of the hepatitis B virus through cleavage of the hepatitis B virus X protein. J Immunol (2012) 188:824–31. doi: 10.4049/jimmunol.1102205

  • 82

    RomeroVFellowsEJenneDEAndradeF. Cleavage of La protein by granzyme H induces cytoplasmic translocation and interferes with La-mediated HCV-IRES translational activity. Cell Death Differ (2009) 16:340–8. doi: 10.1038/cdd.2008.165

  • 83

    RouvierELucianiMFGolsteinP. Fas involvement in Ca(2+)-independent T cell-mediated cytotoxicity. J Exp Med (1993) 177:195200. doi: 10.1084/jem.177.1.195

  • 84

    HuberSA. T cells expressing the gamma delta T cell receptor induce apoptosis in cardiac myocytes. Cardiovasc Res (2000) 45:579–87. doi: 10.1016/s0008-6363(99)00267-9

  • 85

    KägiDVignauxFLedermannBBürkiKDepraetereVNagataSet al. Fas and perforin pathways as major mechanisms of T cell-mediated cytotoxicity. Science (1994) 265:528–30. doi: 10.1126/science.7518614

  • 86

    YamashitaSTanakaYTsutsumiSAburataniHMinatoNIharaS. Analysis of mechanism for human gammadelta T cell recognition of nonpeptide antigens. Biochem Biophys Res Commun (2005) 334:349–60. doi: 10.1016/j.bbrc.2005.06.100

  • 87

    GuervilleFDaburonSMarlinRLartigueLLoizonSPitardVet al. TCR-dependent sensitization of human γδ T cells to non-myeloid IL-18 in cytomegalovirus and tumor stress surveillance. Oncoimmunology (2015) 4:e1003011. doi: 10.1080/2162402X.2014.1003011

  • 88

    DeVicoALGalloRC. Control of HIV-1 infection by soluble factors of the immune response. Nat Rev Microbiol (2004) 2:401–13. doi: 10.1038/nrmicro878

  • 89

    SchneiderWMChevillotteMDRiceCM. Interferon-stimulated genes: a complex web of host defenses. Annu Rev Immunol (2014) 32:513–45. doi: 10.1146/annurev-immunol-032713-120231

  • 90

    SamuelCE. Antiviral actions of interferons. Clin Microbiol Rev (2001) 14:778809. doi: 10.1128/CMR.14.4.778-809.2001

  • 91

    CrosseKMMonsonEABeardMRHelbigKJ. Interferon-Stimulated Genes as Enhancers of Antiviral Innate Immune Signaling. J Innate Immun (2018) 10:8593. doi: 10.1159/000484258

  • 92

    BrassALHuangI-CBenitaYJohnSPKrishnanMNFeeleyEMet al. The IFITM proteins mediate cellular resistance to influenza A H1N1 virus, West Nile virus, and dengue virus. Cell (2009) 139:1243–54. doi: 10.1016/j.cell.2009.12.017

  • 93

    HuangI-CBaileyCCWeyerJLRadoshitzkySRBeckerMMChiangJJet al. Distinct patterns of IFITM-mediated restriction of filoviruses, SARS coronavirus, and influenza A virus. PloS Pathog (2011) 7:e1001258. doi: 10.1371/journal.ppat.1001258

  • 94

    ChakrabartiAJhaBKSilvermanRH. New insights into the role of RNase L in innate immunity. J Interferon Cytokine Res (2011) 31:4957. doi: 10.1089/jir.2010.0120

  • 95

    SzretterKJBrienJDThackrayLBVirginHWCresswellPDiamondMS. The interferon-inducible gene viperin restricts West Nile virus pathogenesis. J Virol (2011) 85:11557–66. doi: 10.1128/JVI.05519-11

  • 96

    WangXHinsonERCresswellP. The interferon-inducible protein viperin inhibits influenza virus release by perturbing lipid rafts. Cell Host Microbe (2007) 2:96105. doi: 10.1016/j.chom.2007.06.009

  • 97

    DunneMRMadrigal-EstebasLTobinLMDohertyDG. (E)-4-hydroxy-3-methyl-but-2 enyl pyrophosphate-stimulated Vgamma9Vdelta2 T cells possess T helper type 1-promoting adjuvant activity for human monocyte-derived dendritic cells. Cancer Immunol Immunother (2010) 59:1109–20. doi: 10.1007/s00262-010-0839-8

  • 98

    SantSJenkinsMRDashPWatsonKAWangZPizzollaAet al. Human γδ T-cell receptor repertoire is shaped by influenza viruses, age and tissue compartmentalisation. Clin Transl Immunol (2019) 8:e1079. doi: 10.1002/cti2.1079

  • 99

    YinZZhangDHWelteTBahtiyarGJungSLiuLet al. Dominance of IL-12 over IL-4 in gamma delta T cell differentiation leads to default production of IFN-gamma: failure to down-regulate IL-12 receptor beta 2-chain expression. J Immunol (2000) 164:3056–64. doi: 10.4049/jimmunol.164.6.3056

  • 100

    GarcíaVESielingPAGongJBarnesPFUyemuraKTanakaYet al. Single-cell cytokine analysis of gamma delta T cell responses to nonpeptide mycobacterial antigens. J Immunol (1997) 159:1328–35.

  • 101

    BattistiniLBorsellinoGSawickiGPocciaFSalvettiMRistoriGet al. Phenotypic and cytokine analysis of human peripheral blood gamma delta T cells expressing NK cell receptors. J Immunol (1997) 159:3723–30.

  • 102

    BarcySDe RosaSCVieiraJDiemKIkomaMCasperCet al. Gamma delta+ T cells involvement in viral immune control of chronic human herpesvirus 8 infection. J Immunol (2008) 180:3417–25. doi: 10.4049/jimmunol.180.5.3417

  • 103

    ConroyMJMac NicholasRTaylorMO’DeaSMulcahyFNorrisSet al. Increased Frequencies of Circulating IFN-γ-Producing Vδ1(+) and Vδ2(+) γδ T Cells in Patients with Asymptomatic Persistent Hepatitis B Virus Infection. Viral Immunol (2015) 28:201–8. doi: 10.1089/vim.2014.0133

  • 104

    AgratiCAlonziTDe SantisRCastillettiCAbbateICapobianchiMRet al. Activation of Vgamma9Vdelta2 T cells by non-peptidic antigens induces the inhibition of subgenomic HCV replication. Int Immunol (2006) 18:11–8. doi: 10.1093/intimm/dxh337

  • 105

    LundqvistCBaranovVTeglundSHammarströmSHammarströmML. Cytokine profile and ultrastructure of intraepithelial gamma delta T cells in chronically inflamed human gingiva suggest a cytotoxic effector function. J Immunol (1994) 153:2302–12.

