Japanese encephalitis virus (JEV) is an important mosquito-borne virus belonging to the genus Flavivirus within the Flaviviridae family1. Many Asia-Pacific countries have long faced enormous public health challenges due to the huge disease burden caused by Japanese encephalitis (JE), but this has improved dramatically with the increasing availability of various types of vaccinations2. Adaptive protective immune responses evoked by natural infection or vaccination contribute to the prevention and antiviral regulation. Humoral immunity and cell-mediated immunity are classified as adaptive immunity, and the induction of the former has always been regarded as a key strategy in vaccine design, albeit with relatively limited understanding in the past3. However, the role of T cell-mediated immunity in limiting flavivirus dissemination and virus clearance has been increasingly focused on and extensively studied4. Furthermore, T cell immunity is not only indispensable in JEV-specific antiviral responses but also plays a prominent role in cross-protection from secondary infection with heterologous flaviviruses, which has been demonstrated in previous studies5. It is speculated that this effect may bypass potential antibody-mediated enhancement effects in infection5. Of note, such cross-reactive T cell immunity is important, especially in the absence of vaccines and antiviral drugs against flaviviruses. Although many studies have been performed to determine the contribution of T cells in JEV infection with respect to CD4+ and CD8+ T cells6,7, the respective lineages secreting cytokines and their functional diversification remain undetermined, which means the elucidation of the exact functions of helper and killer T cells is hindered.
The scale of their antiviral defenses determines the quality of T cell responses. CD4+ or CD8+ T cells that can compatibly confer two or more functions, including cytokine secretion and degranulation, are characterized as polyfunctional T cells (TPFs) upon specific stimulation at the single-cell level8. CD4+ T cells that produce single or multiple cytokines may have various effects and immune memories. For example, IL-2+ IFN-γ+ CD4+ T cells are more likely to form a long-term effective protective response than IL-2+ CD4+ T cells9, which can be used as an important parameter in evaluating the vaccination effect. The frequency of IL-2+ IFN-γ+ CD4+ T cells is increased in patients with long-term non-progression of acquired immune deficiency syndrome (AIDS), while CD4+ T cells in patients with AIDS progression are more inclined to produce IFN-γ alone due to the promoting effect of IL-2 on T cell proliferation10. Furthermore, a subset of IL-2+ IFN-γ+ TNF-α+ was shown to survive long-term in vivo and synergistically promote the killing function11. Although CD8+ T cells are more likely to exhibit cytotoxic activity, some CD4+ T cells are also equipped with cytotoxic activity as an indirectly detected expression of surface CD107a molecules12. In addition, certain T cell subsets express the chemokine MIP-1α, which is often secreted by monocytes to participate in T cell-mediated neutrophil recruitment13. Similarly, CD8+ TPFs can also be used to characterize the versatility of the above markers. Studies have shown that the prime-boost strategy can effectively induce a prolonged period of TPF protective effects13, which can enhance the protection elicited by vaccination. A central feature in examining the immune system is the ability of memory T cells to facilitate stronger, faster, and more effective responses to secondary viral challenges than naïve T cells. Effector memory T cells (TEM) and central memory T cells (TCM) are important T cell subsets that are often differentiated by the composite expression of CD27/CD45RO or CCR7/CD45RA14. TCM (CD27+ CD45RO+ or CCR7+ CD45RA-) tends to localize in secondary lymphoid tissues, while TEM (CD27- CD45RO+ or CCR7- CD45RA-) localizes in lymphoid and peripheral tissues15,16. TEM provides immediate but not sustained defense, whereas TCM sustains the response by proliferating in the secondary lymphoid organs and generating new effectors17. Thus, given that memory cells can mediate specific and efficient recall responses to viruses, questions arise about the contribution of this subset of polyfunctions.
With the development of flow cytometry technology, it has become common to simultaneously detect markers of more than 10 clusters, phenotypes, and differentiation antigens, which is beneficial to more abundantly annotate the functional immunological features on individual T cells to reduce misinterpretation and difficulties in understanding of T cell phenotypes. This study used ex vivo stimulation and flow cytometry to analyze TPF profiles in peripheral blood mononuclear cells (PBMCs) within JEV-vaccinated children. Applying this approach, the understanding of short- and long-term JEV-specific and even cross-reactive T cell immunity induced by vaccination will be expanded.