Immunological Memory of Viral Infections: Mechanisms, Durability, and Implications for Protective Immunity —A Review

Authors

  • Dhefaf Hameed Al-mudhafer Department of Medical Microbiology, College of Medicine, University of Kufa Author
  • Eman Hassani AL-Salami Department of Medical Microbiology, College of Medicine, University of Kufa Author
  • Saif Jabbar Yasir Department of Medical Microbiology, College of Medicine, University of Kufa, Najaf, Iraq Author

DOI:

https://doi.org/10.63939/4vx0dp82

Keywords:

Immunological Memory, Memory B Cells, Memory T Cells, Immune Memory Durability, Immune Reprogramming, Epigenetic Modulation, Protective Immunity

Abstract

Immune memory is a cornerstone of protective immunity against viral infections, enabling rapid and enhanced responses upon re-exposure to viruses. This review focuses on the interrelated roles of memory B cells, memory T cells, follicular helper T cells (Tfh), and cytokine signaling in maintaining long-term immunity, providing a comprehensive overview of the processes, longevity, and outcomes of immune memory. CD8⁺ cytotoxic T cells and CD4⁺ helper T cells are memory T cells that facilitate viral clearance and regulate the immune response, while memory B cells rapidly differentiate into plasma cells, enabling effective antibody-mediated protection. Germline interaction facilitates the formation of long-lasting memory B cells and plasma cells, and follicular helper T cells (Tfh) are essential for this process. Here, we explore how epigenetic regulation of T cell development can influence the establishment and maintenance of immunological memory and discuss in-depth on TCF-1 signaling pathways that play an active role in memory T cell population sustenance. T cell depletion is another important barrier to the retention of efficacious immunological memory, particularly in scenarios of chronic viral infection. Importantly, even though they are exhausted, exhausted T cells likely remain capable of functionally traversing the TCF-1⁺ progenitor pool with the possibility for future therapeutic targets. Importantly, this study demonstrates the significance of both humoral immunity (e.g.: antibodies and memory B cells) as well as cellular immunity (e.g.: memory T cells) to control infections and disease severity. Along with inducing

short-term antibody responses, the results indicate that future vaccine strategies should aim to develop functional memory B cells and long-lived plasma cells, as well as stem-like T cell populations for broad and durable protection. Furthermore, reversing T-cell depletion through epigenetic manipulation could, in principle, improve immunotherapy outcomes and vaccination efficacy in cancer and chronic viral infections. These findings offer valuable insights into the interconnected network supporting immune memory and suggest strategies to mitigate the challenges posed by immune depletion in chronic infections—information crucial for future immunotherapy regimens and vaccine development efforts.

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References

1. Das A, Pathak S, Premkumar M, Sarpparajan CV, Balaji E, Duttaroy AK, et al. A brief overview of SARS-CoV-2 infection and its management strategies: a recent update. Molecular and Cellular Biochemistry. Springer Science+Business Media; 2023 Sept 24;479(9):2195–215. https://doi.org/10.1007/s11010-023-04848-3

2. Sette A, Crotty S. Immunological memory to SARS‐CoV‐2 infection and COVID‐19 vaccines. Immunological Reviews. 2022 June 22;310(1):27–46. https://doi.org/10.1111/imr.13089

3. Radbruch A, Chang H. A long-term perspective on immunity to COVID. Vol. 595, Nature. Nature Portfolio;2021. p.359–60. https://doi.org/10.1038/d41586-021-01557-z

4. Mistry P, Barmania F, Mellet J, Peta KT, Strydom A, Viljoen IM, et al. SARS-CoV-2 Variants, Vaccines, and Host Immunity. Frontiers in Immunology. Frontiers Media; 2022 Jan 3;12:809244–809244. https://doi.org/10.3389/fimmu.2021.809244

5. Cromer D, Juno JA, Khoury DS, Reynaldi A, Wheatley AK, Kent SJ, et al. Prospects for durable immune control of SARS-CoV-2 and prevention of reinfection. Nature reviews Immunology. Nature Portfolio; 2021 Apr 29;21(6):395–404. Available from: https://doi.org/10.1038/s41577-021-00550-x

6. Rodda LB, Netland J, Shehata L, Pruner KB, Morawski PA, Thouvenel CD, et al. Functional SARS-CoV-2-Specific Immune Memory Persists after Mild COVID-19. Cell. 2020 Nov 23;184(1):169. https://doi.org/10.1016/j.cell.2020.11.029

7. Kotaki R, Moriyama S, Takahashi Y. Humoral immunity for durable control of SARS-CoV-2 and its variants. Inflammation and Regeneration. BioMed Central; 2023 Jan 12;43(1). Available from: https://doi.org/10.1186/s41232-023-00255-9

8. Roy RK, Yadav R, Jain A, Tripathi V, Jain M, Singh S, et al. Yin and yang of immunological memory in controlling infections: Overriding self defence mechanisms. International Reviews of Immunology. 2021 Apr 19;41(2):240–52. Available from: https://doi.org/10.1080/08830185.2021.1912037

9. Moga E, Lynton-Pons E, Domingo P. The Robustness of Cellular Immunity Determines the Fate of SARS-CoV-2 Infection. Frontiers in Immunology. Frontiers Media; 2022 June 27;13. https://doi.org/10.3389/fimmu.2022.904686

10. Upreti S, Samant M. A Review on Immunological Responses to SARS-CoV-2 and Various COVID-19 Vaccine Regimens. Pharmaceutical Research. Springer Science+Business Media; 2022 July 1;39(9):2119–34. https://doi.org/10.1007/s11095-022-03323-w

11. Mahdisoltani S, Murugan P, Chakraborty AK, Kardar M. Minimal framework for optimizing vaccination protocols targeting highly mutable pathogens. Physical review E. 2024 Dec 19;110(6). Available from: https://doi.org/10.1103/physreve.110.064137

12. Chen Y, Tong P, Whiteman NB, Moghaddam AS, Zarghami M, Zuiani A, et al. Immune recall improves antibody durability and breadth to SARS-CoV-2 variants. Science Immunology. 2022 May 12;7(78). https://doi.org/10.1126/sciimmunol.abp8328

13. Pepper M, Rodda LB, Netland J, Shehata L, Pruner KB, Morawski PA, et al. Functional SARS-CoV-2-specific immune memory persists after mild COVID-19. 2020 Aug 13; Available from: https://doi.org/10.21203/rs.3.rs-57112/v1

14. Laidlaw BJ, Ellebedy AH. The germinal centre B cell response to SARS-CoV-2. Nature reviews Immunology. Nature Portfolio; 2021 Dec 6;22(1):7–18. Available from: https://doi.org/10.1038/s41577-021-00657-1

15. Rodda LB, Netland J, Shehata L, Pruner KB, Morwaski PA, Thouvenel CD, et al. Functional SARS-CoV-2-specific immune memory persists after mild COVID-19. The Journal of Immunology. 2021 May 1;206. Available from: https://doi.org/10.4049/jimmunol.206.supp.62.06

16. Muecksch F, Wang Z, Cho A, Gaebler C, Tanfous TB, DaSilva J, et al. Increased memory B cell potency and breadth after a SARS-CoV-2 mRNA boost. Nature. 2022 Apr 21;607(7917):128–34. https://doi.org/10.1038/s41586-022-04778-y

17. Aguilar-Bretones M, Fouchier RAM, Koopmans M, Nierop GP van. Impact of antigenic evolution and original antigenic sin on SARS-CoV-2 immunity. Journal of Clinical Investigation. American Society for Clinical Investigation; 2023 Jan 2;133(1). Available from: https://doi.org/10.1172/jci162192

18. Ramirez SI, Grifoni A, Weiskopf D, Parikh UM, Heaps A, Faraji F, et al. Bamlanivimab therapy for acute COVID-19 does not blunt SARS-CoV-2–specific memory T cell responses. JCI Insight. 2022 Nov 15;7(24). https://doi.org/10.1172/jci.insight.163471

19. Torres-Flores A, Wong‐Baeza I, López-Macı́as C. Contribution of memory T cells to the generation of long-lasting immunity against COVID-19. Gaceta Médica de México. Academia Nacional de Medicina de México; 2024 Aug 6;160(2). Available from: https://doi.org/10.24875/gmm.m24000878

20. Zhou Z, Li D, Zhao Z, Shi S, Wu J, Li J, et al. Dynamical modelling of viral infection and cooperative immune protection in COVID-19 patients. PLoS Computational Biology. 2023 Sept 1;19(9). https://doi.org/10.1371/journal.pcbi.1011383

