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Christian ML, Dapp MJ, Scharffenberger SC, Jones H, Song C, Frenkel LM, Krumm A, Mullins JI, Rawlings DJ. CRISPR/Cas9-Mediated Insertion of HIV Long Terminal Repeat within BACH2 Promotes Expansion of T Regulatory-like Cells. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 208:1700-1710. [PMID: 35264460 PMCID: PMC8976747 DOI: 10.4049/jimmunol.2100491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 01/26/2022] [Indexed: 01/10/2023]
Abstract
One key barrier to curative therapies for HIV is the limited understanding of HIV persistence. HIV provirus integration sites (ISs) within BACH2 are common, and almost all sites mapped to date are located upstream of the start codon in the same transcriptional orientation as the gene. These unique features suggest the possibility of insertional mutagenesis at this location. Using CRISPR/Cas9-based homology-directed repair in primary human CD4+ T cells, we directly modeled the effects of HIV integration within BACH2 Integration of the HIV long terminal repeat (LTR) and major splice donor increased BACH2 mRNA and protein levels, altered gene expression, and promoted selective outgrowth of an activated, proliferative, and T regulatory-like cell population. In contrast, introduction of the HIV-LTR alone or an HIV-LTR-major splice donor construct into STAT5B, a second common HIV IS, had no functional impact. Thus, HIV LTR-driven BACH2 expression modulates T cell programming and leads to cellular outgrowth and unique phenotypic changes, findings that support a direct role for IS-dependent HIV-1 persistence.
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Affiliation(s)
| | - Michael J Dapp
- Department of Microbiology, University of Washington, School of Medicine, Seattle, WA
| | | | - Hank Jones
- Seattle Children's Research Institute, Seattle, WA
| | - Chaozhong Song
- Department of Microbiology, University of Washington, School of Medicine, Seattle, WA
| | - Lisa M Frenkel
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics, University of Washington, School of Medicine, Seattle, WA
- Department of Laboratory Medicine, University of Washington, School of Medicine, Seattle, WA
- Department of Global Health, University of Washington, School of Medicine, Seattle, WA
| | - Anthony Krumm
- Department of Microbiology, University of Washington, School of Medicine, Seattle, WA
| | - James I Mullins
- Department of Microbiology, University of Washington, School of Medicine, Seattle, WA;
- Department of Global Health, University of Washington, School of Medicine, Seattle, WA
- Department of Medicine, University of Washington, School of Medicine, Seattle, WA; and
| | - David J Rawlings
- Seattle Children's Research Institute, Seattle, WA;
- Department of Pediatrics, University of Washington, School of Medicine, Seattle, WA
- Department of Immunology, University of Washington, School of Medicine, Seattle, WA
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2
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Grubczak K, Grzeszczuk A, Groth M, Hryniewicz A, Kretowska-Grunwald A, Flisiak R, Moniuszko M. Effects of Pegylated Interferon Alpha and Ribavirin (pegIFN-α/RBV) Therapeutic Approach on Regulatory T Cells in HCV-Monoinfected and HCV/HIV-Coinfected Patients. Viruses 2021; 13:v13081448. [PMID: 34452314 PMCID: PMC8402834 DOI: 10.3390/v13081448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/10/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
Approximately 25% of HIV-infected patients are co-infected with HCV. Notably, the burden of HCV infection (e.g., viral persistence, viral load, or HCV-related liver symptoms) is more pronounced in the presence of HIV co-infection. However, to date, the underlying immune mechanisms accounting for accelerated disease progression in HIV/HCV-coinfected individuals have not been described in sufficient detail. We hypothesized that regulatory T cells (Treg) bearing potent immunosuppressive capacities could not only play a substantial role in the pathogenesis of HCV/HIV coinfection but also modulate the response to the standard anti-viral therapy. MATERIALS AND METHODS To this end, we studied alterations in frequencies of Treg cells in correlation with other Treg-related and virus-related parameters in both HCV and HCV/HIV-infected patients subjected to standard pegIFN-α/RBV therapy. RESULTS Notably, we found that pegIFN-α/RBV therapy significantly increased levels of Treg cells in HCV-infected but not in HIV/HCV-coinfected individuals. Furthermore, HIV/HCV-coinfection was demonstrated to inhibit expansion of regulatory T cells during anti-viral treatment; thus, it might probably be responsible for viral persistence and HCV-related liver damage. CONCLUSIONS Therapy with pegIFN-α/RBV demonstrated a significant effect on regulatory T cells in the course of HIV and/or HCV infection indicating a crucial role in the anti-viral immune response.
