CD4 ؉ T cell responses to aerosol Mycobacterium tuberculosis (Mtb) infection are characterized by the relatively delayed appearance of effector T cells in the lungs. This delay in the adaptive response is likely critical in allowing the bacteria to establish persistent infection. Because of limitations associated with the detection of low frequencies of naïve T cells, it had not been possible to precisely determine when and where naïve antigen-specific T cells are first activated. We have addressed this problem by using early secreted antigenic target 6 (ESAT-6)-specific transgenic CD4 T cells to monitor early T cell activation in vivo. By using an adoptive transfer approach, we directly show that T cell priming to ESAT-6 occurs only after 10 days of infection, is initially restricted to the mediastinal lymph nodes, and does not involve other lymph nodes or the lungs. Primed CD4 T cells rapidly differentiated into proliferating effector cells and ultimately acquired the ability to produce IFN-␥ and TNF-␣ ex vivo. Initiation of T cell priming was enhanced by two full days depending on the magnitude of the challenge inoculum, which suggests that antigen availability is a factor limiting the early CD4 T cell response. These data define a key period in the adaptive immune response to Mtb infection.priming ͉ transgenic mice

The immune response elicited after Mycobacterium tuberculosis (Mtb) infection is critically dependent on CD4 T cells during both acute and chronic infection. How CD4 T-cell responses are maintained throughout infection is not well understood, and evidence from other infection models has suggested that, under conditions of chronic antigen stimulation, T cells can undergo replicative exhaustion. These findings led us to determine whether subpopulations of CD4 T cells existed that displayed markers of terminal differentiation or exhaustion during murine Mtb infection. Analysis of antigen-specific effector CD4 T cells revealed that programmed death-1 (PD-1) and the killer cell lectin-like receptor G1 (KLRG1) delineated subpopulations of T cells. PD-1-expressing CD4 T cells were highly proliferative, whereas KLRG1 cells exhibited a short lifespan and secreted the cytokines IFNγ and TNFα. Adoptive transfer studies demonstrated that proliferating PD-1-positive CD4 T cells differentiated into cytokine-secreting KLRG1-positive T cells, but not vice versa. Thus, proliferating PD-1-positive cells are not exhausted, but appear to be central to maintaining antigen-specific effector T cells during chronic Mtb infection. Our findings suggest that antigen-specific T-cell responses are maintained during chronic mycobacterial infection through the continual production of terminal effector cells from a proliferating precursor population.T uberculosis presents a challenging worldwide public heath problem. Infection with Mycobacterium tuberculosis (Mtb) elicits humoral and cellular immune responses that normally control bacterial burden. However, bacteria are seldom, if ever, eradicated, and control of the infection requires continual effector T-cell responses. Consequently, either the depletion or suppression of T-cell responses results in disease reactivation (1). In the mouse model, Mtb causes chronic infection and control of infection is maintained by T cells essentially indefinitely (2).Although a sustained T-cell response against Mtb infection is necessary, it is not understood how effector T cells are maintained. We have previously demonstrated that CD4 T-cell responses are associated with extensive proliferation throughout Mtb infection (3), suggesting that proliferation is a major mechanism required for the maintenance of T-cell responses. However, it is not clear how T-cell proliferation can be maintained during chronic infection, especially because effector T cells have been described to have a limited capacity for self-renewal (4).Although the numbers of antigen-specific T cells are relatively stable during chronic Mtb infection, CD4 T cells proliferate extensively, suggesting that a high turnover of effector CD4 T cells occurs. This high level of turnover suggests that effector T cells become exhausted or terminally differentiated, and that the maintenance of the T-cell response depends on the continual replacement of effector T cells. The expression of several cellsurface receptors has been correlated with functional e...