21. Pons S, Uhel F, Frapy E, Sérémé Y, Zafrani L, Aschard H, et al. How Protective are Antibodies to SARS-CoV-2, the Main Weapon of the B-Cell Response? Stem Cell Reviews and Reports. Springer Nature; 2022 Nov 24;19(3):585–600. Available from: https://doi.org/10.1007/s12015-022-10477-y

22. Nikolich‐Žugich J, Knox KS, Rios CT, Natt B, Bhattacharya D, Fain MJ. SARS-CoV-2 and COVID-19 in older adults: what we may expect regarding pathogenesis, immune responses, and outcomes. GeroScience. Springer International Publishing; 2020 Apr 1;42(2):505–14. https://doi.org/10.1007/s11357-020-00186-0

23. Son YM, Cheon IS, Wu Y, Li C, Wang Z, Gao X, et al. Tissue-resident CD4 + T helper cells assist the development of protective respiratory B and CD8 + T cell memory responses. Science Immunology. 2021 Jan 8;6(55). https://doi.org/10.1126/sciimmunol.abb6852

24. Vardhana SA, Wolchok JD. The many faces of the anti-COVID immune response. The Journal of Experimental Medicine. 2020 Apr 30;217(6). https://doi.org/10.1084/jem.20200678

25. Sun L, Su Y, Jiao A, Wang X, Zhang B. T cells in health and disease. Signal Transduction and Targeted Therapy. Springer Nature; 2023 June 19;8(1). https://doi.org/10.1038/s41392-023-01471-y

26. Sekaran SD, Ismail AA, Thergarajan G, Chandramathi S, Rahman S, Mani RR, et al. Host immune response against DENV and ZIKV infections. Frontiers in Cellular and Infection Microbiology. Frontiers Media; 2022 Sept 8;12. https://doi.org/10.3389/fcimb.2022.975222

27. Jeyanathan M, Afkhami S, Smaill F, Miller MS, Lichty BD, Xing Z. Immunological considerations for COVID-19 vaccine strategies. Nature reviews Immunology. Nature Portfolio; 2020 Sept 4;20(10):615–32. https://doi.org/10.1038/s41577-020-00434-6

28. Li M, Wang H, Tian L li, Pang Z, Yang Q, Huang T, et al. COVID-19 vaccine development: milestones, lessons and prospects. Signal Transduction and Targeted Therapy. Springer Nature; 2022 May 3;7(1):146–146. https://doi.org/10.1038/s41392-022-00996-y

29. Shah VK, Firmal P, Alam A, Ganguly D, Chattopadhyay S. Overview of Immune Response During SARS-CoV-2 Infection: Lessons From the Past. Frontiers in Immunology. Frontiers Media; 2020 Aug 7;11. https://doi.org/10.3389/fimmu.2020.01949

30. Sadarangani M, Marchant A, Kollmann TR. Immunological mechanisms of vaccine-induced protection against COVID-19 in humans. Nature reviews Immunology. Nature Portfolio; 2021 July 1;21(8):475–84. https://doi.org/10.1038/s41577-021-00578-z

31. Frank K, Paust S. Dynamic Natural Killer Cell and T Cell Responses to Influenza Infection. Frontiers in Cellular and Infection Microbiology. Frontiers Media; 2020 Aug 18;10. Available from: https://doi.org/10.3389/fcimb.2020.00425

32. Wang Y, Tian Q, Ye L. The Differentiation and Maintenance of SARS-CoV-2-Specific Follicular Helper T Cells. Frontiers in Cellular and Infection Microbiology. Frontiers Media; 2022 July 14;12. https://doi.org/10.3389/fcimb.2022.953022

33. Yasamineh S, Kalajahi HG, Yasamineh P, Gholizadeh O, Youshanlouei HR, Matloub SK, et al. Spotlight on therapeutic efficiency of mesenchymal stem cells in viral infections with a focus on COVID-19. Stem Cell Research & Therapy. BioMed Central; 2022 June 17;13(1). https://doi.org/10.1186/s13287-022-02944-7

34. Lim EY, Jackson S, Wills MR. The CD4+ T Cell Response to Human Cytomegalovirus in Healthy and Immunocompromised People. Frontiers in Cellular and Infection Microbiology. Frontiers Media; 2020 May 19;10. https://doi.org/10.3389/fcimb.2020.00202

35. Verma A, Manojkumar A, Dhasmana A, Tripathi M, Jaggi M, Chauhan SC, et al. Recurring SARS-CoV-2 variants: an update on post-pandemic, co-infections and immune response. Nanotheranostics. Ivyspring International Publisher; 2024 Jan 1;8(2):247–69. https://doi.org/10.7150/ntno.91910

36. Mohammed RN, Tamjidifar R, Rahman HS, Adili A, Ghoreishizadeh S, Saeedi H, et al. A comprehensive review about immune responses and exhaustion during coronavirus disease (COVID-19). Cell Communication and Signaling. BioMed Central; 2022 June 2;20(1). https://doi.org/10.1186/s12964-022-00856-w

37. Almendro-Vázquez P, Laguna‐Goya R, Paz‐Artal E. Defending against SARS-CoV-2: The T cell perspective. Frontiers in Immunology. Frontiers Media; 2023 Jan 27;14. https://doi.org/10.3389/fimmu.2023.1107803

38. Ma S, Ming Y, Wu J, Cui G. Cellular metabolism regulates the differentiation and function of T-cell subsets. Cellular and Molecular Immunology. Springer Nature; 2024 Apr 2;21(5):419–35. https://doi.org/10.1038/s41423-024-01148-8

39. Nowill AE, Caruso M, Campos‐Lima PO de. T-cell immunity to SARS-CoV-2: what if the known best is not the optimal course for the long run? Adapting to evolving targets. Frontiers in Immunology. Frontiers Media; 2023 June 14;14. https://doi.org/10.3389/fimmu.2023.1133225

40. Breton G, Mendoza P, Hägglöf T, Oliveira TY, Schaefer-Babajew D, Gaebler C, et al. Persistent cellular immunity to SARS-CoV-2 infection. The Journal of Experimental Medicine. 2021 Jan 27;218(4). https://doi.org/10.1084/jem.20202515

41. Li L, Müftüoğlu M, Liang S, Basyal M, Lv J, Akdogan ME, et al. In-depth analysis of SARS-CoV-2–specific T cells reveals diverse differentiation hierarchies in vaccinated individuals. JCI Insight. 2022 Mar 1;7(7). https://doi.org/10.1172/jci.insight.156559

42. Phetsouphanh C, Khoo WH, Jackson K, Klemm V, Howe A, Aggarwal A, et al. High titre neutralizing antibodies in response to SARS–CoV–2 infection require RBD–specific CD4 T cells that include proliferative memory cells. Frontiers in Immunology. 2022 Dec 5;13. https://doi.org/10.3389/fimmu.2022.1032911

43. Ahmad T, Chaudhuri RK, Joshi MC, Almatroudi A, Rahmani AH, Syed MA. COVID-19: The Emerging Immunopathological Determinants for Recovery or Death. Frontiers in Microbiology. Frontiers Media; 2020 Dec 1;11. https://doi.org/10.3389/fmicb.2020.588409

44. Menges D, Zens KD, Ballouz T, Caduff N, Llanas-Cornejo D, Aschmann HE, et al. Heterogenous humoral and cellular immune responses with distinct trajectories post-SARS-CoV-2 infection in a population-based cohort. Nature Communications. 2022 Aug 18;13(1). Available from: https://doi.org/10.1038/s41467-022-32573-w

45. Menges D, Zens KD, Ballouz T, Caduff N, Llanas-Cornejo D, Aschmann HE, et al. Heterogenous Cellular and Humoral Immune Trajectories after SARS-CoV-2 Infection: Compensatory Responses in a Population-Based Cohort. medRxiv (Cold Spring Harbor Laboratory). 2021 Dec 16; https://doi.org/10.1101/2021.12.15.21267776

46. Miyazawa M. Immunopathogenesis of SARS-CoV-2-induced pneumonia: lessons from influenza virus infection. Inflammation and Regeneration. BioMed Central; 2020 Oct 12;40(1). Available from: https://doi.org/10.1186/s41232-020-00148-1

47. Brasu N, Elia I, Russo V, Montacchiesi G, Stabile SA, Intinis CD, et al. Memory CD8+ T cell diversity and B cell responses correlate with protection against SARS-CoV-2 following mRNA vaccination. Nature Immunology. 2022 Sept 22;23(10):1445–56. Available from: https://doi.org/10.1038/s41590-022-01313-z

48. Tian Y, Carpp LN, Miller HER, Zager M, Newell EW, Gottardo R. Single-cell immunology of SARS-CoV-2 infection. Nature Biotechnology. Nature Portfolio; 2021 Dec 20;40(1):30–41. https://doi.org/10.1038/s41587-021-01131-y

