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Rocco JM, Zhou Y, Liu NS, Laidlaw E, Galindo F, Anderson MV, Rupert A, Lucena Lage S, Ortega-Villa AM, Yu S, Lisco A, Manion M, Vassiliou GS, Dunbar CE, Sereti I. Clonal hematopoiesis in people with advanced HIV and associated inflammatory syndromes. JCI Insight 2024:e174783. [PMID: 38564303 DOI: 10.1172/jci.insight.174783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
People with HIV (PWH) have a higher age-adjusted mortality due to chronic immune activation and age-related comorbidities. PWH also have higher rates of clonal hematopoiesis (CH) than age-matched non-HIV cohorts, however, risk factors influencing the development and expansion of CH in PWH remain incompletely explored. We investigated the relationship between CH, immune biomarkers, and HIV-associated risk factors (CD4, CD8 T-cells, nadir CD4 count, opportunistic infections [OIs], and immune reconstitution inflammatory syndrome [IRIS]) in a diverse cohort of 197-PWH with median age of 42-years, using a 56-gene panel. Seventy-nine percent had a CD4 nadir < 200, 58.9% had prior OIs, and 34.5% had a history of IRIS. The prevalence of CH was high (27.4%), even in younger individuals, and CD8 T-cells and nadir CD4 counts strongly associated with CH after controlling for age. A history of IRIS was associated with CH in a subgroup analysis of ≥ 35-years-old patients. Inflammatory biomarkers were higher in CH carriers compared to non-carriers supporting a dysregulated immune state. These findings suggest PWH with low nadir CD4 and/or inflammatory complications may be at high risk of CH regardless of age and represent a high-risk group that could benefit from risk reduction and potentially targeted immunomodulation.
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Affiliation(s)
- Joseph M Rocco
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Yifan Zhou
- Translational Stem Cell Biology Branch, National Heart, Lung and Blood Inst, NIH, Bethesda, United States of America
| | - Nicholas S Liu
- Translational Stem Cell Biology Branch, National Heart, Lung and Blood Inst, NIH, Bethesda, United States of America
| | - Elizabeth Laidlaw
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Frances Galindo
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Megan V Anderson
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Adam Rupert
- Leidos Biomedical Research Core, Frederick, United States of America
| | - Silvia Lucena Lage
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Ana M Ortega-Villa
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Shiqin Yu
- Translational Stem Cell Biology Branch, National Heart, Lung and Blood Inst, NIH, Bethesda, United States of America
| | - Andrea Lisco
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - Maura Manion
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
| | - George S Vassiliou
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
| | - Cynthia E Dunbar
- Translational Stem Cell Biology Branch, National Heart, Lung and Blood Inst, NIH, Bethesda, United States of America
| | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America
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2
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Delmonte OM, Oguz C, Dobbs K, Myint-Hpu K, Palterer B, Abers MS, Draper D, Truong M, Kaplan IM, Gittelman RM, Zhang Y, Rosen LB, Snow AL, Dalgard CL, Burbelo PD, Imberti L, Sottini A, Quiros-Roldan E, Castelli F, Rossi C, Brugnoni D, Biondi A, Bettini LR, D'Angio M, Bonfanti P, Anderson MV, Saracino A, Chironna M, Di Stefano M, Fiore JR, Santantonio T, Castagnoli R, Marseglia GL, Magliocco M, Bosticardo M, Pala F, Shaw E, Matthews H, Weber SE, Xirasagar S, Barnett J, Oler AJ, Dimitrova D, Bergerson JRE, McDermott DH, Rao VK, Murphy PM, Holland SM, Lisco A, Su HC, Lionakis MS, Cohen JI, Freeman AF, Snyder TM, Lack J, Notarangelo LD. Perturbations of the T-cell receptor repertoire in response to SARS-CoV-2 in immunocompetent and immunocompromised individuals. J Allergy Clin Immunol 2023:S0091-6749(23)02544-7. [PMID: 38154666 DOI: 10.1016/j.jaci.