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Affiliation(s)
- Kamil Grubczak
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
- Correspondence: (K.G.); (M.M.); Tel./Fax: +48-85-748-59-72 (K.G. & M.M.)
| | - Anna Grzeszczuk
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-540 Bialystok, Poland;
| | - Monika Groth
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Anna Hryniewicz
- Department of Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Anna Kretowska-Grunwald
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland;
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Białystok, Poland;
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
- Correspondence: (K.G.); (M.M.); Tel./Fax: +48-85-748-59-72 (K.G. & M.M.)
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3
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Ambada GN, Ntsama CE, Nji NN, Ngu LN, Sake CN, Lissom A, Tchouangeu FT, Tchadji J, Sosso M, Etoa FX, Nchinda GW. Phenotypic characterization of regulatory T cells from antiretroviral-naive HIV-1-infected people. Immunology 2017; 151:405-416. [PMID: 28375551 DOI: 10.1111/imm.12738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/02/2017] [Accepted: 03/27/2017] [Indexed: 01/14/2023] Open
Abstract
Regulatory T (Treg) cells play a key role in dampening excessive immune activation. However, antiretroviral therapy (ART) -naive HIV-1 infection maintains the immune system in a sustained state of activation that could alter both Treg cell surface markers and functions. As Treg cell surface markers are directly linked to their functions the overall objective of this study was to determine how ART-naive HIV infection affects the phenotypic properties of Treg cells. Our data showed that in ART-naive HIV-1 infection, Treg cells are dominated by effector (CD45RA+ CD27- CCR7- CD62L- ) and effector memory (CD45RA- CD27- CCR7- CD62L- ) cells. In contrast Treg cells from HIV-negative individuals were mainly naive (CD45RA+ CD27+ CCR7+ CD62L+ ) and central memory (CD45RA- CD27+ CCR7+ CD62L+ ) cells. Whereas effector and effector memory Treg cells showed enhanced expression of CD39 (P < 0·05), CD73 (P < 0·001), HLA-DR and CD38 (P < 0·001); naive and central memory Treg cells showed a significant reduction in the expression of these markers. Overall Treg cell frequencies within total CD4+ T cells correlated positively with plasmatic HIV-1 viral load. As increased viral load is associated with augmented CD4+ T-cell destruction; this could suggest a resistance of peripheral Treg cells to HIV-1 destruction. Hence the modulation of Treg cell phenotype and frequencies could be considered in designing immunotherapeutic strategies targeting immune system restoration during HIV-1 infection.