  • 106

    CiminiEBonnafousCBordoniVLalleESicardHSacchiAet al. Interferon-α improves phosphoantigen-induced Vγ9Vδ2 T-cells interferon-γ production during chronic HCV infection. PloS One (2012) 7:e37014. doi: 10.1371/journal.pone.0037014

  • 107

    LangFPeyratMAConstantPDavodeauFDavid-AmelineJPoquetYet al. Early activation of human V gamma 9V delta 2 T cell broad cytotoxicity and TNF production by nonpeptidic mycobacterial ligands. J Immunol (1995) 154:5986–94.

  • 108

    LafontVLiautardJSable-TeycheneMSainte-MarieYFaveroJ. Isopentenyl pyrophosphate, a mycobacterial non-peptidic antigen, triggers delayed and highly sustained signaling in human gamma delta T lymphocytes without inducing eown-modulation of T cell antigen receptor. J Biol Chem (2001) 276:15961–7. doi: 10.1074/jbc.M008684200

  • 109

    PavićIPolićBCrnkovićILucinPJonjićSKoszinowskiUH. Participation of endogenous tumour necrosis factor alpha in host resistance to cytomegalovirus infection. J Gen Virol (1993) 74(Pt 10):2215–23. doi: 10.1099/0022-1317-74-10-2215

  • 110

    Rossol-VothRRossolSSchüttKHCorridoriSde CianWFalkeD. In vivo protective effect of tumour necrosis factor alpha against experimental infection with herpes simplex virus type 1. J Gen Virol (1991) 72(Pt 1):143–7. doi: 10.1099/0022-1317-72-1-143

  • 111

    SambhiSKKohonen-CorishMRRamshawIA. Local production of tumor necrosis factor encoded by recombinant vaccinia virus is effective in controlling viral replication in vivo. Proc Natl Acad Sci USA (1991) 88:4025–9. doi: 10.1073/pnas.88.9.4025

  • 112

    LiHLuoKPauzaCD. TNF-alpha is a positive regulatory factor for human Vgamma2 Vdelta2 T cells. J Immunol (2008) 181:7131–7. doi: 10.4049/jimmunol.181.10.7131

  • 113

    PocciaFAgratiCMartiniFMejiaGWallaceMMalkovskyM. Vgamma9Vdelta2 T cell-mediated non-cytolytic antiviral mechanisms and their potential for cell-based therapy. Immunol Lett (2005) 100:1420. doi: 10.1016/j.imlet.2005.06.025

  • 114

    LafontVSanchezFLaprevotteEMichaudH-AGrosLEliaouJ-Fet al. Plasticity of γδ T Cells: Impact on the Anti-Tumor Response. Front Immunol (2014) 5:622. doi: 10.3389/fimmu.2014.00622

  • 115

    BarteeEMcFaddenG. Cytokine synergy: an underappreciated contributor to innate anti-viral immunity. Cytokine (2013) 63:237–40. doi: 10.1016/j.cyto.2013.04.036

  • 116

    QinGLiuYZhengJNgIHYXiangZLamK-Tet al. Type 1 responses of human Vγ9Vδ2 T cells to influenza A viruses. J Virol (2011) 85:10109–16. doi: 10.1128/JVI.05341-11

  • 117

    DongPJuXYanYZhangSCaiMWangHet al. γδ T Cells Provide Protective Function in Highly Pathogenic Avian H5N1 Influenza A Virus Infection. Front Immunol (2018) 9:2812. doi: 10.3389/fimmu.2018.02812

  • 118

    BoismenuRFengLXiaYYChangJCHavranWL. Chemokine expression by intraepithelial gamma delta T cells. Implications for the recruitment of inflammatory cells to damaged epithelia. J Immunol (1996) 157:985–92.

  • 119

    SparrowELFowlerDWFennJCaronJCopierJDalgleishAGet al. The cytotoxic molecule granulysin is capable of inducing either chemotaxis or fugetaxis in dendritic cells depending on maturation: a role for Vδ2+ γδ T cells in the modulation of immune response to tumour? Immunology (2020) 161:245–58. doi: 10.1111/imm.13248

  • 120

    MünzCSteinmanRMFujiiS. Dendritic cell maturation by innate lymphocytes: coordinated stimulation of innate and adaptive immunity. J Exp Med (2005) 202:203–7. doi: 10.1084/jem.20050810

  • 121

    ContiLCasettiRCardoneMVaranoBMartinoABelardelliFet al. Reciprocal activating interaction between dendritic cells and pamidronate-stimulated gammadelta T cells: role of CD86 and inflammatory cytokines. J Immunol (2005) 174:252–60. doi: 10.4049/jimmunol.174.1.252

  • 122

    HimoudiNMorgensternDAYanMVernayBSaraivaLWuYet al. Human γδ T lymphocytes are licensed for professional antigen presentation by interaction with opsonized target cells. J Immunol (2012) 188:1708–16. doi: 10.4049/jimmunol.1102654

  • 123

    MeuterSEberlMMoserB. Prolonged antigen survival and cytosolic export in cross-presenting human gammadelta T cells. Proc Natl Acad Sci USA (2010) 107:8730–5. doi: 10.1073/pnas.1002769107

  • 124

    LamichhanePPSamarasingheAE. The Role of Innate Leukocytes during Influenza Virus Infection. J Immunol Res (2019) 2019:8028725. doi: 10.1155/2019/8028725

  • 125

    MoserBEberlM. γδ T-APCs: a novel tool for immunotherapy? Cell Mol Life Sci (2011) 68:2443–52. doi: 10.1007/s00018-011-0706-6

