CD4+ T-cell subsets: what really counts in preventing HIV disease?

Correlation of central memory CD4+ T-Cell decrease in the peripheral blood with disease progression in SIVmac251-infected Chinese rhesus macaques

BACKGROUND

Correlation of CD4(+) Tcm cells in the peripheral blood to disease progression in SIVmac251 infection was examined in Chinese rhesus macaques.

METHODS

Plasma viral RNA loads were measured by a quantitative real-time reverse transcription-PCR (qRT-PCR) assay for SIV gag. Disease progression was determined based on time of survival. Phenotyping of CD4(+) T-cell subsets in the peripheral blood was longitudinally performed by flow cytometry.

RESULTS

Although CD4(+) T-cell decrease and low CD4(+)/CD8(+) T-cell ratio in the peripheral blood after SIVmac251 infection did not correlate with disease progression, CD4(+) Tcm cell decrease was observed to be correlated to disease progression in the SIVmac251-infected Chinese rhesus macaques.

CONCLUSIONS

Our findings suggest that CD4(+) Tcm cell decrease could be used as a predictive marker for defining the pathogenesis of the SIV disease and consequently HIV/SIV vaccine efficacy in Chinese rhesus macaques.

A randomized case-control study of dynamic changes in peripheral blood Th17/Treg cell balance and interleukin-17 levels in highly active antiretroviral-treated HIV type 1/AIDS patients

Our objective was to dynamically observe changes in peripheral blood Th17, Treg cells, and interleukin (IL)-17 levels in HIV-1/AIDS patients before and after highly active antiretroviral therapy (HAART). The study design consisted of a randomized case-controlled study. A total of 33 HIV-1/AIDS patients were chosen to receive a HAART regimen and 30 healthy volunteers were assigned as controls. Peripheral blood Th17 and Treg cells were measured by flow cytometry before or 6 and 12 months after HAART therapy. The plasma IL-17 level was determined by ELISA. The percentage of Th17 cells to total CD4(+) cells was 1.2 ± 0.37% in HIV/AIDS patients before treatment, which was significantly lower than that in uninfected controls (4.7 ± 1.43%). After HAART therapy for 6 or 12 months, the Th17 percentage increased to 2.5 ± 1.03% and 3.7±1.56%, respectively. The percentage of Treg cells to CD4(+) cells is 9.16 ± 3.33% in HIV/AIDS patients, which was significantly elevated compared to controls (4.43 ± 0.97%). HAART therapy for 6 and 12 months significantly decreased Treg cell percentage (7.19 ± 2.91% and 5.53 ± 1.88%, respectively). Interestingly, the ratio of Th17/Treg cells was significantly decreased in HIV/AIDS patients before treatment, while HAART treatment partially normalized the Th17/Treg ratio. IL-17 levels were 5.3 ± 2.5 and 17.7 ± 6.60 pg/ml in HIV/AIDS patients and controls, respectively; the HAART regimen increased the IL-17 level to 7.7 ± 2.4 and 10.4 ± 3.1 pg/ml at 6 and 12 months, respectively. The percentage of Th17 cells correlated with IL-17 level, but both negatively correlated with viral load before treatment, whereas the percentage of Treg cells positively correlated with viral load before HAART therapy. The imbalance of peripheral blood Th17 and Treg cells may play a crucial role in the pathogenesis of AIDS. HAART can restore the balance of Th17 and Treg cells as well as the IL-17 level, which may gradually rebuild the immune equilibrium in HIV/AIDS patients.

HIV-1 impairs in vitro priming of naïve T cells and gives rise to contact-dependent suppressor T cells

Priming of T cells in lymphoid tissues of HIV-infected individuals occurs in the presence of HIV-1. DC in this milieu activate T cells and disseminate HIV-1 to newly activated T cells, the outcome of which may have serious implications in the development of optimal antiviral responses. We investigated the effects of HIV-1 on DC–naïve T-cell interactions using an allogeneic in vitro system. Our data demonstrate a dramatic decrease in the primary expansion of naïve T cells when cultured with HIV-1-exposed DC. CD4⁺ and CD8⁺ T cells showed enhanced expression of PD-1 and TRAIL, whereas CTLA-4 expression was observed on CD4⁺ T cells. It is worth noting that T cells primed in the presence of HIV-1 suppressed priming of other naïve T cells in a contact-dependent manner. We identified PD-1, CTLA-4, and TRAIL pathways as responsible for this suppresion, as blocking these negative molecules restored T-cell proliferation to a higher degree. In conclusion, the presence of HIV-1 during DC priming produced cells with inhibitory effects on T-cell activation and proliferation, i.e. suppressor T cells, a mechanism that could contribute to the enhancement of HIV-1 pathogenesis.