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Iannetta M, Crea AMA, Di Lorenzo A, Campogiani L, Teti E, Malagnino V, Compagno M, Coppola L, Piermatteo L, Palmieri G, Cimino C, Salpini R, Zingaropoli MA, Ciardi MR, Mastroianni CM, Parisi SG, Svicher V, Andreoni M, Sarmati L. Hepatitis B-related hepatic flare during immune reconstitution syndrome after antiretroviral treatment initiation in an HBV surface antigen-positive patient with HIV: viroimmunological and histological characterization. Open Forum Infect Dis 2022; 9:ofac451. [PMID: 36092833 PMCID: PMC9454030 DOI: 10.1093/ofid/ofac451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022] Open
Abstract
HIV and hepatitis B virus (HBV) coinfection is relatively common. Initiation of antiretroviral therapy (ART) in people with HIV (PWH) causes a progressive restoration of cell-mediated immune functions. In the presence of overt or occult coinfections, immune restoration might lead to immune reconstitution inflammatory syndrome (IRIS). Here, we describe the clinical, immunological, virological, and histological characterization of a case of HBV-related IRIS hepatitis in a PWH after ART initiation. A liver biopsy was performed during HBV-related IRIS hepatic flare, and liver samples were analyzed through immunohistochemistry and molecular techniques, with the assessment of intrahepatic HBV-DNA, covalently closed circular DNA, and HBV pregenomic RNA through a droplet digital polymerase chain reaction system. Immune activation and senescence were also longitudinally assessed. In this clinical case, the hepatic flare occurred 6 weeks after ART initiation with a therapeutic regimen including tenofovir alafenamide (TAF) and emtricitabine (FTC). The episode was self-limiting, characterized by hyperactivation of peripheral blood CD4+ and CD8+ T-lymphocytes, and resolved without ART discontinuation, leading to the achievement of HBsAg seroconversion (HBsAg-/HBsAb+) and HBV-DNA plasma undetectability. Notably, hyperactivation of the immune system plays a pivotal role in promoting the control of HBV replication, thus triggering the achievement of HBsAg seroconversion during treatment with TAF/FTC.
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Affiliation(s)
- M Iannetta
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - A M A Crea
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - A Di Lorenzo
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Campogiani
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - E Teti
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - V Malagnino
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - M Compagno
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Coppola
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Piermatteo
- Department of Experimental Medicine, Tor Vergata University , Rome , Italy
| | - G Palmieri
- Department of Biomedicine and Prevention, Tor Vergata University , Rome , Italy
| | - C Cimino
- Department of Biomedicine and Prevention, Tor Vergata University , Rome , Italy
| | - R Salpini
- Department of Experimental Medicine, Tor Vergata University , Rome , Italy
| | - M A Zingaropoli
- Department of Public Health and Infectious Diseases, Sapienza University , Rome , Italy
| | - M R Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University , Rome , Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University , Rome , Italy
| | - S G Parisi
- Department of Molecular Medicine, University of Padova , Padua , Italy
| | - V Svicher
- Department of Experimental Medicine, Tor Vergata University , Rome , Italy
- Department of Biology, Tor Vergata University , Rome , Italy
| | - M Andreoni
- Department of System Medicine, Tor Vergata University , Rome , Italy
| | - L Sarmati
- Department of System Medicine, Tor Vergata University , Rome , Italy
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De Santis F, Lopez AB, Virtuoso S, Poerio N, Saccomandi P, Olimpieri T, Duca L, Henrici De Angelis L, Aquilano K, D'Andrea MM, Aquaro S, Borsetti A, Ceccherini-Silberstein F, Fraziano M. Phosphatidylcholine Liposomes Down-Modulate CD4 Expression Reducing HIV Entry in Human Type-1 Macrophages. Front Immunol 2022; 13:830788. [PMID: 35663973 PMCID: PMC9160374 DOI: 10.3389/fimmu.2022.830788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
A strategy adopted to combat human immunodeficiency virus type-1 (HIV-1) infection is based on interfering with virus entry into target cells. In this study, we found that phosphatidylcholine (PC) liposomes reduced the expression of the CD4 receptor in human primary type-1 macrophages but not in CD4+ T cells. The down-regulation was specific to CD4, as any effect was not observed in CCR5 membrane expression. Moreover, the reduction of membrane CD4 expression required the Ca2+-independent protein kinase C (PKC), which in turn mediated serine phosphorylation in the intracytoplasmic tail of the CD4 receptor. Serine phosphorylation of CD4 was also associated with its internalization and degradation in acidic compartments. Finally, the observed CD4 downregulation induced by PC liposomes in human primary macrophages reduced the entry of both single-cycle replication and replication competent R5 tropic HIV-1. Altogether, these results show that PC liposomes reduce HIV entry in human macrophages and may impact HIV pathogenesis by lowering the viral reservoir.