  • 126

    BrandesMWillimannKMoserB. Professional antigen-presentation function by human gammadelta T Cells. Science (2005) 309:264–8. doi: 10.1126/science.1110267

  • 127

    BrandesMWillimannKBioleyGLévyNEberlMLuoMet al. Cross-presenting human gammadelta T cells induce robust CD8+ alphabeta T cell responses. Proc Natl Acad Sci U.S.A. (2009) 106:2307–12. doi: 10.1073/pnas.0810059106

  • 128

    BrandesMWillimannKLangABNamK-HJinCBrennerMBet al. Flexible migration program regulates gamma delta T-cell involvement in humoral immunity. Blood (2003) 102:3693–701. doi: 10.1182/blood-2003-04-1016

  • 129

    CaccamoNBattistiniLBonnevilleMPocciaFFourniéJJMeravigliaSet al. CXCR5 identifies a subset of Vgamma9Vdelta2 T cells which secrete IL-4 and IL-10 and help B cells for antibody production. J Immunol (2006) 177:5290–5. doi: 10.4049/jimmunol.177.8.5290

  • 130

    HeXLiangHHongKLiHPengHZhaoYet al. The potential role of CD16+ Vγ2Vδ2 T cell-mediated antibody-dependent cell-mediated cytotoxicity in control of HIV type 1 disease. AIDS Res Hum Retroviruses (2013) 29:1562–70. doi: 10.1089/AID.2013.0111

  • 131

    Gertner-DardenneJBonnafousCBezombesCCapiettoA-HScaglioneVIngoureSet al. Bromohydrin pyrophosphate enhances antibody-dependent cell-mediated cytotoxicity induced by therapeutic antibodies. Blood (2009) 113:4875–84. doi: 10.1182/blood-2008-08-172296

  • 132

    CouziLPitardVMoreauJ-FMervillePDéchanet-MervilleJ. Direct and Indirect Effects of Cytomegalovirus-Induced γδ T Cells after Kidney Transplantation. Front Immunol (2015) 6:3. doi: 10.3389/fimmu.2015.00003

  • 133

    CouziLPitardVSicardXGarrigueIHawcharOMervillePet al. Antibody-dependent anti-cytomegalovirus activity of human γδ T cells expressing CD16 (FcγRIIIa). Blood (2012) 119:1418–27. doi: 10.1182/blood-2011-06-363655

  • 134

    AlexanderAAZManiarACummingsJ-SHebbelerAMSchulzeDHGastmanBRet al. Isopentenyl pyrophosphate-activated CD56+ {gamma}{delta} T lymphocytes display potent antitumor activity toward human squamous cell carcinoma. Clin Cancer Res (2008) 14:4232–40. doi: 10.1158/1078-0432.CCR-07-4912

  • 135

    UrbanEMLiHArmstrongCFocaccettiCCairoCPauzaCD. Control of CD56 expression and tumor cell cytotoxicity in human Vgamma2Vdelta2 T cells. BMC Immunol (2009) 10:50. doi: 10.1186/1471-2172-10-50

  • 136

    QinGLiuYZhengJXiangZNgIHYMalik PeirisJSet al. Phenotypic and functional characterization of human γδ T-cell subsets in response to influenza A viruses. J Infect Dis (2012) 205:1646–53. doi: 10.1093/infdis/jis253

  • 137

    LiHXiangZFengTLiJLiuYFanYet al. Human Vγ9Vδ2-T cells efficiently kill influenza virus-infected lung alveolar epithelial cells. Cell Mol Immunol (2013) 10:159–64. doi: 10.1038/cmi.2012.70

  • 138

    WallaceMBartzSRChangWLMackenzieDAPauzaCDMalkovskyM. Gamma delta T lymphocyte responses to HIV. Clin Exp Immunol (1996) 103:177–84. doi: 10.1046/j.1365-2249.1996.d01-625.x

  • 139

    TuWWLauYLPeirisJSM. Use of humanised mice to study antiviral activity of human γδ-T cells against influenza A viruses. Hong Kong Med J (2014) 20 Suppl 6:46.

  • 140

    DéchanetJMervillePBergéFBone-ManeGTaupinJLMichelPet al. Major expansion of gammadelta T lymphocytes following cytomegalovirus infection in kidney allograft recipients. J Infect Dis (1999) 179:18. doi: 10.1086/314568

  • 141

    LafargeXMervillePCazinMCBergéFPotauxLMoreauJFet al. Cytomegalovirus infection in transplant recipients resolves when circulating gammadelta T lymphocytes expand, suggesting a protective antiviral role. J Infect Dis (2001) 184:533–41. doi: 10.1086/322843

  • 142

    HalaryFPitardVDlubekDKrzysiekRde la SalleHMervillePet al. Shared reactivity of V{delta}2(neg) {gamma}{delta} T cells against cytomegalovirus-infected cells and tumor intestinal epithelial cells. J Exp Med (2005) 201:1567–78. doi: 10.1084/jem.20041851

  • 143

    KaminskiHMénardCEl HayaniBAdjibabiA-NMarsèresGCourantMet al. Characterization of a unique γδ T cell subset as a specific marker of CMV infection severity. J Infect Dis (2020) 223(4):655–66. doi: 10.1093/infdis/jiaa400

  • 144

    JiaZ-HLiY-YWangJ-YZhangJ-YHuangAGuoX-Det al. Activated γδ T cells exhibit cytotoxicity and the capacity for viral clearance in patients with acute hepatitis B. Clin Immunol (2019) 202:40–8. doi: 10.1016/j.clim.2019.03.005

  • 145

    ChenMHuPPengHZengWShiXLeiYet al. Enhanced peripheral γδT cells cytotoxicity potential in patients with HBV-associated acute-on-chronic liver failure might contribute to the disease progression. J Clin Immunol (2012) 32:877–85. doi: 10.1007/s10875-012-9678-z

  • 146

    ChenMZhangDZhenWShiQLiuYLingNet al. Characteristics of circulating T cell receptor gamma-delta T cells from individuals chronically infected with hepatitis B virus (HBV): an association between V(delta)2 subtype and chronic HBV infection. J Infect Dis (2008) 198:1643–50. doi: 10.1086/593065

