Survival of tissue-resident memory T cells requires exogenous lipid uptake and metabolism

Tissue-resident memory T (T-RM) cells persist indefinitely in epithelial barrier tissues and protect the host against pathogens(1-4). However, the biological pathways that enable the long-term survival of T-RM cells are obscure(4,5). Here we show that mouse CD8(+) T-RM cells generated by viral infection of the skin differentially express high levels of several molecules that mediate lipid uptake and intracellular transport, including fatty-acid-binding proteins 4 and 5 (FABP4 and FABP5). We further show that T-cell-specific deficiency of Fabp4 and Fabp5 (Fabp4/Fabp5) impairs exogenous free fatty acid (FFA) uptake by CD8(+) T-RM cells and greatly reduces their long-term survival in vivo, while having no effect on the survival of central memory T (T-CM) cells in lymph nodes. In vitro, CD8(+) T-RM cells, but not CD8(+) T-CM cells, demonstrated increased mitochondrial oxidative metabolism in the presence of exogenous FFAs; this increase was not seen in Fabp4/Fabp5 double-knockout CD8(+) T-RM cells. The persistence of CD8(+) T-RM cells in the skin was strongly diminished by inhibition of mitochondrial FFA beta-oxidation in vivo. Moreover, skin CD8(+) T-RM cells that lacked Fabp4/Fabp5 were less effective at protecting mice from cutaneous viral infection, and lung Fabp4/Fabp5 double-knockout CD8(+) T-RM cells generated by skin vaccinia virus (VACV) infection were less effective at protecting mice from a lethal pulmonary challenge with VACV. Consistent with the mouse data, increased FABP4 and FABP5 expression and enhanced extracellular FFA uptake were also demonstrated in human CD8(+) T-RM cells in normal and psoriatic skin. These results suggest that FABP4 and FABP5 have a critical role in the maintenance, longevity and function of CD8(+) T-RM cells, and suggest that CD8(+) T-RM cells use exogenous FFAs and their oxidative metabolism to persist in tissue and to mediate protective immunity.