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Functional T-cell responses are essential for virus clearance and long-term protection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whereas certain clinical factors, such as older age and immunocompromise, are associated with worse outcome. OBJECTIVE We sought to study the breadth and magnitude of T-cell responses in patients with coronavirus disease 2019 (COVID-19) and in individuals with inborn errors of immunity (IEIs) who had received COVID-19 mRNA vaccine. METHODS Using high-throughput sequencing and bioinformatics tools to characterize the T-cell receptor β repertoire signatures in 540 individuals after SARS-CoV-2 infection, 31 IEI recipients of COVID-19 mRNA vaccine, and healthy controls, we quantified HLA class I- and class II-restricted SARS-CoV-2-specific responses and also identified several HLA allele-clonotype motif associations in patients with COVID-19, including a subcohort of anti-type 1 interferon (IFN-1)-positive patients. RESULTS Our analysis revealed that elderly patients with COVID-19 with critical disease manifested lower SARS-CoV-2 T-cell clonotype diversity as well as T-cell responses with reduced magnitude, whereas the SARS-CoV-2-specific clonotypes targeted a broad range of HLA class I- and class II-restricted epitopes across the viral proteome. The presence of anti-IFN-I antibodies was associated with certain HLA alleles. Finally, COVID-19 mRNA immunization induced an increase in the breadth of SARS-CoV-2-specific clonotypes in patients with IEIs, including those who had failed to seroconvert. CONCLUSIONS Elderly individuals have impaired capacity to develop broad and sustained T-cell responses after SARS-CoV-2 infection. Genetic factors may play a role in the production of anti-IFN-1 antibodies. COVID-19 mRNA vaccines are effective in inducing T-cell responses in patients with IEIs.
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Affiliation(s)
- Ottavia M Delmonte
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
| | - Cihan Oguz
- Integrated Data Sciences Section, Research Technology Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Kerry Dobbs
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Katherine Myint-Hpu
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Boaz Palterer
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Michael S Abers
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Deborah Draper
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Meng Truong
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | | | | | - Yu Zhang
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Lindsey B Rosen
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Andrew L Snow
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md; Department of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, Md
| | - Clifton L Dalgard
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, Md; The American Genome Center, Uniformed Services University of the Health Sciences, Bethesda, Md
| | - Peter D Burbelo
- Adeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Md
| | - Luisa Imberti
- Section of Microbiology, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Alessandra Sottini
- Section of Microbiology, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Eugenia Quiros-Roldan
- Department of Infectious and Tropical Diseases, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Francesco Castelli
- Department of Infectious and Tropical Diseases, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Camillo Rossi
- Direzione Sanitaria, ASST Spedali Civili, Brescia, Italy
| | - Duilio Brugnoni
- Laboratorio Analisi Chimico-Cliniche, ASST Spedali Civili, Brescia, Italy
| | - Andrea Biondi
- Pediatric Department and Centro Tettamanti-European Reference Network on Paediatric Cancer, European Reference Network on Haematological Diseases, and European Reference Network on Hereditary Metabolic Disorders, University of Milano-Bicocca-Fondazione MBBM, Monza, Italy
| | - Laura Rachele Bettini
- Pediatric Department and Centro Tettamanti-European Reference Network on Paediatric Cancer, European Reference Network on Haematological Diseases, and European Reference Network on Hereditary Metabolic Disorders, University of Milano-Bicocca-Fondazione MBBM, Monza, Italy
| | - Mariella D'Angio
- Pediatric Department and Centro Tettamanti-European Reference Network on Paediatric Cancer, European Reference Network on Haematological Diseases, and European Reference Network on Hereditary Metabolic Disorders, University of Milano-Bicocca-Fondazione MBBM, Monza, Italy
| | - Paolo Bonfanti
- Department of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Megan V Anderson
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Annalisa Saracino
- Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, University of Bari, Bari, Italy
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Mariantonietta Di Stefano
- Department of Medical and Surgical Sciences, Section of Infectious Diseases, University of Foggia, Foggia, Italy
