Mycobacterium tuberculosis-specific CD4+, IFNγ+, and TNFα+ multifunctional memory T cells coexpress GM-CSF

Multifunctional T cells expressing several cytokines in parallel are thought to play a crucial role in protection against different infections. To characterize T cell cytokine patterns associated with disease and protection in Mycobacterium tuberculosis infection we determined the expression of IFNγ, IL-2, TNFα, and GM-CSF in T cell subpopulations from children with tuberculosis (TB) and healthy latently M. tuberculosis-infected children (LTBI) after short-term in vitro restimulation. We identified CD4+ effector memory T cells (TEM) as the major source of all measured cytokines after antigen-specific restimulation. TEM from children with TB expressed higher proportions of IFNγ, TNFα, and IL-2 after Mtb restimulation while no differences were detected for GM-CSF between both study groups. GM-CSF secretion strongly depended on antigen-specific stimulation. Analyses of multiple cytokine patterns revealed that the majority of GM-CSF-positive M. tuberculosis-specific memory T cells coexpressed IFNγ and TNFα therefore showing a characteristic feature of multifunctional T cells. We conclude that children with active TB possess higher proportions of IFNγ-, TNFα-, and/or IL-2-positive TEM than children with LTBI while GM-CSF coexpression reveals a novel subpopulation within CD4+ memory T cells not increased in children with active TB.