  • 147

    RajoriyaNFergussonJRLeitheadJAKlenermanP. Gamma Delta T-lymphocytes in Hepatitis C and Chronic Liver Disease. Front Immunol (2014) 5:400. doi: 10.3389/fimmu.2014.00400

  • 148

    OlusolaBAKabelitzDOlaleyeDOOdaiboGN. Early HIV infection is associated with reduced proportions of gamma delta T subsets as well as high creatinine and urea levels. Scand J Immunol (2020) 91:e12868. doi: 10.1111/sji.12868

  • 149

    StrboNAlcaideMLRomeroLBolivarHJonesDPodackERet al. Loss of Intra-Epithelial Endocervical Gamma Delta (GD) 1 T Cells in HIV-Infected Women. Am J Reprod Immunol (2016) 75:134–45. doi: 10.1111/aji.12458

  • 150

    HermierFCombyEDelaunayAPetitjeanJFavennecLBazinCet al. Decreased blood TcR gamma delta+ lymphocytes in AIDS and p24-antigenemic HIV-1-infected patients. Clin Immunol Immunopathol (1993) 69:248–50. doi: 10.1006/clin.1993.1176

  • 151

    LiHPengHMaPRuanYSuBDingXet al. Association between Vgamma2Vdelta2 T cells and disease progression after infection with closely related strains of HIV in China. Clin Infect Dis (2008) 46:1466–72. doi: 10.1086/587107

  • 152

    EndersPJYinCMartiniFEvansPSProppNPocciaFet al. HIV-mediated gammadelta T cell depletion is specific for Vgamma2+ cells expressing the Jgamma1.2 segment. AIDS Res Hum Retroviruses (2003) 19:21–9. doi: 10.1089/08892220360473934

  • 153

    WallaceMScharkoAMPauzaCDFischPImaokaKKawabataSet al. Functional gamma delta T-lymphocyte defect associated with human immunodeficiency virus infections. Mol Med (1997) 3:6071. doi: 10.1007/bf03401668

  • 154

    RiedelDJSajadiMMArmstrongCLCummingsJ-SCairoCRedfieldRRet al. Natural viral suppressors of HIV-1 have a unique capacity to maintain gammadelta T cells. AIDS (2009) 23:1955–64. doi: 10.1097/QAD.0b013e32832ff1ff

  • 155

    BordonJEvansPSProppNDavisCERedfieldRRPauzaCD. Association between longer duration of HIV-suppressive therapy and partial recovery of the V gamma 2 T cell receptor repertoire. J Infect Dis (2004) 189:1482–6. doi: 10.1086/382961

  • 156

    ChaudhrySCairoCVenturiVPauzaCD. The γδ T-cell receptor repertoire is reconstituted in HIV patients after prolonged antiretroviral therapy. AIDS (2013) 27:1557–62. doi: 10.1097/QAD.0b013e3283611888

  • 157

    PocciaFGioiaCMartiniFSacchiAPiacentiniPTempestilliMet al. Zoledronic acid and interleukin-2 treatment improves immunocompetence in HIV-infected persons by activating Vgamma9Vdelta2 T cells. AIDS (2009) 23:555–65. doi: 10.1097/QAD.0b013e3283244619

  • 158

    TayMZPohCMRéniaLMacAryPANgLFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol (2020) 20:363–74. doi: 10.1038/s41577-020-0311-8

  • 159

    Giamarellos-BourboulisEJNeteaMGRovinaNAkinosoglouKAntoniadouAAntonakosNet al. Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure. Cell Host Microbe (2020) 27:9921000.e3. doi: 10.1016/j.chom.2020.04.009

  • 160

    FelsensteinSHerbertJAMcNamaraPSHedrichCM. COVID-19: Immunology and treatment options. Clin Immunol (2020) 215:108448. doi: 10.1016/j.clim.2020.108448

  • 161

    ChenGWuDGuoWCaoYHuangDWangHet al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest (2020) 130:2620–9. doi: 10.1172/JCI137244

  • 162

    TanLWangQZhangDDingJHuangQTangY-Qet al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther (2020) 5:33. doi: 10.1038/s41392-020-0148-4

  • 163

    JiangFDengLZhangLCaiYCheungCWXiaZ. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). J Gen Intern Med (2020) 35:1545–9. doi: 10.1007/s11606-020-05762-w

  • 164

    DiaoBWangCTanYChenXLiuYNingLet al. Reduction and Functional Exhaustion of T Cells in Patients With Coronavirus Disease 2019 (COVID-19). Front Immunol (2020) 11:827. doi: 10.3389/fimmu.2020.00827

  • 165

    WuZMcGooganJM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA (2020) 323:1239–42. doi: 10.1001/jama.2020.2648

  • 166

    VerityROkellLCDorigattiIWinskillPWhittakerCImaiNet al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis (2020) 20:669–77. doi: 10.1016/S1473-3099(20)30243-7

  • 167

    LuXZhangLDuHZhangJLiYYQuJet al. SARS-CoV-2 Infection in Children. N Engl J Med (2020) 382:1663–5. doi: 10.1056/NEJMc2005073

  • 168

    TeranRMitreEVacaMErazoSOviedoGHübnerMPet al. Immune system development during early childhood in tropical Latin America: evidence for the age-dependent down regulation of the innate immune response. Clin Immunol (2011) 138:299310. doi: 10.1016/j.clim.2010.12.011

  • 169

    MolonyRDMalawistaAMontgomeryRR. Reduced dynamic range of antiviral innate immune responses in aging. Exp Gerontol (2018) 107:130–5. doi: 10.1016/j.exger.2017.08.019

  • 170

    MeyerKC. The role of immunity and inflammation in lung senescence and susceptibility to infection in the elderly. Semin Respir Crit Care Med (2010) 31:561–74. doi: 10.1055/s-0030-1265897

  • 171

    RouxAMourinGLarsenMFastenackelsSUrrutiaAGorochovGet al. Differential impact of age and cytomegalovirus infection on the γδ T cell compartment. J Immunol (2013) 191:1300–6. doi: 10.4049/jimmunol.1202940

  • 172

    ReFPocciaFDonniniABartozziBBernardiniGProvincialiM. Skewed representation of functionally distinct populations of Vgamma9Vdelta2 T lymphocytes in aging. Exp Gerontol (2005) 40:5966. doi: 10.1016/j.exger.2004.09.008