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Affiliation(s)
- Federica De Santis
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Ana Borrajo Lopez
- Dipartimento di Medicina Sperimentale, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Sara Virtuoso
- Centro Nazionale per la ricerca su HIV/AIDS, Istituto Superiore di Sanità, Roma, Italy
| | - Noemi Poerio
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Patrizia Saccomandi
- Dipartimento di Medicina Sperimentale, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Tommaso Olimpieri
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Leonardo Duca
- Dipartimento di Medicina Sperimentale, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Lucia Henrici De Angelis
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy.,Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy
| | - Katia Aquilano
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Marco Maria D'Andrea
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - Stefano Aquaro
- Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Rende, Italy
| | - Alessandra Borsetti
- Centro Nazionale per la ricerca su HIV/AIDS, Istituto Superiore di Sanità, Roma, Italy
| | | | - Maurizio Fraziano
- Dipartimento di Biologia, Università degli Studi di Roma "Tor Vergata", Roma, Italy
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3
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Piermatteo L, Scutari R, Chirichiello R, Alkhatib M, Malagnino V, Bertoli A, Iapadre N, Ciotti M, Sarmati L, Andreoni M, Ceccherini-Silberstein F, Salpini R, Svicher V. Droplet digital PCR assay as an innovative and promising highly sensitive assay to unveil residual and cryptic HBV replication in peripheral compartment. Methods 2021; 201:74-81. [PMID: 34000391 DOI: 10.1016/j.ymeth.2021.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 02/07/2023] Open
Abstract
Droplet digital PCR is an innovative and promising approach for highly sensitive quantification of nucleic acids that is being increasingly used in the field of clinical virology, including the setting of hepatitis B virus (HBV). Here, we comprehensively report a robust and reproducible ddPCR assay for the highly sensitive quantification of serum HBV-DNA. The assay showed a limit of detection of 4 copies/ml (<1IU/ml) by Probit analysis, showed a good linearity (R2 = 0.94) and a high intra- and inter-run reproducibility with differences between the values obtained in the same run or in two independent runs never exceeding 0.14logcopies/mL and 0.21logcopies/mL, respectively. By analysing serum samples from chronically HBV infected patients (mostly under antiviral treatment), ddPCR successfully quantified serum HBV-DNA in 89.8% of patients with detectable serum HBV-DNA < 20 IU/mL [equivalent to <112copies/ml] by classical Real-Time PCR assay, with a median (IQR) of 8(5-14)IU/mL [45(28-78)copies/ml], and in 66.7% of patients with undetectable serum HBV-DNA, with a median (IQR) of 5(4-9)IU/mL [28(20-50)copies/ml]. Similarly, by analysing serum samples from patients with a serological profile compatible with occult HBV infection (anti-HBc+/HBsAg-), ddPCR successfully quantified serum HBV-DNA in 40% of patients with a median (IQR) value of 1(1-2)IU/mL [5(5-11)copies/ml], in line with the extremely limited viral replication typically observed in occult HBV infection. Overall, the availability of assays for the highly sensitive quantification of serum HBV-DNA can provide an added value in optimizing the diagnosis of occult hepatitis B infection, improving the therapeutic management of chronically HBV infected patients, also in the light of innovative drugs (upcoming in clinical practise) aimed at achieving HBV functional cure.
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Affiliation(s)
- Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Rossana Scutari
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Mohammad Alkhatib
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Vincenzo Malagnino
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy; Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Nerio Iapadre
- Infectious Diseases Unit, "San Salvatore Hospital", L' Aquila, Italy
| | - Marco Ciotti
- Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Loredana Sarmati
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Romina Salpini
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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Huijser E, Versnel MA. Making Sense of Intracellular Nucleic Acid Sensing in Type I Interferon Activation in Sjögren's Syndrome. J Clin Med 2021; 10:532. [PMID: 33540529 PMCID: PMC7867173 DOI: 10.3390/jcm10030532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/13/2022] Open
Abstract
Primary Sjögren's syndrome (pSS) is a systemic autoimmune rheumatic disease characterized by dryness of the eyes and mucous membranes, which can be accompanied by various extraglandular autoimmune manifestations. The majority of patients exhibit persistent systemic activation of the type I interferon (IFN) system, a feature that is shared with other systemic autoimmune diseases. Type I IFNs are integral to anti-viral immunity and are produced in response to stimulation of pattern recognition receptors, among which nucleic acid (NA) receptors. Dysregulated detection of endogenous NAs has been widely implicated in the pathogenesis of systemic autoimmune diseases. Stimulation of endosomal Toll-like receptors by NA-containing immune complexes are considered to contribute to the systemic type I IFN activation. Accumulating evidence suggest additional roles for cytosolic NA-sensing pathways in the pathogenesis of systemic autoimmune rheumatic diseases. In this review, we will provide an overview of the functions and signaling of intracellular RNA- and DNA-sensing receptors and summarize the evidence for a potential role of these receptors in the pathogenesis of pSS and the sustained systemic type I IFN activation.
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Affiliation(s)
| | - Marjan A. Versnel
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands;
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