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Affiliation(s)
- Georgia N Ambada
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon.,Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaounde one, Yaounde, Cameroon
| | - Claudine E Ntsama
- Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaounde one, Yaounde, Cameroon
| | - Nadesh N Nji
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon
| | - Loveline N Ngu
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon.,Department of Biochemistry, Faculty of Sciences, University of Yaounde one, Yaounde, Cameroon
| | - Carole N Sake
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon.,Department of Biochemistry, Faculty of Sciences, University of Yaounde one, Yaounde, Cameroon
| | - Abel Lissom
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon.,Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaounde one, Yaounde, Cameroon
| | - Flaurent T Tchouangeu
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon.,Department of Biochemistry, University of Dschang, Dschang, Cameroon
| | - Jules Tchadji
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon.,Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaounde one, Yaounde, Cameroon
| | - Martin Sosso
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon
| | | | - Godwin W Nchinda
- Laboratory of Vaccinology/Biobanking, the Chantal Biya International Reference Centre for Research on the Prevention and Management of HIV/AIDS, Yaounde, Cameroon
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Desai SN, Dodge JL, Landay AL, Glesby MJ, Latham PS, Villacres MC, French AL, Gange SJ, Greenblatt RM, Peters MG. Hepatic fibrosis and immune phenotype vary by HCV viremia in HCV/HIV co-infected subjects: A Women's interagency HIV study. Medicine (Baltimore) 2016; 95:e4483. [PMID: 27537569 PMCID: PMC5370796 DOI: 10.1097/md.0000000000004483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
HCV and HIV independently lead to immune dysregulation. The mechanisms leading to advanced liver disease progression in HCV/HIV coinfected subjects remain unclear.In this cross-sectional study, we assessed the association of HCV viremia, liver fibrosis, and immune response patterns in well-characterized HIV phenotypes: Elite controllers (Elites), HIV controlled (ARTc), and HIV uncontrolled (ARTuc) matched by age and race. Groups were stratified by HCV RNA status. Regulatory T-cell frequencies, T-cell activation (HLADR+CD38+), apoptosis (Caspase-3+), and intracellular cytokines (interferon-γ, IL-2, IL-17) were assessed using multiparametric flow-cytometry. Liver fibrosis was scored by AST to platelet ratio index (APRI).We found liver fibrosis (APRI) was 50% lower in Elites and ARTc compared to ARTuc. Higher liver fibrosis was associated with significantly low CD4+ T cell counts (P < 0.001, coefficient r = -0.463). Immune activation varied by HIV phenotype but was not modified by HCV viremia. HCV viremia was associated with elevated CD8 T-cell Caspase-3 in Elites, ARTuc, and HIV- except ARTc. CD8 T-cell Caspase-3 levels were significantly higher in HCV RNA+ Elites (P = 0.04) and ARTuc (P = 0.001) and HIV- groups (P = 0.02) than ARTc. Importantly, ARTuc HCV RNA+ had significantly higher CD4 T-cell interleukin-17 levels than ARTuc HCV RNA- (P = 0.005).HIV control was associated with lower liver fibrosis in HCV/HIV co-infected women. HCV viremia is associated with an inflammatory CD4 TH-17 phenotype in absence of HIV control and higher frequency of pro-apoptosis CD8 T-cells critical to avert progression of HIV and HCV disease that is attenuated in ART controllers. Elite controllers with HCV viremia are more prone to CD8 T-cell apoptosis than ART controllers, which could have negative consequences over time, highlighting the importance of ART control in HCV/HIV coinfected individuals.
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Affiliation(s)
- Seema N. Desai
- Rush University Medical Center, Chicago, IL
- Correspondence: Seema N. Desai, PhD, Assistant Professor, Department of Immunology/Microbiology, Rush University Medical Center, 1735 W. Harrison Street, Chicago, IL 60612 (e-mail: )
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5
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Lei AH, Yang Q, Cai WP, Liu YF, Lan Y, Qin AP, Hu FY, Zhou J. Clinical Significance of Myeloid-Derived Suppressor Cells in Human Immunodeficiency Virus-1/ Hepatitis C Virus-coinfected Patients. Scand J Immunol 2016; 83:438-44. [PMID: 26972443 DOI: 10.1111/sji.12429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/04/2016] [Indexed: 12/13/2022]
Affiliation(s)
- A. H. Lei
- Institute of Human Virology; Zhongshan School of Medicine; Sun Yat-Sen University; Guangzhou China
| | - Q. Yang
- Institute of Human Virology; Zhongshan School of Medicine; Sun Yat-Sen University; Guangzhou China
| | - W. P. Cai
- Department of Infectious Diseases; The Affiliated Guangzhou No. 8 People's Hospital; Guangzhou Medical University; Guangzhou China
| | - Y. F. Liu
- Institute of Human Virology; Zhongshan School of Medicine; Sun Yat-Sen University; Guangzhou China
