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Cockerham LR, Yukl SA, Harvill K, Somsouk M, Joshi SK, Sinclair E, Liegler T, Hoh R, Lyons S, Hunt PW, Rupert A, Sereti I, Morcock DR, Rhodes A, Emson C, Hellerstein MK, Estes JD, Lewin S, Deeks SG, Hatano H. A Randomized Controlled Trial of Lisinopril to Decrease Lymphoid Fibrosis in Antiretroviral-Treated, HIV-infected Individuals. Pathog Immun 2017; 2:310-334. [PMID: 28936485 PMCID: PMC5604865 DOI: 10.20411/pai.v2i3.207] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In HIV infection, lymphoid tissue is disrupted by fibrosis. Angiotensin converting enzyme inhibitors have anti-fibrotic properties. We completed a pilot study to assess whether the addition of lisinopril to antiretroviral therapy (ART) reverses fibrosis of gut tissue, and whether this leads to reduction of HIV RNA and DNA levels. METHODS Thirty HIV-infected individuals on ART were randomized to lisinopril at 20mg daily or matching placebo for 24 weeks. All participants underwent rectal biopsies prior to starting the study drug and at 22 weeks, and there were regular blood draws. The primary end point was the change in HIV RNA and DNA levels in rectal tissue. Secondary outcomes included the change in 1) HIV levels in blood; 2) Gag-specific T-cell responses; 3) levels of T-cell activation; and 4) collagen deposition. RESULTS The addition of lisinopril did not have a significant effect on the levels of HIV RNA or DNA in gut tissue or blood, Gag-specific responses, or levels of T-cell activation. Lisinopril also did not have a significant impact on lymphoid fibrosis in the rectum, as assessed by quantitative histology or heavy water labeling. CONCLUSIONS Treatment with lisinopril for 24 weeks in HIV-infected adults did not have an effect on lymphoid fibrosis, immune activation, or gut tissue viral reservoirs. Further study is needed to see if other anti-fibrotic agents may be useful in reversing lymphoid fibrosis and reducing HIV levels.
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Affiliation(s)
- Leslie R Cockerham
- Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Steven A Yukl
- Department of Medicine, San Francisco VA Medical Center, and University of California, San Francisco (UCSF), San Francisco, California
| | - Kara Harvill
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Ma Somsouk
- Division of Gastroenterology, San Francisco General Hospital, University of California, San Francisco, California
| | - Sunil K Joshi
- Department of Medicine, San Francisco VA Medical Center, and University of California, San Francisco (UCSF), San Francisco, California
| | - Elizabeth Sinclair
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Teri Liegler
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Rebecca Hoh
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Sophie Lyons
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Peter W Hunt
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Adam Rupert
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - David R Morcock
- Frederick National Laboratory, Leidos Biomedical Research, Frederick, Maryland
| | - Ajantha Rhodes
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia.,Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Marc K Hellerstein
- Kinemed, Inc., Emeryville, California.,Department of Nutritional Science and Toxicology, University of California, Berkeley, California
| | - Jacob D Estes
- Frederick National Laboratory, Leidos Biomedical Research, Frederick, Maryland
| | - Sharon Lewin
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia.,Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Steven G Deeks
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
| | - Hiroyu Hatano
- HIV, Infectious Diseases, and Global Medicine Division, San Francisco General Hospital, University of California, San Francisco, California
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2
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Schmitt N, Ueno H. Regulation of human helper T cell subset differentiation by cytokines. Curr Opin Immunol 2015; 34:130-6. [PMID: 25879814 DOI: 10.1016/j.coi.2015.03.007] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 03/24/2015] [Accepted: 03/30/2015] [Indexed: 01/23/2023]
Abstract
Since the discovery of Th1 and Th2 cells in the late 1980s, the family of effector CD4(+) helper T (Th) cell subsets has expanded. The differentiation of naïve CD4(+) T cells is largely determined when they interact with dendritic cells (DCs) in lymphoid organs, and cytokines play a major role in the regulation of Th differentiation in the early stages. Recent studies show that the developmental mechanism of certain Th subsets is not fully shared between mice and humans. Here we will review recent discoveries on the roles of cytokines in the regulation of Th differentiation in humans, and discuss the differences between mice and humans in the developmental mechanisms of several Th subsets, including Th17 cells and T follicular helper (Tfh) cells. We propose that the differentiation of human Th subsets is largely regulated by the three cytokines, IL-12, IL-23, and TGF-β.
