Single-cell RNA sequencing reveals distinct T cell populations in immune-related adverse events of checkpoint inhibitors

Abstract

PD-1 is an inhibitory receptor in T cells, and antibodies that block its interaction with ligands augment anti-tumor immune responses. The clinical potential of these agents is limited by the fact that half of all patients develop immune-related adverse events (irAEs). To generate insights into the cellular changes that occur during anti-PD-1 treatment, we performed single-cell RNA sequencing of circulating T cells collected from patients with cancer. Using the K-nearest-neighbor-based network graph-drawing layout, we show the involvement of distinctive genes and subpopulations of T cells. We identify that at baseline, patients with arthritis have fewer CD8 T_CM cells, patients with pneumonitis have more CD4 T_H2 cells, and patients with thyroiditis have more CD4 T_H17 cells when compared with patients who do not develop irAEs. These data support the hypothesis that different populations of T cells are associated with different irAEs and that characterization of these cells' pre-treatment has the potential to serve as a toxicity-specific predictive biomarker.

Keywords: PD-1; T cells; arthritis; autoimmunity; checkpoint inhibitor; immune-related adverse events; irAEs; pneumonitis; single-cell RNA sequencing; thyroiditis.