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Eller MA, Blom KG, Gonzalez VD, Eller LA, Naluyima P, Laeyendecker O, Quinn TC, Kiwanuka N, Serwadda D, Sewankambo NK, Tasseneetrithep B, Wawer MJ, Gray RH, Marovich MA, Michael NL, de Souza MS, Wabwire-Mangen F, Robb ML, Currier JR, Sandberg JK. Innate and adaptive immune responses both contribute to pathological CD4 T cell activation in HIV-1 infected Ugandans. PLoS One 2011; 6:e18779. [PMID: 21526194 PMCID: PMC3079731 DOI: 10.1371/journal.pone.0018779] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 03/09/2011] [Indexed: 01/27/2023] Open
Abstract
HIV-1 disease progression is associated with persistent immune activation. However, the nature of this association is incompletely understood. Here, we investigated immune activation in the CD4 T cell compartment of chronically HIV-1 infected individuals from Rakai, Uganda. Levels of CD4 T cell activation, assessed as co-expression of PD-1, CD38 and HLA-DR, correlated directly to viral load and inversely to CD4 count. Deeper characterization of these cells indicated an effector memory phenotype with relatively frequent expression of Ki67 despite their PD-1 expression, and levels of these cells were inversely associated with FoxP3+ regulatory T cells. We therefore use the term deregulated effector memory (DEM) cells to describe them. CD4 T cells with a DEM phenotype could be generated by antigen stimulation of recall responses in vitro. Responses against HIV-1 and CMV antigens were enriched among the DEM CD4 T cells in patients, and the diverse Vβ repertoire of DEM CD4 T cells suggested they include diverse antigen-specificities. Furthermore, the levels of DEM CD4 T cells correlated directly to soluble CD14 (sCD14) and IL-6, markers of innate immune activation, in plasma. The size of the activated DEM CD4 T cell subset was predictive of the rate of disease progression, whereas IL-6 was only weakly predictive and sCD14 was not predictive. Taken together, these results are consistent with a model where systemic innate immune activation and chronic antigen stimulation of adaptive T cell responses both play important roles in driving pathological CD4 T cell immune activation in HIV-1 disease.
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Affiliation(s)
- Michael A. Eller
- Makerere University Walter Reed Project, Kampala, Uganda
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
- Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Kim G. Blom
- Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Veronica D. Gonzalez
- Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Leigh Anne Eller
- Makerere University Walter Reed Project, Kampala, Uganda
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
| | | | - Oliver Laeyendecker
- National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
- Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Thomas C. Quinn
- National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
- Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Noah Kiwanuka
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
- Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
| | - David Serwadda
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
- Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
| | - Nelson K. Sewankambo
- Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
- Faculty of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Boonrat Tasseneetrithep
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Maria J. Wawer
- Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
- Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Ronald H. Gray
- Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
- Johns Hopkins Center for Global Health, Baltimore, Maryland, United States of America
| | - Mary A. Marovich
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
| | - Nelson L. Michael
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
| | - Mark S. de Souza
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Fred Wabwire-Mangen
- Makerere University Walter Reed Project, Kampala, Uganda
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Merlin L. Robb
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
| | - Jeffrey R. Currier
- U. S. Military HIV Research Program, Rockville, Maryland, United States of America
| | - Johan K. Sandberg
- Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- * E-mail:
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