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Affiliation(s)
- Nathalie Schmitt
- Baylor Institute for Immunology Research, 3434 Live Oak, Dallas, TX 75204, USA
| | - Hideki Ueno
- Baylor Institute for Immunology Research, 3434 Live Oak, Dallas, TX 75204, USA.
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3
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Tandon R, Chew GM, Byron MM, Borrow P, Niki T, Hirashima M, Barbour JD, Norris PJ, Lanteri MC, Martin JN, Deeks SG, Ndhlovu LC. Galectin-9 is rapidly released during acute HIV-1 infection and remains sustained at high levels despite viral suppression even in elite controllers. AIDS Res Hum Retroviruses 2014; 30:654-64. [PMID: 24786365 DOI: 10.1089/aid.2014.0004] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Galectin-9 (Gal-9) is a β-galactosidase-binding lectin that promotes apoptosis, tissue inflammation, and T cell immune exhaustion, and alters HIV infection in part through engagement with the T cell immunoglobulin mucin domain-3 (Tim-3) receptor and protein disulfide isomerases (PDI). Gal-9 was initially thought to be an eosinophil attractant, but is now known to mediate multiple complex signaling events that affect T cells in both an immunosuppressive and inflammatory manner. To understand the kinetics of circulating Gal-9 levels during HIV infection we measured Gal-9 in plasma during HIV acquisition, in subjects with chronic HIV infection with differing virus control, and in uninfected individuals. During acute HIV infection, circulating Gal-9 was detected as early as 5 days after quantifiable HIV RNA and tracked plasma levels of interleukin (IL)-10, tumor necrosis factor (TNF)-α, and IL-1β. In chronic HIV infection, Gal-9 levels positively correlated with plasma HIV RNA levels (r=0.29; p=0.023), and remained significantly elevated during suppressive antiretroviral therapy (median: 225.3 pg/ml) and in elite controllers (263.3 pg/ml) compared to age-matched HIV-uninfected controls (54 pg/ml). Our findings identify Gal-9 as a novel component of the first wave of the cytokine storm in acute HIV infection that is sustained at elevated levels in virally suppressed subjects and suggest that Gal-9:Tim-3 crosstalk remains active in elite controllers and antiretroviral (ARV)-suppressed subjects, potentially contributing to ongoing inflammation and persistent T cell dysfunction.
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Affiliation(s)
- Ravi Tandon
- Hawaii Center for AIDS, Department of Tropical Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Glen M. Chew
- Hawaii Center for AIDS, Department of Tropical Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Mary M. Byron
- Hawaii Center for AIDS, Department of Tropical Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Persephone Borrow
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Toshiro Niki
- Department of Immunology and Immunopathology, Kagawa University, Kagawa, Japan
| | - Mitsuomi Hirashima
- Department of Immunology and Immunopathology, Kagawa University, Kagawa, Japan
| | - Jason D. Barbour
- Hawaii Center for AIDS, Department of Tropical Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Philip J. Norris
- Blood Systems Research Institute, San Francisco, California
- Department of Laboratory Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California
- Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California
| | | | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California
| | - Steven G. Deeks
- HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California
| | - Lishomwa C. Ndhlovu
- Hawaii Center for AIDS, Department of Tropical Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii
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4
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Yukl SA, Boritz E, Busch M, Bentsen C, Chun TW, Douek D, Eisele E, Haase A, Ho YC, Hütter G, Justement JS, Keating S, Lee TH, Li P, Murray D, Palmer S, Pilcher C, Pillai S, Price RW, Rothenberger M, Schacker T, Siliciano J, Siliciano R, Sinclair E, Strain M, Wong J, Richman D, Deeks SG. Challenges in detecting HIV persistence during potentially curative interventions: a study of the Berlin patient. PLoS Pathog 2013; 9:e1003347. [PMID: 23671416 PMCID: PMC3649997 DOI: 10.1371/journal.ppat.1003347] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 03/20/2013] [Indexed: 11/29/2022] Open
Abstract
There is intense interest in developing curative interventions for HIV. How such a cure will be quantified and defined is not known. We applied a series of measurements of HIV persistence to the study of an HIV-infected adult who has exhibited evidence of cure after allogeneic hematopoietic stem cell transplant from a homozygous CCR5Δ32 donor. Samples from blood, spinal fluid, lymph node, and gut were analyzed in multiple laboratories using different approaches. No HIV DNA or RNA was detected in peripheral blood mononuclear cells (PBMC), spinal fluid, lymph node, or terminal ileum, and no replication-competent virus could be cultured from PBMCs. However, HIV RNA was detected in plasma (2 laboratories) and HIV DNA was detected in the rectum (1 laboratory) at levels considerably lower than those expected in ART-suppressed patients. It was not possible to obtain sequence data from plasma or gut, while an X4 sequence from PBMC did not match the pre-transplant sequence. HIV antibody levels were readily detectable but declined over time; T cell responses were largely absent. The occasional, low-level PCR signals raise the possibility that some HIV nucleic acid might persist, although they could also be false