Anmol ChandeleJaturong SewatanonSivaram GunisettyMohit SinglaNattawat OnlamoonRama S. AkondyHaydn Thomas KissickKaustuv NayakElluri Seetharami ReddyHaroon KalamDhiraj KumarAnil VermaHare Krushna PandaSiyu WangNasikarn AngkasekwinaiKovit PattanapanyasatKulkanya ChokephaibulkitGuruprasad R. MedigeshiRakesh LodhaSushil KabraRafi AhmedKaja Murali-KrishnaInternational Centre for Genetic Engineering and Biotechnology, New DelhiAll India Institute of Medical Sciences, New DelhiMahidol UniversityEmory University School of MedicineTranslational Health Science and Technology Institute2018-12-112019-03-142018-12-112019-03-142016-01-01Journal of Virology. Vol.90, No.24 (2016), 11259-11278109855140022538X2-s2.0-85000995844https://repository.li.mahidol.ac.th/handle/20.500.14594/42848© 2016, American Society for Microbiology. All Rights Reserved. Epidemiological studies suggest that India has the largest number of dengue virus infection cases worldwide. However, there is minimal information about the immunological responses in these patients. CD8 T cells are important in dengue, because they have been implicated in both protection and immunopathology. Here, we provide a detailed analysis of HLA-DR- CD38+ and HLA-DR+ CD38+ effector CD8 T cell subsets in dengue patients from India and Thailand. Both CD8 T cell subsets expanded and expressed markers indicative of antigen-driven proliferation, tissue homing, and cytotoxic effector functions, with the HLADR+ CD38+ subset being the most striking in these effector qualities. The breadth of the dengue-specific CD8 T cell response was diverse, with NS3-specific cells being the most dominant. Interestingly, only a small fraction of these activated effector CD8 T cells produced gamma interferon (IFN-γ) when stimulated with dengue virus peptide pools. Transcriptomics revealed downregulation of key molecules involved in T cell receptor (TCR) signaling. Consistent with this, the majority of these CD8 T cells remained IFN-γ unresponsive even after TCR-dependent polyclonal stimulation (anti-CD3 plus anti-CD28) but produced IFN-γ by TCR-independent polyclonal stimulation (phorbol 12-myristate 13-acetate [PMA] plus ionomycin). Thus, the vast majority of these proliferating, highly differentiated effector CD8 T cells probably acquire TCR refractoriness at the time the patient is experiencing febrile illness that leads to IFN-γ unresponsiveness. Our studies open novel avenues for understanding the mechanisms that fine-tune the balance between CD8 T cell-mediated protective versus pathological effects in dengue.Mahidol UniversityAgricultural and Biological SciencesImmunology and MicrobiologyArticleSCOPUS10.1128/JVI.01424-16