Latent Plasticity of Effector-like Exhausted CD8 T cells contributes to memory responses

Persistent antigen induces a dysfunctional CD8 T cell state known as T cell "exhaustion" characterized by expression of PD-1 and decreased effector functions. Nevertheless, dysfunctional CD8 T cells can mediate control of antigen burden which is long-lasting. While heterogeneity of exhausted CD8 T cells has been described, the cells which actively proliferate and exert viral control have remained elusive. Here, we define subsets of PD-1+ CD8 T cells during chronic infection marked by expression of CX3CR1 with substantial in situ proliferation and high expression of granzyme B. Moreover, these cells maintain the effector pool through self-renewal independently of previously defined stem-like cells. Unexpectedly, CX3CR1+ CD8 T cells retain plasticity to be reprogrammed to memory cells through expression of TCF-1 and re-gain polyfunctionality. Thus, we define a subset of effector-like exhausted CD8 T cells with capacity to contribute to the memory pool, offering a prime target for novel immunotherapies.