CD38-NAD ⁺ Axis Regulates Immunotherapeutic Anti-Tumor T Cell Response

Heightened effector function and prolonged persistence, the key attributes of Th1 and Th17 cells, respectively, are key features of potent anti-tumor T cells. Here, we established ex vivo culture conditions to generate hybrid Th1/17 cells, which persisted long-term in vivo while maintaining their effector function. Using transcriptomics and metabolic profiling approaches, we showed that the enhanced anti-tumor property of Th1/17 cells was dependent on the increased NAD ⁺ -dependent activity of the histone deacetylase Sirt1. Pharmacological or genetic inhibition of Sirt1 activity impaired the anti-tumor potential of Th1/17 cells. Importantly, T cells with reduced surface expression of the NADase CD38 exhibited intrinsically higher NAD ⁺ , enhanced oxidative phosphorylation, higher glutaminolysis, and altered mitochondrial dynamics that vastly improved tumor control. Lastly, blocking CD38 expression improved tumor control even when using Th0 anti-tumor T cells. Thus, strategies targeting the CD38-NAD ⁺ axis could increase the efficacy of anti-tumor adoptive T cell therapy. Chatterjee et al. show that intracellular NAD ⁺ levels control the anti-tumor potential of hybrid Th1/17 cells through the NAD ⁺ -Sirt1-Foxo1 axis. Expression of the NADase CD38 inversely correlates with NAD+ levels and regulates anti-tumor T cell response. Genetic ablation or antibody-mediated targeting of CD38 on T cells improves tumor control.