Invited Speaker CD1-MR1 Workshop 2025

Granzyme K expressing CD8 T cells and innate T cells accumulate in many autoimmune diseases and drive a new pathway of complement activation (#29)

Michael Brenner 1
  1. Harvard Medical School/Brigham and Women's Hospital, Boston, ACT, United States

Granzymes are a family of serine proteases mainly expressed by CD8+ T cells, natural killer cells, and innate-like lymphocytes. Although their major role is thought to be the induction of cell death in virally infected and tumor cells, accumulating evidence suggests some granzymes can regulate inflammation by acting on extracellular substrates. Recently, we found that the majority of tissue CD8+ T cells in rheumatoid arthritis (RA) synovium, inflammatory bowel disease and other inflamed organs express granzyme K (GZMK), a tryptase-like protease with poorly defined function. We show that GZMK can activate the complement cascade by cleaving C2 and C4. The nascent C4b and C2b fragments form a C3 convertase that cleaves C3, allowing further assembly of a C5 convertase that cleaves C5. The resulting convertases trigger every major event in the complement cascade, generating the anaphylatoxins C3a and C5a, the opsonins C4b and C3b, and the membrane attack complex. Importantly, mice deficient in Gzmk have less severe arthritis and psoriasiform dermatitis with concomitant decreases in complement activation. Besides tissue CD8 T cells, granzyme K is expressed by nearly all MAIT cells, CD56 bright NK cells, and by approximately half of human gamma delta T cells and iNKT cells. Our findings describe a previously unidentified pathway of complement activation that is entirely driven by lymphocyte-derived GZMK and proceeds independently of the classical, lectin, or alternative pathways. Given the widespread abundance of GZMK-expressing T cells in tissues in chronic inflammatory diseases and infection, GZMK-mediated complement activation is likely to be an important contributor to tissue inflammation in multiple disease contexts.

  1. Donado et al. Granzyme K activates the entire complement cascade Nature, 2025; https://doi.org/10.1038/s41586-025-08713-9.
  2. Jonsson et al. Granzyme K+ CD8 T cells form a core population in inflamed human tissue. Science Translational Medicine 2022; 14, PMID: 35704599 DOI: 10.1126/scitranslmed.abo0686