  • 173

    ArgentatiKReFDonniniATucciMGFranceschiCBartozziBet al. Numerical and functional alterations of circulating gammadelta T lymphocytes in aged people and centenarians. J Leukoc Biol (2002) 72:6571. doi: 10.1189/jlb.72.1.65

  • 174

    XuWLauZWXFulopTLarbiA. The Aging of γδ T Cells. Cells (2020) 9(5):1181. doi: 10.3390/cells9051181

  • 175

    CaccamoNDieliFWeschDJomaaHEberlM. Sex-specific phenotypical and functional differences in peripheral human Vgamma9/Vdelta2 T cells. J Leukoc Biol (2006) 79:663–6. doi: 10.1189/jlb.1105640

  • 176

    MatricardiPMDal NegroRWNisiniR. The first, holistic immunological model of COVID-19: Implications for prevention, diagnosis, and public health measures. Pediatr Allergy Immunol (2020) 31:454–70. doi: 10.1111/pai.13271

  • 177

    RokniMGhasemiVTavakoliZ. Immune responses and pathogenesis of SARS-CoV-2 during an outbreak in Iran: Comparison with SARS and MERS. Rev Med Virol (2020) 30:e2107. doi: 10.1002/rmv.2107

  • 178

    HiranoTMurakamiM. COVID-19: A New Virus, but a Familiar Receptor and Cytokine Release Syndrome. Immunity (2020) 52:731–3. doi: 10.1016/j.immuni.2020.04.003

  • 179

    RemyKEMazerMStrikerDAEllebedyAHWaltonAHUnsingerJet al. Severe immunosuppression and not a cytokine storm characterizes COVID-19 infections. JCI Insight (2020) 5(17):e140329. doi: 10.1172/jci.insight.140329

  • 180

    PocciaFAgratiCCastillettiCBordiLGioiaCHorejshDet al. Anti-severe acute respiratory syndrome coronavirus immune responses: the role played by V gamma 9V delta 2 T cells. J Infect Dis (2006) 193:1244–9. doi: 10.1086/502975

  • 181

    RijkersGVervenneTvan der PolP. More bricks in the wall against SARS-CoV-2 infection: involvement of γ9δ2 T cells. Cell Mol Immunol (2020) 17:771–2. doi: 10.1038/s41423-020-0473-0

  • 182

    WilkAJRustagiAZhaoNQRoqueJMartínez-ColónGJMcKechnieJLet al. A single-cell atlas of the peripheral immune response in patients with severe COVID-19. Nat Med (2020) 26:1070–6. doi: 10.1038/s41591-020-0944-y

  • 183

    OdakIBarros-MartinsJBošnjakBStahlKDavidSWiesnerOet al. Reappearance of effector T cells is associated with recovery from COVID-19. EBioMedicine (2020) 57:102885. doi: 10.1016/j.ebiom.2020.102885

  • 184

    LiaoMLiuYYuanJWenYXuGZhaoJet al. Single-cell landscape of bronchoalveolar immune cells in patients with COVID-19. Nat Med (2020) 26:842–4. doi: 10.1038/s41591-020-0901-9

  • 185

    ChenX-JLiKXuLYuY-JWuBHeY-Let al. Novel insight from the first lung transplant of a COVID-19 patient. Eur J Clin Invest (2021) 51:e13443. doi: 10.1111/eci.13443

  • 186

  • 187

    LeiLQianHYangXZhangXZhangDDaiTet al. The phenotypic changes of γδ T cells in COVID-19 patients. J Cell Mol Med (2020) 24:11603–6. doi: 10.1111/jcmm.15620

  • 188

    ZhangJ-YWangX-MXingXXuZZhangCSongJ-Wet al. Single-cell landscape of immunological responses in patients with COVID-19. Nat Immunol (2020) 21:1107–18. doi: 10.1038/s41590-020-0762-x

  • 189

    LaingAGLorencADel Molino Del BarrioIDasAFishMMoninLet al. A dynamic COVID-19 immune signature includes associations with poor prognosis. Nat Med (2020) 26:1623–35. doi: 10.1038/s41591-020-1038-6

  • 190

    CarissimoGXuWKwokIAbdadMYChanY-HFongS-Wet al. Whole blood immunophenotyping uncovers immature neutrophil-to-VD2 T-cell ratio as an early marker for severe COVID-19. Nat Commun (2020) 11:5243. doi: 10.1038/s41467-020-19080-6

  • 191

    GuoCLiBMaHWangXCaiPYuQet al. Single-cell analysis of two severe COVID-19 patients reveals a monocyte-associated and tocilizumab-responding cytokine storm. Nat Commun (2020) 11:3924. doi: 10.1038/s41467-020-17834-w

  • 192

    YazdanifarMMashkourNBertainaA. Making a case for using γδ T cells against SARS-CoV-2. Crit Rev Microbiol (2020) 46:689702. doi: 10.1080/1040841X.2020.1822279

  • 193

    HarlyCGuillaumeYNedellecSPeignéC-MMönkkönenHMönkkönenJet al. Key implication of CD277/butyrophilin-3 (BTN3A) in cellular stress sensing by a major human γδ T-cell subset. Blood (2012) 120:2269–79. doi: 10.1182/blood-2012-05-430470

  • 194

    DenigerDCMoyesJSCooperLJN. Clinical applications of gamma delta T cells with multivalent immunity. Front Immunol (2014) 5:636. doi: 10.3389/fimmu.2014.00636

  • 195

    BuccheriSGugginoGCaccamoNLi DonniPDieliF. Efficacy and safety of γδT cell-based tumor immunotherapy: a meta-analysis. J Biol Regul Homeost Agents (2014) 28:8190.