49. Qi F, Cao Y, Zhang S, Zhang Z. Single-cell analysis of the adaptive immune response to SARS-CoV-2 infection and vaccination. Frontiers in Immunology. Frontiers Media; 2022 Sept 2;13. https://doi.org/10.3389/fimmu.2022.964976

50. Lapuente D, Winkler T, Tenbusch M. B-cell and antibody responses to SARS-CoV-2: infection, vaccination, and hybrid immunity. Cellular and Molecular Immunology. Springer Nature; 2023 Nov 10;21(2):144–58. Available from: https://doi.org/10.1038/s41423-023-01095-w

51. Ackermann‐Gäumann R, Lang P, Zens KD. Defining the “Correlate(s) of Protection” to tick-borne encephalitis vaccination and infection – key points and outstanding questions. Frontiers in Immunology. 2024 Jan 22;15. https://doi.org/10.3389/fimmu.2024.1352720

52. Netea MG, Li Y. Immune memory in individuals with COVID-19. Nature Cell Biology. 2021 June 1;23(6):582–4. https://doi.org/10.1038/s41556-021-00689-8

53. Jeffery-Smith A, Burton AR, Lens S, Rees-Spear C, Davies J, Patel M, et al. SARS-CoV-2–specific memory B cells can persist in the elderly who have lost detectable neutralizing antibodies. Journal of Clinical Investigation. 2021 Nov 29;132(2). Available from: https://doi.org/10.1172/jci152042

54. Gu Y, Shunmuganathan BDO, Qian X, Gupta R, Tan RSW, Kozma M, et al. Employment of a high throughput functional assay to define the critical factors that influence vaccine induced cross-variant neutralizing antibodies for SARS-CoV-2. Scientific Reports. 2023 Dec 9 ;13(1). https://doi.org/10.1038/s41598-023-49231-w

55. Ripperger TJ, Bhattacharya D. Transcriptional and Metabolic Control of Memory B Cells and Plasma Cells. Annual Review of Immunology [Internet]. 2021 Feb 9;39(1):345–68. https://doi.org/10.1146/annurev-immunol-093019-125603

56. Odak I, Förster R, Bošnjak B. Hide and seek with SARS-CoV-2: spike receptor-binding domain-specific memory B cells still recognize Omicron variant. Vol. 7, Signal Transduction and Targeted Therapy. Springer Nature; 2022. Available from: https://doi.org/10.1038/s41392-022-01192-8

57. Syeda MZ, Tu H, Huang C, Huang W, Mu Q. B cell memory: from generation to reactivation: a multipronged defense wall against pathogens. Cell Death Discovery. 2024 Mar 7;10(1). Available from: https://doi.org/10.1038/s41420-024-01889-5

58. Nishio A, Hasan S, Park H, Park N, Salas J, Salinas E, et al. Serum neutralization activity declines but memory B cells persist after cure of chronic hepatitis C. Nature Communications. 2022 Sept 16;13(1). https://doi.org/10.1038/s41467-022-33035-z

59. Kealy L, Good‐Jacobson KL. Advances in understanding the formation and fate of B-cell memory in response to immunization or infection. Oxford Open Immunology. 2021 Jan 1;2(1). Available from: https://doi.org/10.1093/oxfimm/iqab018

60. Fryer HA, Hartley GE, Edwards ESJ, O’Hehir RE, Zelm MC van. Humoral immunity and B-cell memory in response to SARS-CoV-2 infection and vaccination. Biochemical Society Transactions. 2022 Nov 24;50(6):1643–58. Available from: https://doi.org/10.1042/bst20220415

61. Zurbuchen Y, Michler J, Taeschler P, Adamo S, Cervia C, Raeber ME, et al. Human memory B cells show plasticity and adopt multiple fates upon recall response to SARS-CoV-2. Nature Immunology. 2023 Apr 27;24(6):955–65. Available from: https://doi.org/10.1038/s41590-023-01497-y

62. Podestà MA, Cavazzoni CB, Hanson BL, Bechu ED, Ralli G, Clement RL, et al. Stepwise differentiation of follicular helper T cells reveals distinct developmental and functional states. Nature Communications. 2023 Nov 24;14(1). Available from: https://doi.org/10.1038/s41467-023-43427-4

63. Foster WS, Lee JL, Thakur N, Newman J, Spencer AJ, Davies S, et al. Tfh cells and the germinal center are required for memory B cell formation & humoral immunity after ChAdOx1 nCoV-19 vaccination. Cell Reports Medicine. 2022 Nov 16;3(12):100845–100845. https://doi.org/10.1016/j.xcrm.2022.100845

64. Choi J, Crotty S, Choi YS. Cytokines in Follicular Helper T Cell Biology in Physiologic and Pathologic Conditions. Immune Network. 2024 Jan 1;24(1). Available from: https://doi.org/10.4110/in.2024.24.e8

65. Boothby M, Brookens SK, Raybuck A, Cho SH. Supplying the trip to antibody production—nutrients, signaling, and the programming of cellular metabolism in the mature B lineage. Cellular and Molecular Immunology. Springer Nature; 2021 Nov 15;19(3):352–69. Available from: https://doi.org/10.1038/s41423-021-00782-w

66. Szabó K, Jámbor I, Szántó A, Horváth IF, Tarr T, Nakken B, et al. The Imbalance of Circulating Follicular T Helper Cell Subsets in Primary Sjögren’s Syndrome Associates With Serological Alterations and Abnormal B-Cell Distribution. Frontiers in Immunology. 2021 Mar 19;12. https://doi.org/10.3389/fimmu.2021.639975

67. Fu N, Xie F, Sun Z, Wang Q. The OX40/OX40L Axis Regulates T Follicular Helper Cell Differentiation: Implications for Autoimmune Diseases. Frontiers in Immunology. Frontiers Media; 2021 June 21;12. https://doi.org/10.3389/fimmu.2021.670637

68. Kim YJ, Choi J, Choi YS. Transcriptional regulation of Tfh dynamics and the formation of immunological synapses. Experimental & Molecular Medicine. Springer Nature; 2024 June 3;56(6):1365–72. https://doi.org/10.1038/s12276-024-01254-7

69. Yu M, Charles A, Cagigi A, Christ W, Österberg B, Falck‐Jones S, et al. Delayed generation of functional virus-specific circulating T follicular helper cells correlates with severe COVID-19. Nature Communications. 2023 Apr 15;14(1). Available from: https://doi.org/10.1038/s41467-023-37835-9

70. Law H, Venturi V, Kelleher AD, Munier CML. Tfh Cells in Health and Immunity: Potential Targets for Systems Biology Approaches to Vaccination. International Journal of Molecular Sciences. 2020 Nov 12;21(22):8524–8524. Available from: https://doi.org/10.3390/ijms21228524

71. Lau AWY, Turner V, Bourne K, Hermes JR, Chan TD, Brink R. BAFFR controls early memory B cell responses but is dispensable for germinal center function. The Journal of Experimental Medicine. 2020 Oct 29;218(2). Available from: https://doi.org/10.1084/jem.20191167

72. He R, Zheng X, Zhang J, Liu B, Wang Q, Wu Q, et al. SARS-CoV-2 spike-specific TFH cells exhibit unique responses in infected and vaccinated individuals. Signal Transduction and Targeted Therapy. 2023 Oct 6;8(1). Available from: https://doi.org/10.1038/s41392-023-01650-x

73. Lakshmanappa YS, Elizaldi SR, Roh JW, Schmidt B, Carroll TD, Weaver KD, et al. SARS-CoV-2 induces robust germinal center CD4 T follicular helper cell responses in rhesus macaques. Nature Communications. 2021 Jan 22;12(1). Available from: https://doi.org/10.1038/s41467-020-20642-x

74. Yu M, Charles A, Cagigi A, Christ W, Österberg B, Falck‐Jones S, et al. Delayed generation of functional virus-specific circulating T follicular helper cells correlates with severe COVID-19. medRxiv (Cold Spring Harbor Laboratory). 2022 July 12; Available from: https://doi.org/10.1101/2022.07.12.22277549

75. Stavropoulou E, Kantartzi K, Tsigalou C, Konstantinidis T, Voidarou C, Konstantinidis T, et al. Unraveling the Interconnection Patterns Across Lung Microbiome, Respiratory Diseases, and COVID-19. Frontiers in Cellular and Infection Microbiology. Frontiers Media; 2021 Jan 28 10. Available from: https://doi.org/10.3389/fcimb.2020.619075

76. Priest DG, Ebihara T, Tulyeu J, Søndergaard JN, Sakakibara S, Sugihara F, et al. Atypical and non-classical CD45RBlo memory B cells are the majority of circulating SARS-CoV-2 specific B cells following mRNA vaccination or COVID-19. Nature Communications. 2024 Aug 9;15(1). https://doi.org/10.1038/s41467-024-50997-4

