Dendritic cells used in anti-HIV immunotherapy showed different modulation in anti-HIV genes expression: New concept for the improvement of patients' selection criteria

Exosomes multifunctional roles in HIV-1: insight into the immune regulation, vaccine development and current progress in delivery system

Human Immunodeficiency Virus (HIV-1) is known to establish a persistent latent infection. The use of combination antiretroviral therapy (cART) can effectively reduce the viral load, but the treatment can be costly and may lead to the development of drug resistance and life-shortening side effects. It is important to develop an ideal and safer in vivo target therapy that will effectively block viral replication and expression in the body. Exosomes have recently emerged as a promising drug delivery vehicle due to their low immunogenicity, nanoscale size (30-150nm), high biocompatibility, and stability in the targeted area. Exosomes, which are genetically produced by different types of cells such as dendritic cells, neurons, T and B cells, epithelial cells, tumor cells, and mast cells, are designed for efficient delivery to targeted cells. In this article, we review and highlight recent developments in the strategy and application of exosome-based HIV-1 vaccines. We also discuss the use of exosome-based antigen delivery systems in vaccine development. HIV-1 antigen can be loaded into exosomes, and this modified cargo can be delivered to target cells or tissues through different loading approaches. This review also discusses the immunological prospects of exosomes and their role as biomarkers in disease progression. However, there are significant administrative and technological obstacles that need to be overcome to fully harness the potential of exosome drug delivery systems.

Exosomes are possibly used as a tool of immune regulation during the dendritic cell-based immune therapy against HIV-I

Dendritic cell (DC)-based immune therapy (IT) against HIV showed variable results. It is known that different factors influence host response to DC-IT. Exosomes derived from DC are regulators of the immune system. In this context, here we hypothesize about the role of the DC-derived exosomes on the DC-IT response. Based on data from RT-PCR array genes expression (focused on the TSG101 gene, an exosome marker) and flow cytometry experiments of a DC-IT against HIV-1 clinical trial, we hypothesize that: During the DC-IT exosomes are used as an additional tool for immune system modulation. In addition, we believe that a low release of exosomes can be more beneficial for the DC-IT response than a high release of exosomes. Our data reinforce the concept that exosomes can act as an immune regulatory tool, however not in a generalized manner, but in a highly precise way. Our hypothesis is based in preliminary experimental data, thus, it should be tested using experimental and functional strategies involving a great number of patients. Once the hypothesis confirmed, the immunomodulatory role of the exosomes during DC-IT must be considered as an important factor in the (I) evaluation, (II) modulation, and (III) success of DC-IT against HIV.