C. Garrod-Ketchely, L. A. Callender, J. Schroth, K. Littlewood, E. C. Carroll, D. Tamsan, V. S. Tsang, I. Nessel, N. E. Riddell, B. Chain, D. Aksentijevic, D. Harding, F. M. Marelli-Berg, J. Bystrom, M. Pereira Da Costa, A. Carrascal-Minino, G. P. Keeling, T. T. Pham, K. Sunassee, R. T. De Rosales, S. Y. Terry, M. Pattrick, C. Sutcliffe, A. Worthington, G. Hood, S. Finer, S. M. Henson
Ageing is accompanied by progressive remodelling of the immune system, but chronic metabolic disease may accelerate this process and drive qualitatively distinct forms of immune dysfunction. Here, we used type 2 diabetes (T2D) as a model of unhealthy immune ageing to identify a distinct population of CD8 TEMRA cells that accumulates in older individuals with T2D. These cells were highly differentiated, oligoclonally expanded and had shorter telomeres, consistent with an increased replicative history and premature senescence-like state. Unlike conventional TEMRA cells, which can preserve cytotoxic function through acquisition of NK-cell receptors, T2D-associated TEMRA cells showed reduced surface expression of KLRG1, NKG2D and NKG2A together with defective receptor recycling. TGF{beta}1 was elevated in T2D and reproduced several features of this phenotype in vitro, including increased TEMRA differentiation, reduced NK-receptor expression, altered receptor trafficking and induction of p21. Functionally, these cells displayed reduced TCR-triggered degranulation, correlating with impaired cytotoxicity and altered tissue distribution in individuals with T2D. Rather than providing effective immune surveillance, the accumulation of these highly differentiated TEMRA cells with diminished effector capacity may compromise immune function. Together, these findings identify a distinct senescent-like CD8 TEMRA state linking metabolic inflammation to dysregulated T cell differentiation.