77. Zhu Q, Xu Y, Wang T, Xie F. Innate and adaptive immune response in SARS-CoV-2 infection-Current perspectives. Frontiers in Immunology. Frontiers Media; 2022 Nov 22;13. Available from: https://doi.org/10.3389/fimmu.2022.1053437

78. Izmirly AM, Alturki SO, Alturki SO, Connors J, Haddad EK. Challenges in Dengue Vaccines Development: Pre-existing Infections and Cross-Reactivity. Frontiers in Immunology. Frontiers Media; 2020 June 16;11. https://doi.org/10.3389/fimmu.2020.01055

79. Galloway DR, Nguyen NX, Li J, Houston N, Gregersen G, Williamson ED, et al. The magnitude of the germinal center B cell and T follicular helper cell response predicts long-lasting antibody titers to plague vaccination. Frontiers in Immunology. 2022 Oct 28;13. Available from: https://doi.org/10.3389/fimmu.2022.1017385

80. Ioannidou K, Ndiaye DR, Noto A, Fenwick C, Fortis SP, Pantaleo G, et al. In Situ Characterization of Follicular Helper CD4 T Cells Using Multiplexed Imaging. Frontiers in Immunology. 2021 Feb 3;11. https://doi.org/10.3389/fimmu.2020.607626

81. Khanam A, Ayithan N, Tang L, Poonia B, Kottilil S. IL-21–Deficient T Follicular Helper Cells Support B Cell Responses Through IL-27 in Patients With Chronic Hepatitis B. Frontiers in Immunology. 2021 Jan 28;11. Available from: https://doi.org/10.3389/fimmu.2020.599648

82. Noel GR, Fontsa ML, Garaud S, Silva PD, Wind A de, Eynden GGV den, et al. Functional Th1-oriented T follicular helper cells that infiltrate human breast cancer promote effective adaptive immunity. Journal of Clinical Investigation. 2021 Aug 19;131(19). Available from: https://doi.org/10.1172/jci139905

83. Lu Y, Craft J. T Follicular Regulatory Cells: Choreographers of Productive Germinal Center Responses. Frontiers in Immunology. Frontiers Media; 2021 June 10;12. Available from: https://doi.org/10.3389/fimmu.2021.679909

84. Nelson AN, Lin WHW, Shivakoti R, Putnam NE, Mangus LM, Adams RJ, et al. Association of persistent wild-type measles virus RNA with long-term humoral immunity in rhesus macaques. JCI Insight. 2020 Jan 14;5(3). Available from: https://doi.org/10.1172/jci.insight.134992

85. DeGottardi Q, Gates TJ, Yang J, James EA, Malhotra U, Chow I, et al. Ontogeny of different subsets of yellow fever virus-specific circulatory CXCR5+ CD4+ T cells after yellow fever vaccination. Scientific Reports. 2020 Sept 24;10(1). Available from: https://doi.org/10.1038/s41598-020-72610-6

86. Cashman SB, Swift T, Song HC, Wright A, Ayer A. Characterization of germinal center and circulating T follicular helper cells using both intracellular and surface CITE-seq. The Journal of Immunology. 2023 May 1;210. Available from: https://doi.org/10.4049/jimmunol.210.supp.250.15

87. Zhang J, Wu Q, Liu Z, Wang Q, Wu J, Hu Y, et al. Spike-specific circulating T follicular helper cell and cross-neutralizing antibody responses in COVID-19-convalescent individuals. Nature Microbiology. 2020 Nov 16;6(1):51–8. Available from: https://doi.org/10.1038/s41564-020-00824-5

88. Subburayalu J. Immune surveillance and humoral immune responses in kidney transplantation – A look back at T follicular helper cells. Frontiers in Immunology. Frontiers Media; 2023 July 12;14. https://doi.org/10.3389/fimmu.2023.1114842

89. Jiang W, Wong J, Tan H, Kelly HG, Whitney PG, Barr I, et al. Screening and development of monoclonal antibodies for identification of ferret T follicular helper cells. Scientific Reports. 2021 Jan 21;11(1). https://doi.org/10.1038/s41598-021-81389-z

90. Godot V, Tchérakian C, Gil L, Cervera-Marzal I, Li G, Cheng L, et al. TLR-9 agonist and CD40-targeting vaccination induces HIV-1 envelope-specific B cells with a diversified immunoglobulin repertoire in humanized mice. PLoS Pathogens. 2020 Nov 30;16(11). Available from: https://doi.org/10.1371/journal.ppat.1009025

91. O’Connor M, Muir R, Chakhtoura M, Fang M, Moysi E, Moir S, et al. A follicular regulatory Innate Lymphoid Cell population impairs interactions between germinal center Tfh and B cells. Communications Biology. 2021 May 12;4(1). Available from: https://doi.org/10.1038/s42003-021-02079-0

92. Zhao Q, Dai H, Liu X, Jiang H, Liu W, Feng Z, et al. Helper T Cells in Idiopathic Membranous Nephropathy. Frontiers in Immunology. Frontiers Media; 2021 May 20;12. Available from: https://doi.org/10.3389/fimmu.2021.665629

93. Gao X, Luo K, Wang D, Wei Y, Yao Y, Deng J, et al. T follicular helper 17 (Tfh17) cells are superior for immunological memory maintenance. eLife. 2023 Jan 19;12. Available from: https://doi.org/10.7554/elife.82217

94. Zhou P, Cao C, Ji T, Zheng T, Dai Y, Liu M, et al. Longitudinal analysis of memory Tfh cells and antibody response following CoronaVac vaccination. JCI Insight. 2023 June 29;8(15). Available from: https://doi.org/10.1172/jci.insight.168437

95. Caldirola MS, Martínez MP, Bezrodnik L, Zwirner NW, Gaillard MI. Immune Monitoring of Patients With Primary Immune Regulation Disorders Unravels Higher Frequencies of Follicular T Cells With Different Profiles That Associate With Alterations in B Cell Subsets. Frontiers in Immunology. 2020 Oct 29;11. Available from: https://doi.org/10.3389/fimmu.2020.576724

96. Song W, Craft J. T Follicular Helper Cell Heterogeneity. Annual Review of Immunology. 2023 Dec 7;42(1):127–52. https://doi.org/10.1146/annurev-immunol-090222-102834

97. Zhu F, McMonigle RJ, Schroeder AR, Xia X, Figge DA, Greer BD, et al. Spatiotemporal resolution of germinal center Tfh cell differentiation and divergence from central memory CD4+ T cell fate. Nature Communications. 2023 June 17;14(1). Available from: https://doi.org/10.1038/s41467-023-39299-3

98. Gao X, Luo K, Wang D, Wei Y, Yao Y, Deng J, et al. Type 17 Follicular Helper T (Tfh17) Cells are Superior for Memory Maintenance. 2022 July 31; Available from: https://doi.org/10.1101/2022.07.31.502219

99. Chi X, Gu J, Ma X. Characteristics and Roles of T Follicular Helper Cells in SARS-CoV-2 Vaccine Response. Vaccines. 2022 Sept 28;10(10):1623–1623. Available from: https://doi.org/10.3390/vaccines10101623

100. Silva-Cayetano A, Fra-Bidó S, Robert PA, Innocentin S, Burton AR, Watson EM, et al. Spatial dysregulation of T follicular helper cells impairs vaccine responses in aging. Nature Immunology. 2023 May 22;24(7):1124–37. https://doi.org/10.1038/s41590-023-01519-9

101. Gao X, Luo K, Wang D, Wei Y, Yao Y, Deng J, et al. Author response: T follicular helper 17 (Tfh17) cells are superior for immunological memory maintenance. 2022 Dec 17; http://dx.doi.org/10.7554/elife.82217.sa2

102. Yang Q, Zhang F, Chen H, Hu Y, Yang N, Yang W, et al. The differentiation courses of the Tfh cells: a new perspective on autoimmune disease pathogenesis and treatment. Bioscience Reports. Portland Press; 2023 Dec 5;44(1). https://doi.org/10.1042/bsr20231723

103. Salek‐Ardakani S, Fousteri G, Cicalese MP. Editorial: Follicular helper T cells in immunity and autoimmunity, volume II. Frontiers in Immunology. 2026 Feb 9;17. Available from: https://doi.org/10.3389/fimmu.2026.1790802

104. Murayama K, Ikegami I, Kamekura R, Sakamoto H, Yanagi M, Kamiya S, et al. CD4+CD8+ T follicular helper cells regulate humoral immunity in chronic inflammatory lesions. Frontiers in Immunology. 2022 Aug 25;13. Available from: https://doi.org/10.3389/fimmu.2022.941385