| | - Jose Ramon Fiore
- Department of Medical and Surgical Sciences, Section of Infectious Diseases, University of Foggia, Foggia, Italy
| | - Teresa Santantonio
- Department of Medical and Surgical Sciences, Section of Infectious Diseases, University of Foggia, Foggia, Italy
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gian Luigi Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mary Magliocco
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Marita Bosticardo
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Francesca Pala
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Elana Shaw
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Helen Matthews
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Sarah E Weber
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Sandhya Xirasagar
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Jason Barnett
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Andrew J Oler
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Dimana Dimitrova
- Center for Immuno-Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Md
| | - Jenna R E Bergerson
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - David H McDermott
- Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - V Koneti Rao
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Philip M Murphy
- Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Steven M Holland
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Andrea Lisco
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Helen C Su
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Michail S Lionakis
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Alexandra F Freeman
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | | | - Justin Lack
- Integrated Data Sciences Section, Research Technology Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
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3
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Lisco A, Ortega-Villa AM, Mystakelis H, Anderson MV, Mateja A, Laidlaw E, Manion M, Roby G, Higgins J, Kuriakose S, Walkiewicz MA, Similuk M, Leiding JW, Freeman AF, Sheikh V, Sereti I. Reappraisal of Idiopathic CD4 Lymphocytopenia at 30 Years. N Engl J Med 2023; 388:1680-1691. [PMID: 37133586 PMCID: PMC10239023 DOI: 10.1056/nejmoa2202348] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Idiopathic CD4 lymphocytopenia (ICL) is a clinical syndrome that is defined by CD4 lymphopenia of less than 300 cells per cubic millimeter in the absence of any primary or acquired cause of immunodeficiency. Some 30 years after its original identification, ICL has remained a disease of obscure cause, with limited evidence with respect to its prognosis or management, despite diagnostic and therapeutic innovations. METHODS We evaluated the clinical, genetic, immunologic, and prognostic characteristics of 108 patients who were enrolled during an 11-year period. We performed whole-exome and targeted gene sequencing to identify genetic causes of lymphopenia. We also performed longitudinal linear mixed-model analyses of T-cell count trajectories and evaluated predictors of clinical events, the response to immunization against coronavirus disease 2019 (Covid-19), and mortality. RESULTS After the exclusion of patients with genetic and acquired causes of CD4 lymphopenia, the study population included 91 patients with ICL during 374 person-years of follow-up. The median CD4+ T-cell count among the patients was 80 cells per cubic millimeter. The most prevalent opportunistic infections were diseases related to human papillomavirus (in 29%), cryptococcosis (in 24%), molluscum contagiosum (in 9%), and nontuberculous mycobacterial diseases (in 5%). A reduced CD4 count (<100 cells per cubic millimeter), as compared with a CD4 count of 101 to 300 cells, was associated with a higher risk of opportunistic infection (odds ratio, 5.3; 95% confidence interval [CI], 2.8 to 10.7) and invasive cancer (odds ratio, 2.1; 95% CI, 1.1 to 4.3) and a lower risk of autoimmunity (odds ratio, 0.5; 95% CI, 0.2 to 0.9). The risk of death was similar to that in the age- and sex-adjusted general population, but the prevalence of cancer was higher. CONCLUSIONS Among the study patients, ICL continued to be associated with increased susceptibility to viral, encapsulated fungal, and mycobacterial diseases, as well as with a reduced response to novel antigens and an increased risk of cancer. (Funded by the National Institute of Allergy and Infectious Diseases and the National Cancer Institute; ClinicalTrials.gov number, NCT00867269.).