positives. Since HIV levels in well-treated individuals are near the limits of detection of current assays, more sensitive assays need to be developed and validated. The absence of recrudescent HIV replication and waning HIV-specific immune responses five years after withdrawal of treatment provide proof of a clinical cure. There is intense interest in developing a cure for HIV. How such a cure will be quantified and defined is not known. We applied a series of measurements of HIV persistence to the study of an HIV+ adult who has exhibited evidence of cure after a stem cell transplant. Samples from blood, spinal fluid, lymph node, and gut were analyzed in multiple laboratories using different approaches. No HIV was detected in blood cells, spinal fluid, lymph node, or small intestine, and no infectious virus was recovered from blood. However, HIV was detected in plasma (2 laboratories) and HIV DNA was detected in the rectum (1 laboratory) at levels considerably lower than those expected in antiretroviral treated patients. The occasional, low-level HIV signals might be due to persistent HIV or might reflect false positives. The sensitivity of the current generation of assays to detect HIV RNA, HIV DNA, and infectious virus are close to the limits of detection. Improvements in these tests will be needed for future curative studies. The lack of rebounding virus after five years without therapy, the failure to isolate infectious virus, and the waning HIV-specific immune responses all indicate that the Berlin Patient has been effectively cured.
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Affiliation(s)
- Steven A. Yukl
- San Francisco VA Medical Center (SFVA) and University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | - Eli Boritz
- Vaccine Research Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Michael Busch
- Blood Systems Research Institute (BSRI), San Francisco, California, United States of America
| | | | - Tae-Wook Chun
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Daniel Douek
- Vaccine Research Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Evelyn Eisele
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ashley Haase
- University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Ya-Chi Ho
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Gero Hütter
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Mannheim, Germany
| | - J. Shawn Justement
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sheila Keating
- Blood Systems Research Institute (BSRI), San Francisco, California, United States of America
| | - Tzong-Hae Lee
- Blood Systems Research Institute (BSRI), San Francisco, California, United States of America
| | - Peilin Li
- San Francisco VA Medical Center (SFVA) and University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | - Danielle Murray
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sarah Palmer
- Department of Diagnostics and Vaccinology, Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Christopher Pilcher
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | - Satish Pillai
- San Francisco VA Medical Center (SFVA) and University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | - Richard W. Price
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | | | - Timothy Schacker
- University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Janet Siliciano
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Robert Siliciano
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Howard Hughes Medical Institute, Baltimore, Maryland, United States of America
| | - Elizabeth Sinclair
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | - Matt Strain
- University of California San Diego (UCSD), La Jolla, California, and Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
| | - Joseph Wong
- San Francisco VA Medical Center (SFVA) and University of California, San Francisco (UCSF), San Francisco, California, United States of America
| | - Douglas Richman
- University of California San Diego (UCSD), La Jolla, California, and Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
| | - Steven G. Deeks
- Department of Medicine, University of California, San Francisco (UCSF), San Francisco, California, United States of America
- * E-mail:
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5
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Liao W, Lin JX, Leonard WJ. Interleukin-2 at the crossroads of effector responses, tolerance, and immunotherapy. Immunity 2013; 38:13-25. [PMID: 23352221 DOI: 10.1016/j.immuni.2013.01.004] [Citation(s) in RCA: 746] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/07/2013] [Indexed: 02/07/2023]
Abstract
Interleukin-2 (IL-2) is a pleiotropic cytokine produced after antigen activation that plays pivotal roles in the immune response. Discovered as a T cell growth factor, IL-2 additionally promotes CD8(+) T cell and natural killer cell cytolytic activity and modulates T cell differentiation programs in response to antigen, promoting naïve CD4(+) T cell differentiation into T helper 1 (Th1) and T helper 2 (Th2) cells while inhibiting T helper 17 (Th17) and T follicular helper (Tfh) cell differentiation. Moreover, IL-2 is essential for the development and maintenance of T regulatory cells and for activation-induced cell death, thereby mediating tolerance and limiting inappropriate immune reactions. In this review, we focus on the molecular mechanisms and complex cellular actions of IL-2, its cooperative and opposing effects with other cytokines, and how both promoting and blocking the actions of IL-2 are being utilized in clinical medicine.
