IntroductionWith increasing age, the ability of the immune system to protect against new antigenic challenges or to control chronic infection erodes. 1 Elderly persons are more likely to develop bacterial infections in lungs, skin, and the urinary tract. 2 The incidence and severity of viral infections increases, and the responses to prophylactic vaccinations decline. [3][4][5][6][7] A dwindling in thymic production of naive T cells, resulting in a decreasing size and diversity of the naive cell compartment, contributes to the defective adaptive immune response. [8][9][10] However, the immune defect is not limited to naive T cells; memory T cells and, in particular, CD8 T cells are also affected by aging. Central memory CD8 T cells decline at the expense of end-differentiated CD8 effector T cells. 11 In parallel, CD8 T cells undergo phenotypic changes that are of functional importance. 12 CD8 T cells tend to lose the expression of the CD28 molecule and are, therefore, less responsive to stimulation by antigen-presenting cells. Because cross-presentation of antigen by dendritic cells is an important pathway to elicit CD8 responses to viral infections, the CD28 loss has a negative effect. 13,14 More important than the CD28 loss may be the de novo expression of negative regulatory receptors that occurs on many CD8 T cells. 15,16 The best-studied receptors so far are the killer immunoglobulinlike receptors (KIRs) that recognize MHC class I variants. KIRs are a multigene family encoded within the leukocyte receptor cluster on chromosome 19 and comprise inhibitory and, less frequently, stimulatory receptors. 17,18 Inhibitory receptors have ITIM motifs in their cytoplasmic domains and recruit SHP-1 that dephosphorylates various tyrosine kinases in the early T-cell receptor (TCR) signaling pathway. 19,20 On antigenic stimulation of the TCR, the KIR receptor recognizes an MHC class I ligand on the very same target cell, is recruited to the TCR recognition complex, and enters the central supramolecular activation cluster with a delay of approximately 30 minutes. 21 This delay is sufficient to not compromise effector cell functions such as cytotoxicity; however, the eventual recruitment of KIRs to the antigen-recognition complex prematurely terminates TCR signaling and inhibits activation-induced transcription that requires sustained stimulation such as the initiation of T-cell proliferation and cytokine transcription.The mechanisms that drive increasing KIR expression on T cells with age are unclear. KIRs are primarily expressed on natural killer (NK) cells where they are clonally distributed. 22 The clonal distribution pattern is entirely maintained by CpG DNA methylation. Inhibition of the DNA methyltransferase (DNMT) by 5-aza-2Ј-deoxycytidine (5-Aza-dC) leads to a global expression of KIRs on all NK cells. 23,24 Previous studies have shown that transcriptional control of KIR expression differs in T cells compared with NK cells; however, even naive CD4 T cells have the transcriptional machinery to support the activation...