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T cells in health and disease

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SPRINGERNATURE
DOI: 10.1038/s41392-023-01471-y

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T cells play a crucial role in maintaining immune functions and preventing diseases. They differentiate into CD4(+) helper and CD8(+) cytotoxic effector and memory cells, which regulate immune responses and provide long-term protection. In response to infections and tumors, T cells develop into heterogeneous populations with various functions under precise regulation of transcriptional and epigenetic programs. Abnormal T-cell immunity can lead to autoimmune diseases.
T cells are crucial for immune functions to maintain health and prevent disease. T cell development occurs in a stepwise process in the thymus and mainly generates CD4(+) and CD8(+) T cell subsets. Upon antigen stimulation, naive T cells differentiate into CD4(+) helper and CD8(+) cytotoxic effector and memory cells, mediating direct killing, diverse immune regulatory function, and long-term protection. In response to acute and chronic infections and tumors, T cells adopt distinct differentiation trajectories and develop into a range of heterogeneous populations with various phenotype, differentiation potential, and functionality under precise and elaborate regulations of transcriptional and epigenetic programs. Abnormal T-cell immunity can initiate and promote the pathogenesis of autoimmune diseases. In this review, we summarize the current understanding of T cell development, CD4(+) and CD8(+) T cell classification, and differentiation in physiological settings. We further elaborate the heterogeneity, differentiation, functionality, and regulation network of CD4(+) and CD8(+) T cells in infectious disease, chronic infection and tumor, and autoimmune disease, highlighting the exhausted CD8(+) T cell differentiation trajectory, CD4(+) T cell helper function, T cell contributions to immunotherapy and autoimmune pathogenesis. We also discuss the development and function of gamma delta T cells in tissue surveillance, infection, and tumor immunity. Finally, we summarized current T-cell-based immunotherapies in both cancer and autoimmune diseases, with an emphasis on their clinical applications. A better understanding of T cell immunity provides insight into developing novel prophylactic and therapeutic strategies in human diseases.

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