Using T cells that expressed full-length or mutant (deletion or single alanine substitution) LAG-3, and an anti-LAG-3 antibody that efficiently prevents LAG-3 from binding to its ligand, peptide-loaded MHCII, Maeda and Sugiura et al. found that LAG-3-mediated inhibition of T cell activation (IL-2 production) correlated with LAG-3 cell surface expression levels and that LAG-3 transduces two independent intracellular inhibitory signals: through a motif in the membrane-proximal region, deemed Fxxl, and through a C-terminal EX repeat. These newly identified motifs suggest a distinct inhibitory mechanism for LAG-3 compared with other known inhibitory receptors.

T cell activation is tightly regulated by both stimulatory and inhibitory co-receptors and has been a focus in the development of interventions for managing cancer or autoimmune diseases. Targeting the inhibitory co-receptors programmed cell death 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) has successfully eradicated tumors but induced immune-related adverse-events in human and mice. The beneficial and adverse effects of targeting these co-receptors highlight their importance in cancer immunity and also autoimmunity. Although therapeutic potencies of other inhibitory co-receptors are under extensive investigation, their inhibitory mechanisms and their functional differences are not well understood. Here we analyzed the inhibitory mechanisms of lymphocyte activation gene-3 (LAG-3), another inhibitory co-receptor by using an in vitro T cell activation system and a high-affinity anti-LAG-3 Ab that strongly interferes with the binding of LAG-3 to its ligand. We found that the expression level of LAG-3 strongly correlates with the inhibitory function of LAG-3, suggesting that LAG-3 functions as a rheostat rather than as a breaker of T cell activation. By evaluating the inhibitory capacities of various LAG-3 variants relative to their expression levels, we found that LAG-3 transduces two independent inhibitory signals through an FxxL motif in the membrane-proximal region and the C-terminal EX repeat. These motifs have not been previously reported for inhibitory co-receptors, suggesting that LAG-3 inhibits T cell activation through a non-redundant inhibitory mechanisms along with the other inhibitory co-receptors. Our findings provide a rationale for combinatorial targeting of LAG-3 and the other inhibitory co-receptors to improve cancer immunotherapy.

Author Info: (1) Division of Immune Regulation, Institute of Advanced Medical Sciences, Tokushima University, Japan. (2) Institute of Advanced Medical Sciences, Tokushima University, Japan. (3)

Author Info: (1) Division of Immune Regulation, Institute of Advanced Medical Sciences, Tokushima University, Japan. (2) Institute of Advanced Medical Sciences, Tokushima University, Japan. (3) Division of Immune Regulation, Institute of Advanced Medical Sciences, Tokushima University, Japan. (4) Division of Immune Regulation, Institute of Advanced Medical Sciences, Tokushima University, Japan. (5) Division of Immune Regulation, Institute of Advanced Medical Sciences, Tokushima University, Japan.