105. Qi J, Liu C, Bai Z, Li X, Yao G. T follicular helper cells and T follicular regulatory cells in autoimmune diseases. Frontiers in Immunology. Frontiers Media; 2023 Apr 28;14. Available from: https://doi.org/10.3389/fimmu.2023.1178792

106. Han F, Zhao Z, Zhao X, Bai X, Fu W, Zheng L, et al. A novel memory-like Tfh cell subset is precursor to effector Tfh cells in recall immune responses. The Journal of Experimental Medicine. 2023 Dec 4;221(1). https://doi.org/10.1084/jem.20221927

107. Dave S, Ballesteros‐Tato A. Noncanonical functions of T follicular helper cells. Science Immunology. 2025 June 13;10(108). https://doi.org/10.1126/sciimmunol.adr1052

108. Künzli M, Schreiner D, Pereboom TC, Swarnalekha N, Litzler LC, Lötscher J, et al. Long-lived T follicular helper cells retain plasticity and help sustain humoral immunity. Science Immunology. 2020 Mar 6;5(45). https://doi.org/10.1126/sciimmunol.aay5552

109. Yanagi M, Ikegami I, Kamekura R, Sato T, Sato T, Kamiya S, et al. Bob1 maintains T follicular helper cells for long-term humoral immunity. Communications Biology. 2024 Feb 15;7(1). https://doi.org/10.1038/s42003-024-05827-0

110. Sheikh AA, Groom JR. Transcription tipping points for T follicular helper cell and T-helper 1 cell fate commitment. Cellular and Molecular Immunology. Springer Nature; 2020 Sept 30;18(3):528–38. https://doi.org/10.1038/s41423-020-00554-y

111. Yi L, Li Y. Stem-like T cells and niches: Implications in human health and disease. Frontiers in Immunology. Frontiers Media; 2022 Aug 17;13. Available from: https://doi.org/10.3389/fimmu.2022.907172

112. Krueger PD, Osum KC, Jenkins MK, Krueger PD, Osum KC, Jenkins MK. CD4+ Memory T-Cell Formation during Type 1 Immune Responses. Cold Spring Harbor Perspectives in Biology. Cold Spring Harbor Laboratory Press; 2021 Apr 26;13(12). Available from: https://doi.org/10.1101/cshperspect.a038141

113. Raynor J, Chapman NM, Chi H. Metabolic Control of Memory T-Cell Generation and Stemness. Cold Spring Harbor Perspectives in Biology. Cold Spring Harbor Laboratory Press; 2021 Apr 5;13(6). https://doi.org/10.1101/cshperspect.a037770

114. Juno JA, Hill DL. T follicular helper cells and their impact on humoral responses during pathogen and vaccine challenge. Current Opinion in Immunology. 2021 Nov 30;74:112–7. Available from: https://doi.org/10.1016/j.coi.2021.11.004

115. Govender M, Hopkins FR, Göransson R, Svanberg C, Shankar EM, Hjorth M, et al. T cell perturbations persist for at least 6 months following hospitalization for COVID-19. Frontiers in Immunology. 2022 Aug 8;13. Available from: https://doi.org/10.3389/fimmu.2022.931039

116. Shukla S, Shukla AK, Ray N, Upadhyay AM, Mirone G, Mongre RK. Long-lasting Response of Human Circulating T-follicular Helper Cells (cTfh) To Post SARS-CoV-2 mRNA Immunization. 2024 Nov 13;7(1):228–46. Available from: https://doi.org/10.9734/aji/2024/v7i1147

117. Shen F, Shen Y, Xu Y, Zhao J, Zhao Z, Liu J, et al. Dysregulation of circulating T follicular helper cell subsets and their potential role in the pathogenesis of syphilis. Frontiers in Immunology. 2023 Oct 12 14. Available from: https://doi.org/10.3389/fimmu.2023.1264508

118. Kim C, Jin J, Weyand CM, Goronzy JJ. The Transcription Factor TCF1 in T Cell Differentiation and Aging. International Journal of Molecular Sciences. 2020 Sept 5;21(18):6497–6497. Available from: https://doi.org/10.3390/ijms21186497

119. Yermanos A, Sandu I, Pedrioli A, Borsa M, Wagen F, Oetiker N, et al. Profiling Virus-Specific Tcf1+ T Cell Repertoires During Acute and Chronic Viral Infection. Frontiers in Immunology. 2020 May 29;11. https://doi.org/10.3389/fimmu.2020.00986

120. Gonzalez NM, Zou D, Gu A, Chen W. Schrödinger’s T Cells: Molecular Insights Into Stemness and Exhaustion. Frontiers in Immunology. Frontiers Media; 2021 Aug 26;12. Available from: https://doi.org/10.3389/fimmu.2021.725618

121. Rutishauser RL, Deguit CDT, Hiatt J, Blaeschke F, Roth TL, Wang L, et al. TCF-1 regulates HIV-specific CD8+ T cell expansion capacity. JCI Insight. 2020 Dec 22;6(3). Available from: https://doi.org/10.1172/jci.insight.136648

122. Yermanos A, Sandu I, Pedrioli A, Borsa M, Wagen F, Oetiker N, et al. Profiling virus-specific Tcf1+ T cell repertoires during acute and chronic viral infection. bioRxiv (Cold Spring Harbor Laboratory). 2020 Mar 23; Available from: https://doi.org/10.1101/2020.03.20.000646

123. Seo W, Jerin C, Nishikawa H. Transcriptional regulatory network for the establishment of CD8+ T cell exhaustion. Experimental & Molecular Medicine. Springer Nature; 2021 Feb 1;53(2):202–9. https://doi.org/10.1038/s12276-021-005680

124. Takata H, Trautmann L. Transforming dysfunctional CD8+ T cells into natural controller–like CD8+ T cells: can TCF-1 be the magic wand?. Vol. 132, Journal of Clinical Investigation. American Society for Clinical Investigation; 2022. Available from: https://doi.org/10.1172/jci160474

125. Hofmann M, Jandus C, Lee LN, Utzschneider DT. Editorial: Memory T Cells in Chronic Infections and Tumors. Frontiers in Immunology. 2021 Feb 17;12. Available from: https://doi.org/10.3389/fimmu.2021.656010

126. Deak LC, Nicolini V, Hashimoto M, Karagianni M, Schwalie P, Lauener L, et al. PD-1-cis IL-2R agonism yields better effectors from stem-like CD8+ T cells. Nature. 2022 Sept 28;610(7930):161–72. https://doi.org/10.1038/s41586-022-05192-0

127. Busselaar J, Tian S, Eenennaam H van, Borst J. Helpless Priming Sends CD8+ T Cells on the Road to Exhaustion. Frontiers in Immunology. 2020 Oct 6 [;11. Available from: https://doi.org/10.3389/fimmu.2020.592569

128. Hu Y, Hudson WH, Kissick H, Medina CB, Baptista AP, Ma C, et al. TGF-β regulates the stem-like state of PD-1+ TCF-1+ virus-specific CD8 T cells during chronic infection. The Journal of Experimental Medicine. 2022 July 21;219(10). Available from: https://doi.org/10.1084/jem.20211574

129. Wen S, Lu H, Wang D, Guo J, Dai W, Wang Z. TCF-1 maintains CD8+ T cell stemness in tumor microenvironment. Journal of Leukocyte Biology. 2021 May 28;110(3):585–90. Available from: https://doi.org/10.1002/jlb.5mr1120-778r

130. Galletti G, Simone GD, Mazza EMC, Puccio S, Mezzanotte C, Bi T, et al. Two subsets of stem-like CD8+ memory T cell progenitors with distinct fate commitments in humans. Nature Immunology. 2020 Oct 12;21(12):1552–62. Available from: https://doi.org/10.1038/s41590-020-0791-5

131. Cai H, Shi J, Yin LB, Zheng JF, Fu Y, Jiang Y, et al. Downregulation of TCF1 in HIV Infection Impairs T-cell Proliferative Capacity by Disrupting Mitochondrial Function. Frontiers in Microbiology. 2022 July 6;13. Available from: https://doi.org/10.3389/fmicb.2022.880873

132. Na J, Engwerda C. The role of CD4+ T cells in visceral leishmaniasis; new and emerging roles for NKG7 and TGFβ. Frontiers in Cellular and Infection Microbiology. 2024 May 31;14. https://doi.org/10.3389/fcimb.2024.1414493

133. Kanev K, Zehn D. Origin and fine-tuning of effector CD8 T cell subpopulations in chronic infection. Current Opinion in Virology. Elsevier BV; 2020 Nov 1;46:27–35. Available from: https://doi.org/10.1016/j.coviro.2020.10.003

