Characterization of the HIV-1 Latent Reservoir in CCR5-Delta 32 Heterozygotes

描述（由申请人提供）：尽管高效抗逆转录病毒疗法（HAART）的出现大大降低了与HIV-1感染相关的发病率和死亡率，但由于治疗期间潜伏感染细胞的持续存在，病毒根除是无法实现的。越来越多的数据表明，“非艾滋病”心血管、肺部、肾脏和肝脏疾病被HIV-1感染放大，甚至病毒抑制的患者也会出现过早的免疫衰老。这些现实情况使人们对制定根除感染者体内艾滋病毒-1的战略产生了明显的兴趣。最近，据报道有三个病例表明，治愈HIV-1实际上是可以实现的。“柏林病人”和两名来自波士顿的患者，他们都是hiv阳性并接受了同种异体骨髓移植，似乎完全缺乏HIV-1遗传物质，抗HIV-1抗体水平也在下降。这三个人有一个共同的特征；它们是杂合的CCR5- δ 32突变（CCR5- δ 32）。CCR5基因的32个碱基对缺失影响了CCR5趋化因子受体的表达和稳定性，CCR5趋化因子受体被大多数HIV-1毒株用作进入性辅助受体。在CCR5-??中三个假定的HIV-1根除病例在HIV-1储存库和治疗策略的背景下，32个杂合子值得对这种突变进行调查。CCR5 - ? ?32个杂合子在细胞表面表达的CCR5显著减少，阻碍了嗜CCR5 (R5) HIV-1的进入。我们假设CCR5-?？由于这种缺陷，32个杂合子拥有一个更小、更不稳定的库。首先，HIV-1储存库的初始定植可能在CCR5-?？32个杂合子，由于病毒进入的限制，导致在抗逆转录病毒启动前的储存库较小。其次，在ART过程中，CCR5-?？32杂合子，由于HIV-1的细胞和组织分布偏斜，调节潜伏感染细胞的周转率，半衰期和增殖能力。这种歪斜分布可能部分是由CCR5- 1中替代HIV-1共受体使用的选择驱动的。32个杂合子，包括使用（X4）病毒富集cxcr4，该病毒优先感染表达cxcr4的细胞，如初始CD4+ T细胞。在本提案中，我们将使用系统生物学，翻译的方法来检查的大小，细胞分布和病毒的遗传组成

DESCRIPTION (provided by applicant): Although the advent of highly active antiretroviral therapy (HAART) has dramatically reduced the morbidity and mortality associated with HIV-1 infection, viral eradication is not achievable due to the persistence of latently- infected cells during treatment. Accumulating data suggest that "non-AIDS" cardiovascular, pulmonary, renal and hepatic diseases are amplified by HIV-1 infection, and even patients with viral suppression develop premature immune senescence. These realities have created a pronounced interest in developing strategies to eradicate HIV-1 in infected individuals. Recently, three cases have been reported that suggest a cure for HIV-1 may in fact be achievable. The "Berlin Patient" and two individuals from Boston, all of whom were HIV-positive and underwent allogeneic bone marrow transplantation, appear to be completely devoid of HIV-1 genetic material and exhibit waning anti-HIV-1 antibody levels. All three individuals share a common feature; they are heterozygous for the CCR5-delta 32 mutation (CCR5-?32). This 32 base pair deletion in the CCR5 gene affects the expression and stability of the CCR5 chemokine receptor which is utilized as an entry coreceptor by most HIV-1 strains. The three putative cases of HIV-1 eradication in CCR5-??32 heterozygotes warrant investigation into this mutation within the context of the HIV-1 reservoir and curative strategies. CCR5-??32 heterozygotes express significantly less CCR5 at the cell surface, impeding the entry of CCR5- tropic (R5) HIV-1. We hypothesize that CCR5-??32 heterozygotes harbor a smaller and less stable reservoir due to this deficit. Firstly, initial colonization of the HIV-1 reservoir is likely impeded in CCR5-??32 heterozygotes due to restriction of viral entry, resulting in a smaller reservoir before ART initiation. Secondly, the decay of the reservoir during ART may be accelerated in CCR5-??32 heterozygotes due to skewed cellular and tissue distribution of HIV-1, modulating the turnover rate, half-life and proliferative capacity of latently infected cells. This skewed distribution maybe driven in part by selection for alternative HIV-1 coreceptor usage in CCR5-??32 heterozygotes, including enrichment of CXCR4-using (X4) viruses which preferentially infect CXCR4-expressing cells such as naive CD4+ T cells. In this proposal, we will use a systems biology, translational approach to examine the size, cellular distribution, and viral genetic composition of the HIV-1 reservoir in the blood and lymphoid tissues of HIV-1-infected CCR5-??32 heterozygotes and case-matched CCR5 wildtype individuals. This study should yield valuable insights into the cellular and molecular determinants of HIV-1 persistence and eradication.