  • 196

    QinGMaoHZhengJSiaSFLiuYChanP-Let al. Phosphoantigen-expanded human gammadelta T cells display potent cytotoxicity against monocyte-derived macrophages infected with human and avian influenza viruses. J Infect Dis (2009) 200:858–65. doi: 10.1086/605413

  • 197

    DaguzanCMoulinMKulyk-BarbierHDavrincheCPeyrottesSChampagneE. Aminobisphosphonates Synergize with Human Cytomegalovirus To Activate the Antiviral Activity of Vγ9Vδ2 Cells. J Immunol (2016) 196:2219–29. doi: 10.4049/jimmunol.1501661

  • 198

    PooniaBPauzaCD. Gamma delta T cells from HIV+ donors can be expanded in vitro by zoledronate/interleukin-2 to become cytotoxic effectors for antibody-dependent cellular cytotoxicity. Cytotherapy (2012) 14:173–81. doi: 10.3109/14653249.2011.623693

  • 199

    GarridoCClohoseyMLWhitworthCPHudgensMMargolisDMSoriano-SarabiaN. γδ T cells: an immunotherapeutic approach for HIV cure strategies. JCI Insight (2018) 3(12):e120121. doi: 10.1172/jci.insight.120121

  • 200

    HuberSShiCBuddRC. Gammadelta T cells promote a Th1 response during coxsackievirus B3 infection in vivo: role of Fas and Fas ligand. J Virol (2002) 76:6487–94. doi: 10.1128/jvi.76.13.6487-6494.2002

  • 201

    KhairallahCNetzerSVillacrecesAJuzanMRousseauBDulantoSet al. γδ T cells confer protection against murine cytomegalovirus (MCMV). PloS Pathog (2015) 11:e1004702. doi: 10.1371/journal.ppat.1004702

  • 202

    SellSDietzMSchneiderAHoltappelsRMachMWinklerTH. Control of murine cytomegalovirus infection by γδ T cells. PloS Pathog (2015) 11:e1004481. doi: 10.1371/journal.ppat.1004481

  • 203

    TuWZhengJLiuYSiaSFLiuMQinGet al. The aminobisphosphonate pamidronate controls influenza pathogenesis by expanding a gammadelta T cell population in humanized mice. J Exp Med (2011) 208:1511–22. doi: 10.1084/jem.20110226

  • 204

    DieliFVermijlenDFulfaroFCaccamoNMeravigliaSCiceroGet al. Targeting human {gamma}delta} T cells with zoledronate and interleukin-2 for immunotherapy of hormone-refractory prostate cancer. Cancer Res (2007) 67:7450–7. doi: 10.1158/0008-5472.CAN-07-0199

  • 205

    PresseyJGAdamsJHarkinsLKellyDYouZLambLS. In vivo expansion and activation of γδ T cells as immunotherapy for refractory neuroblastoma: A phase 1 study. Med (Baltimore) (2016) 95:e4909. doi: 10.1097/MD.0000000000004909

  • 206

    WilhelmMKunzmannVEcksteinSReimerPWeissingerFRuedigerTet al. Gammadelta T cells for immune therapy of patients with lymphoid malignancies. Blood (2003) 102:200–6. doi: 10.1182/blood-2002-12-3665

  • 207

    AliZShaoLHallidayLReichenbergAHintzMJomaaHet al. Prolonged (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate-driven antimicrobial and cytotoxic responses of pulmonary and systemic Vgamma2Vdelta2 T cells in macaques. J Immunol (2007) 179:8287–96. doi: 10.4049/jimmunol.179.12.8287

  • 208

    HuangDChenCYAliZShaoLShenLLockmanHAet al. Antigen-specific Vgamma2Vdelta2 T effector cells confer homeostatic protection against pneumonic plaque lesions. Proc Natl Acad Sci USA (2009) 106:7553–8. doi: 10.1073/pnas.0811250106

  • 209

    ChenCYYaoSHuangDWeiHSicardHZengGet al. Phosphoantigen/IL2 expansion and differentiation of Vγ2Vδ2 T cells increase resistance to tuberculosis in nonhuman primates. PloS Pathog (2013) 9:e1003501. doi: 10.1371/journal.ppat.1003501

  • 210

    PocciaFGioiaCMartiniFSacchiAPiacentiniPTempestilliMet al. Zoledronic acid and interleukin-2 treatment improves immunocompetence in HIV-infected persons by activating Vgamma9Vdelta2 T cells. AIDS (2009) 23:555–65. doi: 10.1097/QAD.0b013e3283244619

  • 211

    JunoJAKentSJ. What Can Gamma Delta T Cells Contribute to an HIV Cure? Front Cell Infect Microbiol (2020) 10:233. doi: 10.3389/fcimb.2020.00233

  • 212

    BillingtonEOReidIR. Benefits of Bisphosphonate Therapy: Beyond the Skeleton. Curr Osteoporos Rep (2020) 18:587–96. doi: 10.1007/s11914-020-00612-4

  • 213

    BrufskyAMartiJLGNasrazadaniALotzeMT. Boning up: amino-bisphophonates as immunostimulants and endosomal disruptors of dendritic cell in SARS-CoV-2 infection. J Transl Med (2020) 18:261. doi: 10.1186/s12967-020-02433-6

  • 214

    FrencherJTShenHYanLWilsonJOFreitagNERizzoANet al. HMBPP-deficient Listeria mutant immunization alters pulmonary/systemic responses, effector functions, and memory polarization of Vγ2Vδ2 T cells. J Leukoc Biol (2014) 96:957–67. doi: 10.1189/jlb.6HI1213-632R

  • 215

    FowlerDWCopierJDalgleishAGBodman-SmithMD. Tripartite immune cell co-operation in the Bacillus Calmette Guérin-induced activation of γδ T cells. Immunol Cell Biol (2013) 91:461–8. doi: 10.1038/icb.2013.30

  • 216

    WorkalemahuGWangHPuanK-JNadaMHKuzuyamaTJonesBDet al. Metabolic engineering of Salmonella vaccine bacteria to boost human Vγ2Vδ2 T cell immunity. J Immunol (2014) 193:708–21. doi: 10.4049/jimmunol.1302746

  • 217

    DantzlerKWde la ParteLJagannathanP. Emerging role of γδ T cells in vaccine-mediated protection from infectious diseases. Clin Transl Immunol (2019) 8:e1072. doi: 10.1002/cti2.1072

  • 218

    HoftDFBabusisEWorkuSSpencerCTLottenbachKTruscottSMet al. Live and inactivated influenza vaccines induce similar humoral responses, but only live vaccines induce diverse T-cell responses in young children. J Infect Dis (2011) 204:845–53. doi: 10.1093/infdis/jir436