134. Zhang F, Ding X, Huang H, Jiang H, Jiang J, Zheng X. Revolutionizing tumor immunotherapy: unleashing the power of progenitor exhausted T cells. Cancer Biology and Medicine. 2024 May 31;1–14. https://doi.org/10.20892/j.issn.2095-3941.2024.0105

135. Lee J, Lee K, Bae H, Lee K, Lee S, Ma J, et al. IL-15 promotes self-renewal of progenitor exhausted CD8 T cells during persistent antigenic stimulation. Frontiers in Immunology. 2023 June 20;14. https://doi.org/10.3389/fimmu.2023.1117092

136. Pichler A, Cannons JL, Schwartzberg PL. The Road Less Taken: Less Appreciated Pathways for Manipulating CD8+ T Cell Exhaustion. Frontiers in Immunology. Frontiers Media; 2022 July 6;13. https://doi.org/10.3389/fimmu.2022.926714

137. Chung HK, McDonald B, Kaech SM. The architectural design of CD8+ T cell responses in acute and chronic infection: Parallel structures with divergent fates. The Journal of Experimental Medicine. Rockefeller University Press; 2021 Mar 23;218(4). Available from: https://doi.org/10.1084/jem.20201730

138. Humblin É, Korpas I, Lu J, Filipescu D, Heide V van der, Goldstein S, et al. Sustained CD28 costimulation is required for self-renewal and differentiation of TCF-1 + PD-1 + CD8 T cells. Science Immunology. 2023 Aug 4;8(86). Available from: https://doi.org/10.1126/sciimmunol.adg0878

139. Chi X, Luo S, Ye P, Hwang W, Cha J, Yan X, et al. T-cell exhaustion and stemness in antitumor immunity: Characteristics, mechanisms, and implications. Frontiers in Immunology. Frontiers Media; 2023 Feb 20;14. Available from: https://doi.org/10.3389/fimmu.2023.1104771

140. Ma C, Zhang N. Lymphoid tissue residency: A key to understand Tcf-1+PD-1+ T cells. Frontiers in Immunology. Frontiers Media; 2022 Dec 7;13. Available from: https://doi.org/10.3389/fimmu.2022.1074698

141. Jiang W, He Y, He W, Wu G, Zhou X, Sheng Q, et al. Exhausted CD8+T Cells in the Tumor Immune Microenvironment: New Pathways to Therapy. Frontiers in Immunology. Frontiers Media; 2021 Feb 2;11. Available from: https://doi.org/10.3389/fimmu.2020.622509

142. Chen Y, Xu Z, Sun H, Ouyang X, Han Y, Yu H, et al. Regulation of CD8+ T memory and exhaustion by the mTOR signals. Cellular and Molecular Immunology. Springer Nature; 2023 Aug 15;20(9):1023–39. https://doi.org/10.1038/s41423-023-01064-3

143. Tsui C, Kretschmer L, Rapelius S, Gabriel SS, Chisanga D, Knöpper K, et al. MYB orchestrates T cell exhaustion and response to checkpoint inhibition. Nature. 2022 Aug 17;609(7926):354–60. https://doi.org/10.1038/s41586-022-05105-1

144. Bulliard Y, Andersson BS, Baysal MA, Damiano JS, Tsimberidou AM. Reprogramming T cell differentiation and exhaustion in CAR-T cell therapy. Journal of Hematology & Oncology. BioMed Central; 2023 Oct 25;16(1). Available from: https://doi.org/10.1186/s13045-023-01504-7

145. Ni L. Potential mechanisms of cancer stem‐like progenitor T‐cell bio‐behaviours. Clinical and Translational Medicine. 2024 Aug 1;14(8). Available from: https://doi.org/10.1002/ctm2.1817

146. Zhang J, Lei F, Tan H. The development of CD8 T-cell exhaustion heterogeneity and the therapeutic potentials in cancer. Frontiers in Immunology. Frontiers Media; 2023 May 18;14https://doi.org/10.3389/fimmu.2023.1166128

147. Tian W, Qin G, Jia M, Li W, WEI-LI C, Wang H, et al. Hierarchical transcriptional network governing heterogeneous T cell exhaustion and its implications for immune checkpoint blockade. Frontiers in Immunology. Frontiers Media; 2023 June 16;14. https://doi.org/10.3389/fimmu.2023.1198551

148. Dolina JS, Budimir N, Thomas GD, Salek‐Ardakani S. CD8+ T Cell Exhaustion in Cancer. Frontiers in Immunology. Frontiers Media; 2021 July 20;12. Available from: https://doi.org/10.3389/fimmu.2021.715234

149. Cai C, Samir J, Pirozyan MR, Adikari T, Gupta M, Leung P, et al. Identification of human progenitors of exhausted CD8+ T cells associated with elevated IFN-γ response in early phase of viral infection. Nature Communications. 2022 Dec 7;13(1). Available from: https://doi.org/10.1038/s41467-022-35281-7

150. Menezes MN de, Chen AXY, Kulkarni N, Sampurno S, Saw NYL, Yap KM, et al. High efficiency CRISPR knock-in demonstrates that TCF1 is insufficient to reverse T cell exhaustion. Nature Communications. 2026 Feb 17; Available from: https://doi.org/10.1038/s41467-026-69671-y

151. Pagé N, Lemeille S, Vincenti I, Klimek B, Mariotte A, Wagner I, et al. Persistence of self-reactive CD8+ T cells in the CNS requires TOX-dependent chromatin remodeling. Nature Communications. 2021 Feb 12;12(1). https://doi.org/10.1038/s41467-021-21109-3

152. Li C, Yuan Y, Jiang X, Wang Q. Epigenetic regulation of CD8+ T cell exhaustion: recent advances and update. Frontiers in Immunology. 2025 Oct 21;16. Available from: https://doi.org/10.3389/fimmu.2025.1700039

153. Blake MK, O’Connell PM, Aldhamen YA. Fundamentals to therapeutics: Epigenetic modulation of CD8+ T Cell exhaustion in the tumor microenvironment. Frontiers in Cell and Developmental Biology. Frontiers Media; 2023 Jan 4;10. Available from: https://doi.org/10.3389/fcell.2022.1082195

154. Koh C, Lee S, Kwak M, Kim B, Chung Y. CD8 T-cell subsets: heterogeneity, functions, and therapeutic potential. Experimental & Molecular Medicine. Springer Nature; 2023 Nov 1;55(11):2287–99. https://doi.org/10.1038/s12276-023-01105-x

155. Schnell A, Bod L, Madi A, Kuchroo VK. The yin and yang of co-inhibitory receptors: toward anti-tumor immunity without autoimmunity. Cell Research. Springer Nature; 2020 Jan 23;30(4):285–99. https://doi.org/10.1038/s41422-020-0277-x

156. Zhang Z, Liu S, Zhang B, Qiao L, Zhang Y, Zhang Y. T Cell Dysfunction and Exhaustion in Cancer. Frontiers in Cell and Developmental Biology. Frontiers Media; 2020 Feb 11;8. Available from: https://doi.org/10.3389/fcell.2020.00017

157. Neubert EN, DeRogatis JM, Lewis SA, Viramontes KM, Ortega P, Henriquez ML, et al. HMGB2 regulates the differentiation and stemness of exhausted CD8+ T cells during chronic viral infection and cancer. Nature Communications. 2023 Sept 13;14(1). Available from: https://doi.org/10.1038/s41467-023-41352-0

158. Wagle MV, Vervoort SJ, Kelly MJ, Byl WVD, Peters TJ, Martin BP, et al. Antigen-driven EGR2 expression is required for exhausted CD8+ T cell stability and maintenance. Nature Communications. 2021 May 13;12(1). https://doi.org/10.1038/s41467-021-23044-9

159. Lacher S, Dörr J, Almeida GP de, Hönninger J, Bayerl F, Hirschberger A, et al. PGE2 limits effector expansion of tumour-infiltrating stem-like CD8+ T cells. Nature. 2024 Apr 24;629(8011):417–25. https://doi.org/10.1038/s41586-024-07254-x

160. Manna MPL, Azgomi MS, Tamburini B, Badami GD, Mohammadnezhad L, Dieli F, et al. Phenotypic and Immunometabolic Aspects on Stem Cell Memory and Resident Memory CD8+ T Cells. Frontiers in Immunology. Frontiers Media; 2022 June 17;13. Available from: https://doi.org/10.3389/fimmu.2022.884148

161. Rudloff M, Zumbo P, Favret NR, Roetman JJ, Román CRD, Erwin MM, et al. Hallmarks of CD8+ T cell dysfunction are established within hours of tumor antigen encounter before cell division. Nature Immunology. 2023 Aug 3;24(9):1527–39. Available from: https://doi.org/10.1038/s41590-023-01578-y

