Quantifying immune cell telomere content at single-cell resolution in context of PD-1 checkpoint immunotherapy

Abstract

Biological processes such as aging, carcinogenesis, and immune responses depend on the ability of cells to maintain or rapidly expand populations. This capacity is constrained by a cells replicative potential, which is reflected in its telomere content. Despite the central role of telomeres in cancer and immunity, their analysis at single-cell resolution across diverse cell types remains challenging. Here we show that scATAC-seq data enables quantitative telomeromics when key technical and biological confounders are accounted for. We present a computational framework that addresses read sparsity, telomere representation, and chromatin-state-dependent competition for sequencing signal, enabling robust estimation of telomere content and telomeric variant repeat composition from scATAC-seq data. By inferring global chromatin condensation directly from scATAC-seq profiles, our approach corrects for cell-cycle-associated biases while simultaneously capturing chromatin-state dysregulation in cancer. Applied to a large cancer atlas, this framework reveals patient-specific telomere maintenance phenotypes, including telomerase-associated and alternative lengthening of telomeres (ALT)-like profiles preserved across subclonal populations. Extending beyond cancer cells, we observe that telomere content in exhausted T cell subpopulations prior to immunotherapy is predictive for effective response to PD-1 checkpoint blockade. Together, these results establish scATAC-seq as a robust platform for single-cell telomeromics in cancer and immunity. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=78 SRC="FIGDIR/small/609339v2_ufig1.gif" ALT="Figure 1"> View larger version (26K): org.highwire.dtl.DTLVardef@4f9498org.highwire.dtl.DTLVardef@a4b787org.highwire.dtl.DTLVardef@d1e25org.highwire.dtl.DTLVardef@136196b_HPS_FORMAT_FIGEXP M_FIG C_FIG Created in BioRender. Popp, F. (2026) https://BioRender.com/mi2jove