  • 219

    ReFDonniniAProvincialiM. Induction of alphadelta- and alphabeta-mediated T cell responses in healthy elderly subjects after influenza vaccination. Biogerontology (2006) 7:249–59. doi: 10.1007/s10522-006-9024-z

  • 220

    Tenner-RaczKStahl HennigCUberlaKStoiberHIgnatiusRHeeneyJet al. Early protection against pathogenic virus infection at a mucosal challenge site after vaccination with attenuated simian immunodeficiency virus. Proc Natl Acad Sci USA (2004) 101:3017–22. doi: 10.1073/pnas.0308677101

  • 221

    NeteaMGJoostenLABLatzEMillsKHGNatoliGStunnenbergHGet al. Trained immunity: A program of innate immune memory in health and disease. Science (2016) 352:aaf1098. doi: 10.1126/science.aaf1098

  • 222

    CoffmanRLSherASederRA. Vaccine adjuvants: putting innate immunity to work. Immunity (2010) 33:492503. doi: 10.1016/j.immuni.2010.10.002

  • 223

    SørupSStensballeLGKrauseTGAabyPBennCSRavnH. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark: Nationwide Retrospective Cohort Study. Open Forum Infect Dis (2016) 3:ofv204. doi: 10.1093/ofid/ofv204

  • 224

    AabyPSambBSimondonFSeckAMKnudsenKWhittleH. Non-specific beneficial effect of measles immunisation: analysis of mortality studies from developing countries. BMJ (1995) 311:481–5. doi: 10.1136/bmj.311.7003.481

  • 225

    BennCSNeteaMGSelinLKAabyP. A small jab - a big effect: nonspecific immunomodulation by vaccines. Trends Immunol (2013) 34:431–9. doi: 10.1016/j.it.2013.04.004

  • 226

    NeteaMGDomínguez-AndrésJBarreiroLBChavakisTDivangahiMFuchsEet al. Defining trained immunity and its role in health and disease. Nat Rev Immunol (2020) 20:375–88. doi: 10.1038/s41577-020-0285-6

  • 227

    NeteaMGQuintinJvan der MeerJWM. Trained immunity: a memory for innate host defense. Cell Host Microbe (2011) 9:355–61. doi: 10.1016/j.chom.2011.04.006

  • 228

    LauCMAdamsNMGearyCDWeizmanO-ERappMPritykinYet al. Epigenetic control of innate and adaptive immune memory. Nat Immunol (2018) 19:963–72. doi: 10.1038/s41590-018-0176-1

  • 229

    UthayakumarDParisSChapatLFreyburgerLPouletHDe LucaK. Non-specific Effects of Vaccines Illustrated Through the BCG Example: From Observations to Demonstrations. Front Immunol (2018) 9:2869. doi: 10.3389/fimmu.2018.02869

  • 230

    Biering-SørensenSAabyPLundNMonteiroIJensenKJEriksenHBet al. Early BCG-Denmark and Neonatal Mortality Among Infants Weighing <2500 g: A Randomized Controlled Trial. Clin Infect Dis (2017) 65:1183–90. doi: 10.1093/cid/cix525

  • 231

    de CastroMJPardo-SecoJMartinón-TorresF. Nonspecific (Heterologous) Protection of Neonatal BCG Vaccination Against Hospitalization Due to Respiratory Infection and Sepsis. Clin Infect Dis (2015) 60:1611–9. doi: 10.1093/cid/civ144

  • 232

    MillerAReandelarMJ. Correlation between universal BCG vaccination policy and reduced mortality for COVID-19. medRxiv (2020). doi: 10.1101/2020.03.24.20042937

  • 233

    ShetARayD. Differential COVID-19-attributable mortality and BCG vaccine use in countries. medRxiv (2020). doi: 10.1101/2020.04.01.20049478

  • 234

    DayalDGuptaS. Connecting BCG Vaccination and COVID-19: Additional Data. medRxiv (2020). doi: 10.1101/2020.04.07.20053272

  • 235

    CoviánCRetamal-DíazABuenoSMKalergisAM. Could BCG Vaccination Induce Protective Trained Immunity for SARS-CoV-2? Front Immunol (2020) 11:970 doi: 10.3389/fimmu.2020.00970

  • 236

    RivasMNEbingerJEWuMSunNBraunJSobhaniKet al. BCG vaccination history associates with decreased SARS-CoV-2 seroprevalence across a diverse cohort of health care workers. J Clin Invest (2021) 131(2):e145157. doi: 10.1172/JCI145157

  • 237

    HenselJMcAndrewsKMMcGrailDJDowlatshahiDPLeBleuVSKalluriR. Protection against SARS-CoV-2 by BCG vaccination is not supported by epidemiological analyses. Sci Rep (2020) 10:18377. doi: 10.1038/s41598-020-75491-x

  • 238

    KleenT-OGaldonAAMacDonaldASDalgleishAG. Mitigating Coronavirus Induced Dysfunctional Immunity for At-Risk Populations in COVID-19: Trained Immunity, BCG and “New Old Friends.” Front Immunol (2020) 11:2059. doi: 10.3389/fimmu.2020.02059

  • 239

    NeteaMGGiamarellos-BourboulisEJDomínguez-AndrésJCurtisNvan CrevelRvan de VeerdonkFLet al. Trained Immunity: a Tool for Reducing Susceptibility to and the Severity of SARS-CoV-2 Infection. Cell (2020) 181:969–77. doi: 10.1016/j.cell.2020.04.042

  • 240

    CurtisNSparrowAGhebreyesusTANeteaMG. Considering BCG vaccination to reduce the impact of COVID-19. Lancet (2020) 395:1545–6. doi: 10.1016/S0140-6736(20)31025-4

  • 241

    WardhanaDatauEASultanaAMandangVVVJimE. The efficacy of Bacillus Calmette-Guerin vaccinations for the prevention of acute upper respiratory tract infection in the elderly. Acta Med Indones (2011) 43:185–90.