162. Chen C, Liu J, Chen Y, Lin A, Mou W, Zhu L, et al. Application of ATAC-seq in tumor-specific T cell exhaustion. Cancer Gene Therapy. Springer Nature; 2022 July 6;30(1):1–10. Available from: https://doi.org/10.1038/s41417-022-00495-w

163. Zeng Z, Feng W, Ren X. Exhausted T cells and epigenetic status. Cancer Biology and Medicine. 2020 Jan 1;17(4):923–36. https://doi.org/10.20892/j.issn.2095-3941.2020.0338

164. Li Y, Han M, Wei H, Huang W, Chen Z, Zhang T, et al. Id2 epigenetically controls CD8+ T-cell exhaustion by disrupting the assembly of the Tcf3-LSD1 complex. Cellular and Molecular Immunology. 2024 Jan 29;21(3):292–308. Available from: https://doi.org/10.1038/s41423-023-01118-6

165. Li X, Li Y, Dong L, Chang YX, Zhang X, Wang C, et al. Decitabine priming increases anti–PD-1 antitumor efficacy by promoting CD8+ progenitor exhausted T cell expansion in tumor models. Journal of Clinical Investigation. 2023 Feb 28;133(7). Available from: https://doi.org/10.1172/jci165673

166. Liu S, Sun Q, Ren X. Novel strategies for cancer immunotherapy: counter-immunoediting therapy. Journal of Hematology & Oncology. BioMed Central; 2023 Apr 13;16(1). Available from: https://doi.org/10.1186/s13045-023-01430-8

167. Ding J, Yang K, Zhou H, Huang YF, Li H, Zong Z. Landscapes and mechanisms of CD8+ T cell exhaustion in gastrointestinal cancer. Frontiers in Immunology. Frontiers Media; 2023 Apr 25;14. https://doi.org/10.3389/fimmu.2023.1149622

168. Tien F, Lu H, Lin S, Tsai HC. Epigenetic remodeling of the immune landscape in cancer: therapeutic hurdles and opportunities. Journal of Biomedical Science. BioMed Central; 2023 Jan 10;30(1). https://doi.org/10.1186/s12929-022-00893-0

169. Liu Y, Debo B, Li M, Shi Z, Sheng W, Shi Y. LSD1 inhibition sustains T cell invigoration with a durable response to PD-1 blockade. Nature Communications. 2021 Nov 24 12(1). Available from: https://doi.org/10.1038/s41467-021-27179-7

170. Lamplugh ZL, Fan Y. Vascular Microenvironment, Tumor Immunity and Immunotherapy. Frontiers in Immunology. Frontiers Media; 2021 Dec 20;12. Available from: https://doi.org/10.3389/fimmu.2021.811485

171. Gao Z, Feng Y, Xu J, Liang J. T-cell exhaustion in immune-mediated inflammatory diseases: New implications for immunotherapy. Frontiers in Immunology. Frontiers Media; 2022 Sept 23;13. https://doi.org/10.3389/fimmu.2022.977394

172. Chen-Camaño R, DeAntonio R, López-Vergès S. T-cell exhaustion in COVID-19: what do we know? Frontiers in Immunology. 2025 Oct 29;16. Available from: https://doi.org/10.3389/fimmu.2025.1678149

173. Immune Responses to Persistent or Recurrent Antigens: Implications for Immunological Memory and Immunotherapy. Frontiers research topics. Frontiers Media; 2021. Available from: https://doi.org/10.3389/978-2-88966-718-5

174. Viganó S, Bobisse S, Coukos G, Perreau M, Harari A. Cancer and HIV-1 Infection: Patterns of Chronic Antigen Exposure. Frontiers in Immunology. Frontiers Media; 2020 June 30;11. https://doi.org/10.3389/fimmu.2020.01350

175. Wang B, Yin H, Zhang Y, Zhao Q, Wang H, Wei J, et al. Overcoming acquired resistance to cancer immune checkpoint therapy: potential strategies based on molecular mechanisms. Cell & Bioscience. BioMed Central; 2023 June 30;13(1). Available from: https://doi.org/10.1186/s13578-023-01073-9

176. Martin G, Sen DR, Pace M, Robinson N, Meyerowitz J, Adland E, et al. Epigenetic Features of HIV-Induced T-Cell Exhaustion Persist Despite Early Antiretroviral Therapy. Frontiers in Immunology. 2021 June 4 [cited 2025 Sept];12. Available from: https://doi.org/10.3389/fimmu.2021.647688

177. Pace L. Temporal and Epigenetic Control of Plasticity and Fate Decision during CD8+T-Cell Memory Differentiation. Cold Spring Harbor Perspectives in Biology. Cold Spring Harbor Laboratory Press; 2021 May 10;13(12). Available from: https://doi.org/10.1101/cshperspect.a037754

178. DiNardo AR, Rajapakshe K, Nishiguchi T, Grimm SL, Mtetwa G, Dlamini Q, et al. DNA hypermethylation during tuberculosis dampens host immune responsiveness. Journal of Clinical Investigation. 2020 Mar 10;130(6):3113–23. https://doi.org/10.1172/jci134622

179. Metzemaekers M, Rinzema NJ, Stadhouders R. Epigenetic priming as a driver of memory recall and dysfunction in T cells. The Journal of Experimental Medicine. 2025 July 31;222(9). Available from: https://doi.org/10.1084/jem.20241433

180. Rose JR, Akdogan‐Ozdilek B, Rahmberg AR, Powell MD, Hicks SL, Scharer CD, et al. Distinct transcriptomic and epigenomic modalities underpin human memory T cell subsets and their activation potential. Communications Biology. 2023 Apr 3;6(1). Available from: https://doi.org/10.1038/s42003-023-04747-9

181. Muroyama Y, Wherry EJ. Memory T-Cell Heterogeneity and Terminology. Cold Spring Harbor Perspectives in Biology. Cold Spring Harbor Laboratory Press; 2021 Mar 29;13(10). Available from: https://doi.org/10.1101/cshperspect.a037929

182. Montacchiesi G, Pace L. Epigenetics and CD8+ T cell memory*. Immunological Reviews. 2021 Dec 18;305(1):77–89. https://doi.org/10.1111/imr.13057

183. Zebley CC, Akondy R, Youngblood B, Kissick H. Defining the Molecular Hallmarks of T-Cell Memory. Cold Spring Harbor Perspectives in Biology. 2021 June 14;14(3). Available from: https://doi.org/10.1101/cshperspect.a037804

184. Peng S, Lin A, Jiang A, Zhang C, Zhang J, Cheng Q, et al. CTLs heterogeneity and plasticity: implications for cancer immunotherapy. Molecular Cancer. 2024 Mar 21;23(1). Available from: https://doi.org/10.1186/s12943-024-01972-6

185. Li W, Zhang L. Rewiring Mitochondrial Metabolism for CD8+ T Cell Memory Formation and Effective Cancer Immunotherapy. Frontiers in Immunology. Frontiers Media; 2020 Aug 27;11. https://doi.org/10.3389/fimmu.2020.01834

186. Devenish LP, Mhlanga MM, Negishi Y. Immune Regulation in Time and Space: The Role of Local- and Long-Range Genomic Interactions in Regulating Immune Responses. Frontiers in Immunology. Frontiers Media; 2021 May 11;12. Available from: https://doi.org/10.3389/fimmu.2021.662565

187. Liu Q, Sun Z, Chen L. Memory T cells: strategies for optimizing tumor immunotherapy. Protein & Cell. Springer Science+Business Media; 2020 Mar 27;11(8):549–64. Available from: https://doi.org/10.1007/s13238-020-00707-9

188. Zhang Z, Butler RA, Koestler DC, Bell-Glenn S, Warrier G, Molinaro AM, et al. Comparative analysis of the DNA methylation landscape in CD4, CD8, and B memory lineages. Clinical Epigenetics. 2022 Dec 1;14(1). https://doi.org/10.1186/s13148-022-01399-0

189. Xiong D, Zhang L, Sun Z. Targeting the epigenome to reinvigorate T cells for cancer immunotherapy. Military Medical Research. BioMed Central; 2023 Dec 4 10(1). Available from: https://doi.org/10.1186/s40779-023-00496-2

190. Lan Z, Chen Z, Yang N, Liu T, Li S, Shi Y, et al. Epigenetic control of tissue resident memory T cells. Frontiers in Immunology. Frontiers Media; 2025 Aug 15;16. Available from: https://doi.org/10.3389/fimmu.2025.1605972