| | - Y. Lan
- Department of Infectious Diseases; The Affiliated Guangzhou No. 8 People's Hospital; Guangzhou Medical University; Guangzhou China
| | - A. P. Qin
- Institute of Human Virology; Zhongshan School of Medicine; Sun Yat-Sen University; Guangzhou China
| | - F. Y. Hu
- Department of Infectious Diseases; The Affiliated Guangzhou No. 8 People's Hospital; Guangzhou Medical University; Guangzhou China
| | - J. Zhou
- Institute of Human Virology; Zhongshan School of Medicine; Sun Yat-Sen University; Guangzhou China
- Key Laboratory of Tropical Disease Control; Chinese Ministry of Education; Sun Yat-sen University; Guangzhou China
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6
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Sarsekeyeva N, Kosherova B. Evaluation of immunological indices in HIV-infected patients with chronic hepatitis C in Kazakhstan. Int J Gen Med 2016; 9:147-53. [PMID: 27284263 PMCID: PMC4883804 DOI: 10.2147/ijgm.s101303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate immunological indices in HIV-infected patients with chronic hepatitis C (CHC) who are injecting drug users. Materials and methods The study examined 38 patients coinfected with HIV and CHC who were injecting drug users and 36 patients with HIV/CHC who were not injecting drug users. In the study of immune status, the relative and absolute numbers of CD3+, CD4+, CD8+, CD16+, and CD20+ cells were determined by means of flow cytofluorometry of “FACSCount” using monoclonal antibodies of the company Becton Dickinson. The level of circulating immune complexes in blood serum was determined by means of precipitation in polyethylene glycol solution. Results It was found that T-cell immunodeficiency was developing in patients coinfected with HIV and CHC. T-cell immunodeficiency was characterized by a decrease in the number of T-helpers, mainly for injecting drug users. At the same time, patients coinfected with HIV and CHC experienced markedly elevated levels of circulating immune complexes, mainly among injecting drug users. The evaluation of immunogram indices in injecting drug users coinfected with HIV and CHC, depending on the stage of HIV infection, revealed a greater degree of immune-suppression of T-helper cells in clinical stage III. Conclusion Our comprehensive immunological study of patients coinfected with HIV and CHC revealed a pronounced dysfunction of the immune system. The comparison of the immune system indices in patients with HIV/CHC showed a more pronounced T-cell suppression in injecting drug users than in patients with HIV/CHC but who were not injecting drug users.
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Affiliation(s)
- Nazgul Sarsekeyeva
- Department of Infectious Diseases and Dermatovenerology, Karaganda State Medical University, Karaganda, Kazakhstan; Karaganda Regional Center for the AIDS Prevention and Control, Karaganda, Kazakhstan
| | - Bakhyt Kosherova
- Rectorate of Karaganda State Medical University, Karaganda, Kazakhstan
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7
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Association of chronic hepatitis C infection with T-cell phenotypes in HIV-negative and HIV-positive women. J Acquir Immune Defic Syndr 2014; 67:295-303. [PMID: 25314250 DOI: 10.1097/qai.0000000000000310] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) viremia is thought to have broad systemic effects on the cellular immune system that go beyond its impact on just those T cells that are HCV specific. However, previous studies of chronic HCV and circulating T-cell subsets (activation and differentiation phenotypes) in HIV negatives used general population controls, rather than a risk-appropriate comparison group. Studies in HIV positives did not address overall immune status (total CD4⁺ count). METHODS We used fresh blood from HIV-positive and at-risk HIV-negative women, with and without chronic HCV, to measure percentages of activated CD4⁺ and CD8⁺ T cells, Tregs, and T-cell differentiation phenotypes (naive, central memory, effector memory (EM), and terminally differentiated effector). This included 158 HIV negatives and 464 HIV positives, of whom 18 and 63, respectively, were HCV viremic. RESULTS In multivariate models of HIV negatives, HCV viremia was associated with 25% fewer naive CD4⁺ (P = 0.03), 33% more EM CD4⁺ (P = 0.0002), and 37% fewer central memory CD8⁺ (P = 0.02) T cells. Among HIV positives, we observed only 1 of these 3 relationships: higher percentage of EM CD4⁺ among HCV viremic women. Furthermore, the association with EM CD4⁺ among HIV positives was limited to individuals with diminished immune status (total CD4⁺ count ≤500 cells/μL), as were associations of HCV viremia with higher percentages of activated CD4⁺ and Tregs. Among HIV positives with high CD4⁺ count, no significant associations were observed. CONCLUSIONS These data suggest that HCV viremia in HIV negatives is associated with accelerated T-cell differentiation, but among HIV positives, the impact of HCV viremia is less straightforward and varies by total CD4v count.