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Affiliation(s)
- Andrea Lisco
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Ana M Ortega-Villa
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Harry Mystakelis
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Megan V Anderson
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Allyson Mateja
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Elizabeth Laidlaw
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Maura Manion
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Gregg Roby
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Jeanette Higgins
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Safia Kuriakose
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Magdalena A Walkiewicz
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Morgan Similuk
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Jennifer W Leiding
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Alexandra F Freeman
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Virginia Sheikh
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
| | - Irini Sereti
- From the Laboratory of Immunoregulation (A.L., H.M., M.V.A., E.L., M.M., G.R., V.S., I.S.), Biostatistics Research Branch, Division of Clinical Research (A.M.O.-V.), Centralized Sequencing Program, Division of Intramural Research (M.A.W., M.S.), and the Laboratory of Clinical Immunology and Microbiology (A.F.F.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the Clinical Monitoring Research Program Directorate (A.M.), Leidos Biomedical Research (J.H.), and the Clinical Research Directorate (S.K.), Frederick National Laboratory for Cancer Research, Frederick, and the Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore (J.W.L.) - all in Maryland
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4
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Rocco JM, Laghetti P, Di Stefano M, Sereti I, Ortega-Villa A, Wang J, Rupert A, Chironna M, Ye's P, Liu X, Anderson MV, Burbelo PB, Fiore JR, Saracino A, Lisco A. Impact of Innate Immunity, Endothelial Damage, and Metabolic Biomarkers on COVID-19 Severity and Mortality. Open Forum Infect Dis 2022; 9:ofac427. [PMID: 36111172 PMCID: PMC9452087 DOI: 10.1093/ofid/ofac427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/18/2022] [Indexed: 01/24/2023] Open
Abstract
In this study, abnormal levels of myeloid activation, endothelial damage, and innate immune markers were associated with severe coronavirus disease 2019 (COVID-19), while higher levels of metabolic biomarkers (irisin, leptin) demonstrated a protective effect. These data support a model for COVID-19 immunopathogenesis linking robust inflammation and endothelial damage in metabolically predisposed individuals.
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Affiliation(s)
- Joseph M Rocco
- Correspondence: J. Rocco, MD, National Institute of Allergy & Infectious Diseases, National Institutes of Health, 10 Center Dr, Building. 10 Room 11B17, Bethesda, MD 20892 ()
| | | | | | | | - Ana Ortega-Villa
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jing Wang
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Adam Rupert
- Leidos Biomedical Research, Inc., Frederick, Maryland, USA
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Peiying Ye's
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Xiangdong Liu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Megan V Anderson
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter B Burbelo
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
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5
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Lisco A, Hsu AP, Dimitrova D, Proctor DM, Mace EM, Ye P, Anderson MV, Hicks SN, Grivas C, Hammoud DA, Manion M, Starrett GJ, Farrel A, Dobbs K, Brownell I, Buck C, Notarangelo LD, Orange JS, Leonard WJ, Orestes MI, Peters AT, Kanakry JA, Segre JA, Kong HH, Sereti I. Treatment of Relapsing HPV Diseases by Restored Function of Natural Killer Cells. N Engl J Med 2021; 385:921-929. [PMID: 34469647 PMCID: PMC8590529 DOI: 10.1056/nejmoa2102715] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Human papillomavirus (HPV) infections underlie a wide spectrum of both benign and malignant epithelial diseases. In this report, we describe the case of a young man who had encephalitis caused by herpes simplex virus during adolescence and currently presented with multiple recurrent skin and mucosal lesions caused by HPV. The patient was found to have a pathogenic germline mutation in the X-linked interleukin-2 receptor subunit gamma gene (IL2RG), which was somatically reverted in T cells but not in natural killer (NK) cells. Allogeneic hematopoietic-cell transplantation led to restoration of NK cytotoxicity, with normalization of the skin microbiome and persistent remission of all HPV-related diseases. NK cytotoxicity appears to play a role in containing HPV colonization and the ensuing HPV-related hyperplastic or dysplastic lesions. (Funded by the National Institutes of Health and the Herbert Irving Comprehensive Cancer Center Flow Cytometry Shared Resources.).