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Affiliation(s)
- Wei Liao
- Laboratory of Molecular Immunology and Immunology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892-1674, USA
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6
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Leal FE, Ndhlovu LC, Hasenkrug AM, Bruno FR, Carvalho KI, Wynn-Williams H, Neto WK, Sanabani SS, Segurado AC, Nixon DF, Kallas EG. Expansion in CD39⁺ CD4⁺ immunoregulatory t cells and rarity of Th17 cells in HTLV-1 infected patients is associated with neurological complications. PLoS Negl Trop Dis 2013; 7:e2028. [PMID: 23409198 PMCID: PMC3566991 DOI: 10.1371/journal.pntd.0002028] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 12/07/2012] [Indexed: 12/12/2022] Open
Abstract
HTLV-1 infection is associated with several inflammatory disorders, including the neurodegenerative condition HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It is unclear why a minority of infected subjects develops HAM/TSP. CD4⁺ T cells are the main target of infection and play a pivotal role in regulating immunity to HTLV and are hypothesized to participate in the pathogenesis of HAM/TSP. The CD39 ectonucleotidase receptor is expressed on CD4⁺ T cells and based on co-expression with CD25, marks T cells with distinct regulatory (CD39⁺CD25⁺) and effector (CD39⁺CD25⁻) function. Here, we investigated the expression of CD39 on CD4⁺ T cells from a cohort of HAM/TSP patients, HTLV-1 asymptomatic carriers (AC), and matched uninfected controls. The frequency of CD39⁺ CD4⁺ T cells was increased in HTLV-1 infected patients, regardless of clinical status. More importantly, the proportion of the immunostimulatory CD39⁺CD25⁻ CD4⁺ T-cell subset was significantly elevated in HAM/TSP patients as compared to AC and phenotypically had lower levels of the immunoinhibitory receptor, PD-1. We saw no difference in the frequency of CD39⁺CD25⁺ regulatory (Treg) cells between AC and HAM/TSP patients. However, these cells transition from being anergic to displaying a polyfunctional cytokine response following HTLV-1 infection. CD39⁻CD25⁺ T cell subsets predominantly secreted the inflammatory cytokine IL-17. We found that HAM/TSP patients had significantly fewer numbers of IL-17 secreting CD4⁺ T cells compared to uninfected controls. Taken together, we show that the expression of CD39 is upregulated on CD4⁺ T cells HAM/TSP patients. This upregulation may play a role in the development of the proinflammatory milieu through pathways both distinct and separate among the different CD39 T cell subsets. CD39 upregulation may therefore serve as a surrogate diagnostic marker of progression and could potentially be a target for interventions to reduce the development of HAM/TSP.
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Affiliation(s)
- Fabio E. Leal
- The Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
- Hawaii Center of AIDS, Department of Tropical Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States of America
- Deparment of Infectious Diseases, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Lishomwa C. Ndhlovu
- The Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
- Hawaii Center of AIDS, Department of Tropical Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States of America
| | - Aaron M. Hasenkrug
- The Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Fernanda R. Bruno
- Division of Clinical Immunology and Allergy, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Karina I. Carvalho
- Division of Clinical Immunology and Allergy, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Harry Wynn-Williams
- Hawaii Center of AIDS, Department of Tropical Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States of America
| | - Walter K. Neto
- Molecular Biology Laboratory, Fundação Pró-Sangue, Hemocentro de São Paulo, Brazil
- Department of Translational Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Sabri S. Sanabani
- Deparment of Infectious Diseases, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Aluisio C. Segurado
- Deparment of Infectious Diseases, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Douglas F. Nixon
- The Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Esper G. Kallas
- Deparment of Infectious Diseases, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of Sao Paulo Medical School, Sao Paulo, Brazil
- * E-mail:
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7
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Alvarez Y, Tuen M, Nàdas A, Hioe CE. In vitro restoration of Th17 response during HIV infection with an antiretroviral drug and Th17 differentiation cytokines. AIDS Res Hum Retroviruses 2012; 28:823-34. [PMID: 22011036 DOI: 10.1089/aid.2011.0184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The Th17 subset is preferentially depleted as compared to the Th1 subset in chronically HIV-infected patients, even after successful antiretroviral therapy. In this study, we have established an in vitro system utilizing primary human CD4 T cell cultures that recapitulates the dramatic loss of Th17 response upon HIV-1 infection that is accompanied with a less profound Th1 decrease. With this experimental system, we showed that blocking viral entry with CCR5 ligands or TAK779 reduced the infection and enhanced Th17 response but not Th1 response. Antiretroviral drug 3TC (lamivudine), given at the time of infection, completely prevented the loss of Th17 and Th1 responses but was ineffective when given after infection was already established. Only when Th17 differentiation cytokines were given along with 3TC to the cultures with established HIV infection was Th17 response fully restored and virus replication kept suppressed. Finally, a significant increase of Th17 response was achieved in peripheral lymphocytes of HIV-infected patients on antiretroviral therapy after treatment with Th17 differentiation cytokines. These data demonstrate the presence of CD4 T cells remaining capable of mounting Th17 response during HIV infection and indicate the potential use of immunotherapeutic modalities to supplement antiretroviral drugs for restoring Th17 response in chronically HIV-infected patients.