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8
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Cho H, Kikuchi M, Li Y, Nakamoto N, Amorosa VK, Valiga ME, Chang KM. Induction of Multiple Immune Regulatory Pathways with Differential Impact in HCV/HIV Coinfection. Front Immunol 2014; 5:265. [PMID: 25071758 PMCID: PMC4086204 DOI: 10.3389/fimmu.2014.00265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 05/23/2014] [Indexed: 12/13/2022] Open
Abstract
Persistent viral infections including HCV, HBV, and HIV are associated with increased immune regulatory pathways including the extrinsic FoxP3+CD4+ regulatory T cells (Tregs) and intrinsic inhibitory pathways such as programed death-1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4) with potentially reversible suppression of antiviral effector T cells (1–12). Immunological consequences of viral coinfections relative to these immune regulatory pathways and their interplay are not well-defined. In this study, we examined the frequency, phenotype, and effector function of circulating T cell subsets in patients with chronic HCV and/or HIV infection, hypothesizing that HCV/HIV coinfection will result in greater immune dysregulation with pathogenetic consequences (13, 14). We show that multiple T cell inhibitory pathways are induced in HCV/HIV coinfection including FoxP3+ Tregs, PD-1, and CTLA-4 in inverse association with overall CD4 T cell frequency but not with liver function or HCV RNA titers. The inverse association between CD4 T cell frequency and their FoxP3, PD-1, or CTLA-4 expression remained significant in all subjects combined regardless of HCV and/or HIV infection, suggesting a global homeostatic mechanism to maintain immune regulation relative to CD4 T cell frequency. PD-1 blockade rescued T cell responses to HIV but not HCV without significant impact by CTLA-4 blockade in vitro. Collectively, these findings highlight complex immune interactions in viral coinfections and differential regulatory pathways influencing virus-specific T cells that are relevant in immunotherapeutic development.
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Affiliation(s)
- Hyosun Cho
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA ; Duksung Women's University , Seoul , South Korea
| | - Masahiro Kikuchi
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA
| | - Yun Li
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA
| | - Nobuhiro Nakamoto
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA
| | - Valerianna K Amorosa
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA
| | - Mary E Valiga
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA
| | - Kyong-Mi Chang
- Philadelphia VAMC , Philadelphia, PA , USA ; Department of Medicine, University of Pennsylvania School of Medicine , Philadelphia, PA , USA
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9
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Williams SK, Donaldson E, Van der Kleij T, Dixon L, Fisher M, Tibble J, Gilleece Y, Klenerman P, Banham AH, Howard M, Webster DP. Quantification of hepatic FOXP3+ T-lymphocytes in HIV/hepatitis C coinfection. J Viral Hepat 2014; 21:251-9. [PMID: 24597693 PMCID: PMC4159582 DOI: 10.1111/jvh.12141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/01/2013] [Indexed: 12/15/2022]
Abstract