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Affiliation(s)
- Andrea Lisco
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Amy P Hsu
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Dimana Dimitrova
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Diana M Proctor
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Emily M Mace
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Peiying Ye
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Megan V Anderson
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Stephanie N Hicks
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Christopher Grivas
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Dima A Hammoud
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Maura Manion
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Gabriel J Starrett
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Alvin Farrel
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Kerry Dobbs
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Isaac Brownell
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Christopher Buck
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Luigi D Notarangelo
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Jordan S Orange
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Warren J Leonard
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Michael I Orestes
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Anju T Peters
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Jennifer A Kanakry
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Julia A Segre
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Heidi H Kong
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
| | - Irini Sereti
- From the Laboratories of Immunoregulation (A.L., P.Y., M.V.A., C.G., M.M., I.S.) and Clinical Immunology and Microbiology (A.P.H., K.D., L.D.N.), National Institute of Allergy and Infectious Diseases, the Experimental Transplantation and Immunotherapy Branch (D.D., S.N.H., J.A.K.) and the Laboratory of Cellular Oncology (G.J.S., C.B.), National Cancer Institute, the Translational and Functional Genomics Branch, National Human Genome Research Institute (D.M.P., J.A.S.), the Laboratory of Molecular Immunology and the Immunology Center, National Heart, Lung, and Blood Institute (A.F., W.J.L.), the Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (H.H.K., I.B.), and the Center for Infectious Disease Imaging (D.A.H.), National Institutes of Health, and Walter Reed National Military Medical Center (M.I.O.) - all in Bethesda, MD; Vagelos College of Physicians and Surgeons, Columbia University, New York (E.M.M., J.S.O.); and the Department of Medicine and Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago (A.T.P.)
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Lisco A, Ye P, Wong CS, Pei L, Hsu AP, Mace EM, Orange JS, Lage SL, Ward AJ, Migueles SA, Connors M, Anderson MV, Buckner CM, Moir S, Rupert A, Dulau-Florea A, Ogbogu P, Timberlake D, Notarangelo LD, Pittaluga S, Abraham RS, Sereti I. Lost in Translation: Lack of CD4 Expression due to a Novel Genetic Defect. J Infect Dis 2021; 223:645-654. [PMID: 33471124 DOI: 10.1093/infdis/jiab025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023] Open
Abstract
CD4 expression identifies a subset of mature T cells primarily assisting the germinal center reaction and contributing to CD8+ T-cell and B-cell activation, functions, and longevity. Herein, we present a family in which a novel variant disrupting the translation-initiation codon of the CD4 gene resulted in complete loss of membrane and plasma soluble CD4 in peripheral blood, lymph node, bone marrow, skin, and ileum of a homozygous proband. This inherited CD4 knockout disease illustrates the clinical and immunological features of a complete deficiency of any functional component of CD4 and its similarities and differences with other clinical models of primary or acquired loss of CD4+ T cells. The first inherited loss of any functional component of CD4, including soluble CD4, is clinically distinct from any other congenital or acquired CD4 T-cell defect and characterized by compensatory changes in T-cell subsets and functional impairment of B cells, monocytes, and natural killer cells.