  • 242

    ArtsRJWMoorlagSJCFMNovakovicBLiYWangS-YOostingMet al. BCG Vaccination Protects against Experimental Viral Infection in Humans through the Induction of Cytokines Associated with Trained Immunity. Cell Host Microbe (2018) 23:89100.e5. doi: 10.1016/j.chom.2017.12.010

  • 243

    MoorlagSJCFMArtsRJWvan CrevelRNeteaMG. Non-specific effects of BCG vaccine on viral infections. Clin Microbiol Infect (2019) 25:1473–8. doi: 10.1016/j.cmi.2019.04.020

  • 244

    MazzolaTNDa SilvaMTNMorenoYMFLimaSCBSCarnielEFMorcilloAMet al. Robust gammadelta+ T cell expansion in infants immunized at birth with BCG vaccine. Vaccine (2007) 25:6313–20. doi: 10.1016/j.vaccine.2007.06.039

  • 245

    TaştanYArvasADemirGAlikaşifoğluMGürEKirayE. Influence of Bacillus Calmette-Guèrin vaccination at birth and 2 months old age on the peripheral blood T-cell subpopulations [gamma/delta and alpha-beta T cell]. Pediatr Allergy Immunol (2005) 16:624–9. doi: 10.1111/j.1399-3038.2005.00329.x

  • 246

    ZuffereyCGermanoSDuttaBRitzNCurtisN. The contribution of non-conventional T cells and NK cells in the mycobacterial-specific IFNγ response in Bacille Calmette-Guérin (BCG)-immunized infants. PloS One (2013) 8:e77334. doi: 10.1371/journal.pone.0077334

  • 247

    BukowskiJFMoritaCTBrennerMB. Recognition and destruction of virus-infected cells by human gamma delta CTL. J Immunol (1994) 153:5133–40.

  • 248

    PitardVRoumanesDLafargeXCouziLGarrigueILafonM-Eet al. Long-term expansion of effector/memory Vdelta2-gammadelta T cells is a specific blood signature of CMV infection. Blood (2008) 112:1317–24. doi: 10.1182/blood-2008-01-136713

  • 249

    HoftDFBrownRMRoodmanST. Bacille Calmette-Guérin vaccination enhances human gamma delta T cell responsiveness to mycobacteria suggestive of a memory-like phenotype. J Immunol (1998) 161:1045–54.

  • 250

    ShenYZhouDQiuLLaiXSimonMShenLet al. Adaptive immune response of Vgamma2Vdelta2+ T cells during mycobacterial infections. Science (2002) 295:2255–8. doi: 10.1126/science.1068819

  • 251

    ChenZWLetvinNL. Adaptive immune response of Vgamma2Vdelta2 T cells: a new paradigm. Trends Immunol (2003) 24:213–9. doi: 10.1016/s1471-4906(03)00032-2

  • 252

    YangJJonesMSRamosRIChanAALeeAFFoshagLJet al. Insights into Local Tumor Microenvironment Immune Factors Associated with Regression of Cutaneous Melanoma Metastases by Mycobacterium bovis Bacille Calmette-Guérin. Front Oncol (2017) 7:61. doi: 10.3389/fonc.2017.00061

  • 253

    GuptaPK. New disease old vaccine: Is recombinant BCG vaccine an answer for COVID-19? Cell Immunol (2020) 356:104187. doi: 10.1016/j.cellimm.2020.104187

  • 254

    DalgleishAGMudanSFusiA. Enhanced effect of checkpoint inhibitors when given after or together with IMM-101: significant responses in four advanced melanoma patients with no additional major toxicity. J Transl Med (2018) 16:227. doi: 10.1186/s12967-018-1602-8

  • 255

    O’NeillLAJNeteaMG. BCG-induced trained immunity: can it offer protection against COVID-19? Nat Rev Immunol (2020) 20:335–7. doi: 10.1038/s41577-020-0337-y

  • 256

    Sánchez-RamónSConejeroLNeteaMGSanchoDPalomaresÓSubizaJL. Trained Immunity-Based Vaccines: A New Paradigm for the Development of Broad-Spectrum Anti-infectious Formulations. Front Immunol (2018) 9:2936. doi: 10.3389/fimmu.2018.02936

  • 257

    TuvimMJEvansSEClementCGDickeyBFGilbertBE. Augmented lung inflammation protects against influenza A pneumonia. PloS One (2009) 4:e4176. doi: 10.1371/journal.pone.0004176

  • 258

    ShenLFrencherJHuangDWangWYangEChenCYet al. Immunization of Vγ2Vδ2 T cells programs sustained effector memory responses that control tuberculosis in nonhuman primates. Proc Natl Acad Sci U.S.A. (2019) 116:6371–8. doi: 10.1073/pnas.1811380116

  • 259

    FenoglioDZocchiMRParodiADurandoPGabutitpGGaspariniRet al. MF-59 adjuvant influence on the functions of gammadelta T cells in HIV-1+ adults immunized with influenza seasonal vaccine. J Prev Med Hyg (2011) 52:137–41.

  • 260

    LeentjensJKoxMStokmanRGerretsenJDiavatopoulosDAvan CrevelRet al. BCG Vaccination Enhances the Immunogenicity of Subsequent Influenza Vaccination in Healthy Volunteers: A Randomized, Placebo-Controlled Pilot Study. J Infect Dis (2015) 212:1930–8. doi: 10.1093/infdis/jiv332

Summary

Keywords

gamma delta T cell, innate immunity, trained immunity, antiviral, virus, COVID-19, BCG, vaccine

Citation

Caron J, Ridgley LA and Bodman-Smith M (2021) How to Train Your Dragon: Harnessing Gamma Delta T Cells Antiviral Functions and Trained Immunity in a Pandemic Era. Front. Immunol. 12:666983. doi: 10.3389/fimmu.2021.666983

Received

11 February 2021

Accepted

12 March 2021

Published

29 March 2021

Volume

12 - 2021

Edited by

Xu Yu, Massachusetts General Hospital and Harvard Medical School, United States

Reviewed by

Jodi L. McGill, Iowa State University, United States; Ciputra Hartana, Ragon Institute of MGH, MIT and Harvard, United States

Updates

Copyright

*Correspondence: Mark Bodman-Smith,

This article was submitted to Viral Immunology, a section of the journal Frontiers in Immunology

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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