Coinfection with HIV adversely impacts every stage of hepatitis C (HCV) infection. Liver damage in HCV infection results from host antiviral responses rather than direct viral pathogenesis. Despite depressed cellular immunity, coinfected patients show accelerated hepatic fibrosis compared with HCV monoinfected patients. This paradox is poorly understood. T-regulatory (Treg) cells (CD4+ and FOXP3+) are hypothesized to limit hepatic damage in HCV. Our hypothesis was that reduced frequency of hepatic Treg in HIV/HCV coinfection compared with HCV monoinfection may explain poorer outcomes. We quantified FOXP3+, CD4+, CD8+ and CD20+ cells in liver biopsies of 35 male subjects matched by age and ISHAK fibrosis score, 12 HIV monoinfected, 11 HCV monoinfected and 12 HIV/HCV coinfected. Cell counts were performed using indirect immunohistochemical staining and light microscopy. HIV/HCV coinfected subjects had fewer hepatic FOXP3+ (P = 0.031) and CD4+ cells (P = 0.001) than HCV monoinfected subjects. Coinfected subjects had more hepatic CD8+ cells compared with HCV monoinfected (P = 0.023), and a lower ratio of FOXP3+ to CD8+ cells (0.08 vs 0.27, P < 0.001). Multivariate analysis showed number of CD4+ cells controlled for differences in number of FOXP3+ cells. Fewer hepatic FOXP3+ and CD4+ cells in HIV/HCV coinfection compared with HCV monoinfection suggests lower Treg activity, driven by an overall loss of CD4+ cells. Higher number of CD8+ cells in HIV/HCV coinfection suggests higher cytotoxic activity. This may explain poorer outcomes in HIV/HCV coinfected patients and suggests a potential mechanism by which highly active antiretroviral therapy may benefit these patients.
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Affiliation(s)
| | - E. Donaldson
- Brighton and Sussex University HospitalsBrightonUK
| | | | - L. Dixon
- Brighton and Sussex University HospitalsBrightonUK
| | - M. Fisher
- Brighton and Sussex University HospitalsBrightonUK
| | - J. Tibble
- Brighton and Sussex University HospitalsBrightonUK
| | - Y. Gilleece
- Brighton and Sussex University HospitalsBrightonUK
| | - P. Klenerman
- Peter Medawar Building for Pathogen ResearchNuffield Department of Clinical MedicineUniversity of OxfordOxfordUK
| | - A. H. Banham
- Nuffield Division of Clinical Laboratory SciencesRadcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - M. Howard
- Brighton and Sussex University HospitalsBrightonUK
| | - D. P. Webster
- Brighton and Sussex Medical SchoolBrightonUK,
Correspondence: Daniel P. Webster, Department of Virology, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
E‐mail:
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10
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Kang W, Tong HI, Sun Y, Lu Y. Hepatitis C virus infection in patients with HIV-1: epidemiology, natural history and management. Expert Rev Gastroenterol Hepatol 2014; 8:247-66. [PMID: 24450362 DOI: 10.1586/17474124.2014.876357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hepatitis C virus (HCV)-related liver diseases have contributed to increased morbidity and mortality in HIV-1-infected individuals in the era of effective antiretroviral therapy. HCV transmission patterns have changed among the HIV co-infected population during the last decade, with acute HCV infection emerging worldwide. HIV infection accelerates the progression of HCV-related liver diseases and consequently cirrhosis, liver failure, and hepatocellular carcinoma. However, the current standard treatment of HCV infection with pegylated interferon plus ribavirin results in only a limited viral response. Furthermore, cumbersome pill regimens, antiretroviral related hepatotoxicity, and drug interactions of HCV and HIV regimens complicate therapy strategies. Fortunately, in the near future, new direct-acting anti-HCV agents will widen therapeutic options for HCV/HIV co-infection. Liver transplantation is also gradually accepted as a therapeutic option for end stage liver disease of HCV/HIV co-infected patients.
