NKG2D-mediated cytotoxicity of CD4 cytotoxic T cells in multiple myeloma

S Sojeong Kim J Jeong-Eun Kwak (1Yonsei University College of Medicine, Seoul, South Korea) J June-Young Koh (2Inocras Inc, San Diego, United States) J Ji Eun Lee H Hye Won Kook (1Yonsei University College of Medicine, Seoul, South Korea) M Minchae Kim (4Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea) H Haerim Chung (1Yonsei University College of Medicine, Seoul, South Korea) Y Yu Ri Kim S Soo Jeong Kim J Jin Seok Kim (10Yonsei University College of Medicine, Severance Hospital, Seoul, Korea) J June-won Cheong (11Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea) M Min Goo Lee (Brain Korea 21 project for Medical Science, Yonsei University College of Medicine) H Hoyoung Lee (6Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea) S Su-Hyung Park E Eui-Cheol Shin S Saeam Shin (1Severance Hospital, Yonsei University College of Medicine, Department of Laboratory Medicine, Seoul, Korea) S Sun Och Yoon (8Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea) I Il-Kyu Choi (4Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea) J Jeong Seok Lee H Hyunsoo Cho (1Yonsei University College of Medicine, Seoul, South Korea)

Abstract

Abstract Emerging evidence indicates that CD4+ T cells contribute to antitumor immunity beyond their traditional roles as helpers or regulators. However, the specific subset of CD4+ T cells mediating beneficial outcomes in patients with multiple myeloma remains unclear. Here, we performed single-cell RNA sequencing and T-cell receptor sequencing on CD4+ T cells sorted from the bone marrow of patients across the stages of myeloma progression. We identified several distinct states of CD4+ cytotoxic T lymphocytes (CTLs) that were significantly increased and clonally expanded in patients with myeloma. CD4+ CTLs displayed transcriptional and phenotypic characteristics indicative of cytotoxicity, demonstrating their ability to directly kill myeloma cells. This cytotoxicity, however, was abrogated by NKG2D blockade. Notably, the abundance of NKG2D+CD4+ CTLs correlated with improved survival in patients with myeloma. Our findings suggest that harnessing CD4+ CTLs could lead to novel strategies for enhancing immunotherapy outcomes in multiple myeloma.

Article Details

Journal Blood
Volume / Issue Vol. 146, Issue 4
Published July 24, 2025
Pages 456-470
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (20)

S

Sojeong Kim

J

Jeong-Eun Kwak

1Yonsei University College of Medicine, Seoul, South Korea

J

June-Young Koh

2Inocras Inc, San Diego, United States

J

Ji Eun Lee

H

Hye Won Kook

1Yonsei University College of Medicine, Seoul, South Korea

M

Minchae Kim

4Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea

H

Haerim Chung

1Yonsei University College of Medicine, Seoul, South Korea

Y

Yu Ri Kim

S

Soo Jeong Kim

J

Jin Seok Kim

10Yonsei University College of Medicine, Severance Hospital, Seoul, Korea

J

June-won Cheong

11Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

M

Min Goo Lee

Brain Korea 21 project for Medical Science, Yonsei University College of Medicine

H

Hoyoung Lee

6Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea

S

Su-Hyung Park

E

Eui-Cheol Shin

S

Saeam Shin

1Severance Hospital, Yonsei University College of Medicine, Department of Laboratory Medicine, Seoul, Korea

S

Sun Och Yoon

8Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea

I

Il-Kyu Choi

4Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea

J

Jeong Seok Lee

H

Hyunsoo Cho

1Yonsei University College of Medicine, Seoul, South Korea