191. Frias AB, Boi SK, Lan X, Youngblood B. Epigenetic regulation of T cell adaptive immunity. Immunological Reviews. 2021 Feb 28;300(1):9–21. Available from: https://doi.org/10.1111/imr.12943

192. Guo T, Li W, Cai X. Applications of Single-Cell Omics to Dissect Tumor Microenvironment. Frontiers in Genetics. Frontiers Media; 2020 Nov 27;11. Available from: https://doi.org/10.3389/fgene.2020.548719

193. Liu R, Zhao E, Yu H, Yuan C, Abbas MN, Cui H. Methylation across the central dogma in health and diseases: new therapeutic strategies. Signal Transduction and Targeted Therapy. Springer Nature; 2023 Aug 24;8(1). Available from: https://doi.org/10.1038/s41392-023-01528-y

194. Cheng B, Yu Q, Wang W. Intimate communications within the tumor microenvironment: stromal factors function as an orchestra. Journal of Biomedical Science. BioMed Central; 2023 Jan 4;30(1). https://doi.org/10.1186/s12929-022-00894-z

195. Niborski LL, Gueguen P, Ye M, Thiolat A, Ramos RN, Caudana P, et al. CD8+T cell responsiveness to anti-PD-1 is epigenetically regulated by Suv39h1 in melanomas. Nature Communications. 2022 June 29;13(1). https://doi.org/10.1038/s41467-022-31504-z

196. Li S, Hao L, Zhang J, Deng J, Hu X. Focus on T cell exhaustion: new advances in traditional Chinese medicine in infection and cancer. Chinese Medicine. BioMed Central; 2023 June 24;18(1). https://doi.org/10.1186/s13020-023-00785-x

197. Wong W, Yin B, Lam CYK, Huang Y, Yan J, Tan Z, et al. The Interplay Between Epigenetic Regulation and CD8+ T Cell Differentiation/Exhaustion for T Cell Immunotherapy. Frontiers in Cell and Developmental Biology. 2022 Jan 11;9:783227–783227. Available from: https://doi.org/10.3389/fcell.2021.783227

198. Torres L, Simone B, Campos T, Goepfert-Waterman E, Shestova O, Manne S, et al. Divergent exhaustion networks define memory CD8+ T cell subset fate under chronic stimulation and reveal targets for epigenetic reprogramming. Blood. 2025 Nov 3;146:4777–4777. Available from: https://doi.org/10.1182/blood-2025-4777

199. Niborski LL, Guéguen P, Ye M, Thiolat A, Ramos RN, Caudana P, et al. Epigenetic control of CD8+ T cell responsiveness to a-PD-1 by Suv39h1. HAL (Le Centre pour la Communication Scientifique Directe). 2020 Dec 4; https://hal.science/hal-03041343

200. Yousif A, Saadey AA, Lowin A, Castillo C, Saini A, Chan WK, et al. Modulating the epigenetic interplay in exhausted CD8 T cells for effective immunotherapy. The Journal of Immunology. 2024 May 1;212. Available from: https://doi.org/10.4049/jimmunol.212.supp.1492.6003

201. Wu Y, Wu Y, Gao Z, Yu W, Zhang L, Zhou F. Revitalizing T cells: breakthroughs and challenges in overcoming T cell exhaustion. Signal Transduction and Targeted Therapy. 2026 Jan 1;11(1):2–2. https://doi.org/10.1038/s41392-025-02327-3

202. Jenkins E, Whitehead T, Fellermeyer M, Davis SJ, Sharma S. The current state and future of T-cell exhaustion research. Oxford Open Immunology. 2023 Jan 1;4(1). Available from: https://doi.org/10.1093/oxfimm/iqad006

203. Quezada LK, Jin W, Liu YC, Kim ES, He Z, Indralingam CS, et al. Early transcriptional and epigenetic divergence of CD8+ T cells responding to acute versus chronic infection. PLoS Biology. 2023 Jan 30;21(1). Available from: https://doi.org/10.1371/journal.pbio.3001983

204. Stairiker CJ, Thomas GD, Salek‐Ardakani S. EZH2 as a Regulator of CD8+ T Cell Fate and Function. Frontiers in Immunology. Frontiers Media; 2020 Oct 6;11. Available from: https://doi.org/10.3389/fimmu.2020.593203

205. Maes K, Mondino A, Lasarte JJ, Agirre X, Vanderkerken K, Prósper F, et al. Epigenetic Modifiers: Anti-Neoplastic Drugs With Immunomodulating Potential. Frontiers in Immunology. Frontiers Media; 2021 Mar 30;12. Available from: https://doi.org/10.3389/fimmu.2021.652160

206. Zhou L, Xu N, Shibata H, Saloura V, Uppaluri R. Epigenetic modulation of immunotherapy and implications in head and neck cancer. Cancer and Metastasis Reviews. Springer Science+Business Media; 2021 Jan 5;40(1):141–52. Available from: https://doi.org/10.1007/s10555-020-09944-0

207. Huang J, Zhang J, Guo Z, Li C, Tan Z, Wang J, et al. Easy or Not—The Advances of EZH2 in Regulating T Cell Development, Differentiation, and Activation in Antitumor Immunity. Frontiers in Immunology. Frontiers Media; 2021 Oct 19;12. Available from: https://doi.org/10.3389/fimmu.2021.741302

208. Karin M, Shalapour S. Regulation of antitumor immunity by inflammation-induced epigenetic alterations. Cellular and Molecular Immunology. Springer Nature; 2021 Aug 31;19(1):59–66. https://doi.org/10.1038/s41423-021-00756-y

209. DiNardo AR, Netea MG, Musher DM. Postinfectious Epigenetic Immune Modifications — A Double-Edged Sword. New England Journal of Medicine. Massachusetts Medical Society; 2021 Jan 20;384(3):261–70. Available from: https://doi.org/10.1056/nejmra2028358

210. Samareh P, Agudelo-Garcia PA, Zhang Z, Gilbert M, Mendoza M, Huang H, et al. Chromatin repression by PRC2 results in reduced gene expression driving key features of CD8 T cell exhaustion. The Journal of Immunology. 2025 Aug 7 ;214(11):2987–3002. Available from: https://doi.org/10.1093/jimmun/vkaf188

211. Cheng H, Qiu Y, Xu Y, Chen L, Ma K, Tao M, et al. Extracellular acidosis restricts one-carbon metabolism and preserves T cell stemness. Nature Metabolism. 2023 Jan 30;5(2):314–30. https://doi.org/10.1038/s42255-022-00730-6

212. Hou Y, Žák J, Shi Y, Pratumchai I, Dinner B, Wang W, et al. Transient EZH2 suppression by Tazemetostat during in vitro expansion maintains T cell stemness and improves adoptive T cell therapy. 2023 Feb 7; https://doi.org/10.1101/2023.02.07.527459

213. Hou Y, Žák J, Shi Y, Pratumchai I, Dinner B, Wang W, et al. Transient EZH2 Suppression by Tazemetostat during In Vitro Expansion Maintains T-Cell Stemness and Improves Adoptive T-Cell Therapy. Cancer Immunology Research. 2024 Oct 4;13(1):47–65. Available from: https://doi.org/10.1158/2326-6066.cir-24-0089

214. Hou Y, Wu P, PI. 811 Transient EZH2 suppression by tazemetostat during in vitro expansion maintains T cell stemness and improves adoptive T cell therapy. Regular and Young Investigator Award Abstracts. 2023 Oct 31; Available from: https://doi.org/10.1136/jitc-2023-sitc2023.0811

215. Hou Y, Žák J, Shi Y, Pratumchai I, Dinner B, Wang W, et al. Data from Transient EZH2 Suppression by Tazemetostat during In Vitro Expansion Maintains T-Cell Stemness and Improves Adoptive T-Cell Therapy. 2025 Jan 9; https://doi.org/10.1158/2326-6066.c.7618111

216. Hou Y, Wu P. Abstract LB339: Transient EZH2 suppression by tazemetostat during in vitro expansion maintains T cell stemness and improves adoptive T cell therapy. Cancer Research. 2024 Apr 5;84. http://dx.doi.org/10.1158/1538-7445.am2024-lb339

217. Dai E, Zhu Z, Wahed S, Qu Z, Storkus WJ, Guo ZS. Epigenetic modulation of antitumor immunity for improved cancer immunotherapy. Molecular Cancer. BioMed Central; 2021 Dec 20;20(1). https://doi.org/10.1186/s12943-021-01464-x

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2026-05-31

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1.
Immunological Memory of Viral Infections: Mechanisms, Durability, and Implications for Protective Immunity —A Review. JPMS [Internet]. 2026 May 31 [cited 2026 Jun. 19];2(5):107-56. Available from: https://pms-journal.de/index.php/pms/article/view/46

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