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Affiliation(s)
- Andrea Lisco
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Peying Ye
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Chun-Shu Wong
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Luxin Pei
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Amy P Hsu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Emily M Mace
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Jordan S Orange
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Silvia Lucena Lage
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Addison Jon Ward
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephen A Migueles
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Mark Connors
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Megan V Anderson
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Clarisa M Buckner
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Susan Moir
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Adam Rupert
- Leidos Biomedical Research, Inc, Frederick, Maryland, USA
| | | | - Princess Ogbogu
- Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Dylan Timberlake
- Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Luigi D Notarangelo
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Stefania Pittaluga
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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7
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Lisco A, Wong CS, Lage SL, Levy I, Brophy J, Lennox J, Manion M, Anderson MV, Mejia Y, Grivas C, Mystakelis H, Burbelo PD, Perez-Diez A, Rupert A, Martens CA, Anzick SL, Morse C, Chan S, Deleage C, Sereti I. Identification of rare HIV-1-infected patients with extreme CD4+ T cell decline despite ART-mediated viral suppression. JCI Insight 2019; 4:127113. [PMID: 30996137 DOI: 10.1172/jci.insight.127113] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/12/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The goal of antiretroviral therapy (ART) is to suppress HIV-1 replication and reconstitute CD4+ T cells. Here, we report on HIV-infected individuals who had a paradoxical decline in CD4+ T cells despite ART-mediated suppression of plasma HIV-1 load (pVL). We defined such an immunological outcome as extreme immune decline (EXID). METHODS EXID's clinical and immunological characteristics were compared to immunological responders (IRs), immunological nonresponders (INRs), healthy controls (HCs), and idiopathic CD4+ lymphopenia (ICL) patients. T cell immunophenotyping and assembly/activation of inflammasomes were evaluated by flow cytometry. PBMC transcriptome analysis and genetic screening for pathogenic variants were performed. Levels of cytokines/chemokines were measured by electrochemiluminescence. Luciferase immunoprecipitation system and NK-mediated antibody-dependent cellular cytotoxicity (ADCC) assays were used to identify anti-lymphocyte autoantibodies. RESULTS EXIDs were infected with non-B HIV-1 subtypes and after 192 weeks of consistent ART-mediated pVL suppression had a median CD4+ decrease of 157 cells/μl, compared with CD4+ increases of 193 cells/μl and 427 cells/μl in INR and IR, respectively. EXID had reduced naive CD4+ T cells, but similar proportions of cycling CD4+ T cells and HLA-DR+CD38+CD8+ T cells compared with IR and INR. Levels of inflammatory cytokines were also similar in EXID and INR, but the IL-7 axis was profoundly perturbed compared with HC, IR, INR, and ICL. Genes involved in T cell and monocyte/macrophage function, autophagy, and cell migration were differentially expressed in EXID. Two of the 5 EXIDs had autoantibodies causing ADCC, while 2 different EXIDs had an increased inflammasome/caspase-1 activation despite consistently ART-suppressed pVL. CONCLUSIONS EXID is a distinct immunological outcome compared with previously described INR. Anti-CD4+ T cell autoantibodies and aberrant inflammasome/caspase-1 activation despite suppressed HIV-1 viremia are among the mechanisms responsible for EXID.
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Affiliation(s)
- Andrea Lisco
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Chun-Shu Wong
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Silvia Lucena Lage
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Itzchak Levy
- Sheba Medical Center, Tel Hashomer and the Sackler Medical School, Tel Aviv, Israel
| | - Jason Brophy
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Jeffrey Lennox
- Grady Memorial Hospital, Emory University, Atlanta, Georgia, USA
| | - Maura Manion
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Megan V Anderson
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Yolanda Mejia
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Christopher Grivas
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Harry Mystakelis
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Peter D Burbelo
- Dental Clinical Research Core, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
| | - Ainhoa Perez-Diez
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Adam Rupert
- AIDS Monitoring Laboratory, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Craig A Martens
- Rocky Mountain Laboratory, Genomics Unit, NIAID, NIH, Hamilton, Montana, USA
| | - Sarah L Anzick
- Rocky Mountain Laboratory, Genomics Unit, NIAID, NIH, Hamilton, Montana, USA
| | - Caryn Morse
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Shanna Chan
- Winnipeg Regional Health Authority, Manitoba, Canada
| | - Claire Deleage
- Tissue Analysis Core, AIDS and Cancer Virus Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Irini Sereti
- Laboratory of Immunoregulation, HIV Pathogenesis Section, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
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8
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Anderson MV. How to review your own contracts. J Tenn Med Assoc 1989; 82:432-3. [PMID: 2761252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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9
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Whitner MS, Anderson MV. Sexually transmitted diseases in children. Health Care Women Int 1987; 8:9-18. [PMID: 3100484 DOI: 10.1080/07399338709515764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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10
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Anderson MV, Barlow JF. Forty-seven year old woman with sudden onset of aphasia. S D J Med 1980; 33:27-33. [PMID: 6932736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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