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Affiliation(s)
- Yelina Alvarez
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Michael Tuen
- Department of Pathology, New York University School of Medicine, New York, New York
- Veterans Affairs New York Harbor Healthcare System, New York, New York
| | - Arthur Nàdas
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
| | - Catarina E. Hioe
- Department of Pathology, New York University School of Medicine, New York, New York
- Veterans Affairs New York Harbor Healthcare System, New York, New York
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8
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Burton CT, Westrop SJ, Eccles-James I, Boasso A, Nelson MR, Bower M, Imami N. Altered phenotype of regulatory T cells associated with lack of human immunodeficiency virus (HIV)-1-specific suppressive function. Clin Exp Immunol 2011; 166:191-200. [PMID: 21985365 DOI: 10.1111/j.1365-2249.2011.04451.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Mechanisms by which CD4+ regulatory T cells (T(regs)) mediate suppression of virus-specific responses remain poorly defined. Adenosine, mediated via CD39 and CD73, has been shown to play a role in the action of murine T(regs) . In this study we investigate the phenotype of T(regs) in the context of human immunodeficiency virus (HIV)-1 infection, and the function of these cells in response to HIV-1-Gag and cytomegalovirus (CMV) peptides. Phenotypic data demonstrate a decrease in forkhead box transcription factor 3 (FoxP3+) T(reg) numbers in the peripheral blood of HIV-1+ individuals compared to healthy controls, which is most pronounced in those with high HIV-1 RNA plasma load. Due to aberrant expression of CD27 and CD127 during HIV-1 disease, these markers are unreliable for T(reg) identification. The CD3+ CD4+ CD25(hi) CD45RO+ phenotype correlated well with FoxP3 expression in both the HIV-1+ and seronegative control cohorts. We observed expression of CD39 but not CD73 on T(regs) from HIV-1+ and healthy control cohorts. We demonstrate, through T(reg) depletion, the suppressive potential of T(regs) over anti-CMV responses in the context of HIV-1 infection; however, no recovery of the HIV-1-specific T cell response was observed indicating a preferential loss of HIV-1-specific T(reg) function. We propose that before immunotherapeutic manipulation of T(regs) is considered, the immunoregulatory profile and distribution kinetics of this population in chronic HIV-1 infection must be elucidated fully.
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Affiliation(s)
- C T Burton
- Department of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK
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9
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Abstract
Significant research has been conducted on the role of regulatory T cells (Tregs) in HIV infection. To date, however, it is not clear whether Tregs play a detrimental role or a beneficial role in the pathogenesis of HIV infection. In fact, a number of immunotherapeutic strategies to control HIV infection have revealed a possible antagonistic role for Tregs. This necessitates investigating ways to counteract the suppressive function, such as through Treg depletion or blockade of specific Treg immunosuppressive mechanisms, without further increasing the cellular immune activation associated with chronic HIV infection. Simply applying Treg immunotherapeutic strategies used in diseases other than HIV may pose problems due to the complexity of HIV immunopathogenesis. Studies are therefore necessary to elucidate the different immunoregulatory networks in HIV infection in order to determine the specific cellular or molecular pathways that can be altered to boost the body's immune control of HIV.
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Affiliation(s)
- Bernard Jc Macatangay
- HIV/AIDS Program, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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