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Affiliation(s)
- Wen Kang
- Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
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11
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Simonetta F, Bourgeois C. CD4+FOXP3+ Regulatory T-Cell Subsets in Human Immunodeficiency Virus Infection. Front Immunol 2013; 4:215. [PMID: 23908654 PMCID: PMC3727053 DOI: 10.3389/fimmu.2013.00215] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 07/13/2013] [Indexed: 01/29/2023] Open
Abstract
The role of CD4+FOXP3+ regulatory T cells (Treg) in human immunodeficiency virus (HIV) infection has been an area of intensive investigation and remains a matter of ardent debate. Investigation and interpretation suffered from uncertainties concerning Treg quantification. Firstly, Treg quantification and function in HIV infection remain controversial in part because of the lack of reliable and specific markers to identify human Tregs. Secondly, analyzing Treg percentages or absolute numbers led to apparent discrepancies that are now solved: it is now commonly accepted that Treg are targets of HIV infection, but are preferentially preserved compared to conventional CD4 T cells. Moreover, the duality of immune defects associated to HIV infection, i.e., low grade chronic inflammation and defects in HIV-specific responses also casts doubts on the potential impact of Treg on HIV infection. Tregs may be beneficial or/and detrimental to the control of HIV infection by suppressing chronic inflammation or HIV-specific responses respectively. Indeed both effects of Treg suppression have been described in HIV infection. The discovery in recent years of the existence of phenotypically and functionally distinct human CD4+FOXP3+ Treg subsets may provide a unique opportunity to reconcile these contrasting results. It is tempting to speculate that different Treg subsets exert these different suppressive effects. This review summarizes available data concerning Treg fate during HIV infection when considering Treg globally or as subsets. We discuss how the identification of naïve and effector Treg subsets modulates our understanding of Treg biology during HIV infection and the potential impact of HIV infection on mechanisms governing peripheral differentiation of adaptive Tregs.
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Affiliation(s)
- Federico Simonetta
- INSERM, U1012 , Le Kremlin-Bicêtre , France ; Université Paris-SUD, UMR-S1012 , Le Kremlin-Bicêtre , France ; Division of Immunology and Allergy, Department of Internal Medicine, Geneva University Hospitals , Geneva , Switzerland
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Hartling HJ, Gaardbo JC, Ronit A, Knudsen LS, Ullum H, Vainer B, Clausen MR, Skogstrand K, Gerstoft J, Nielsen SD. CD4⁺ and CD8⁺ regulatory T cells (Tregs) are elevated and display an active phenotype in patients with chronic HCV mono-infection and HIV/HCV co-infection. Scand J Immunol 2012; 76:294-305. [PMID: 22671952 DOI: 10.1111/j.1365-3083.2012.02725.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study was to examine regulatory T cells (Tregs) in peripheral blood and liver tissue in patients with chronic hepatitis C virus (HCV) mono-infection and in patients with HIV/HCV co-infection. In a cross-sectional study were included 51 patients with chronic HCV infection, 24 patients with HIV/HCV co-infection and 24 healthy individuals. CD4⁺ and CD8⁺ Tregs were determined using flow cytometry. Fibrosis was examined by transient elastography. Inflammation, fibrosis and Tregs were determined in liver biopsies from 12 patients. Increased frequency of CD4⁺ and CD8⁺ Tregs was found in HIV/HCV co-infected patients [median: 6.4% (IQR: 5.7-6.9) and 1.0% (0.7-1.2), respectively] compared to HCV mono-infected patients [5.6% (4.2-6.3), P = 0.01 and 0.5% (0.3-0.7), P < 0.001, respectively]. Furthermore, HCV mono-infected patients had increased frequencies of Tregs compared with healthy controls (P < 0.05). However, no associations between the frequency of Tregs and fibrosis were found. Furthermore, characterization of CD4⁺ Tregs using CD45RA demonstrated a higher frequency of activated Tregs in both HCV mono-infected and HIV/HCV co-infected patients compared with healthy controls. Finally, number of intrahepatic Tregs was associated with both peripheral CD8⁺ Tregs and intrahepatic inflammation. In conclusion, HCV mono-infected patients and particularly HIV/HCV co-infected patients have increased the frequency of CD4⁺ and CD8⁺ Tregs compared with healthy controls. Furthermore, CD4⁺ Tregs in infected patients displayed an active phenotype. Tregs were not associated with fibrosis, but a positive correlation between intrahepatic Tregs and inflammation was found. Taken together, these results suggest a role for Tregs in the pathogenesis of chronic HCV infection.
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Affiliation(s)
- H J Hartling
- Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
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