Induction of autophagy to enhance CAR-T cells in HIV cure approaches

摘要 嵌合抗原受体(CAR)T细胞是一种很有前途的免疫治疗方法 HIV-1感染。然而，CAR-T细胞也会受到以下因素的影响：免疫功能障碍/衰竭 慢性艾滋病毒感染期间的持续性炎症。预防耗尽/恢复反兴奋剂功能的策略 HIV CAR-T细胞是最终实现HIV功能性治愈的关键。我们的初步研究表明 自噬诱导可改善线粒体功能，促进CAR-T细胞毒性T细胞 体外活性。重要的是，我们发现诱导自噬可以防止过量的干扰素-I信号和 自噬诱导剂雷帕霉素对慢性HIV感染人源化小鼠的体内治疗作用 炎症，恢复耗尽的抗病毒T细胞功能，并减少病毒载量。另外，我们发现， 自噬诱导剂，如雷帕霉素，可通过PKC激活剂bryostatin-1有效逆转HIV-1潜伏期 同时降低T细胞活化相关的免疫毒性。因此，我们假设自噬 诱导可通过提高存活率、持久性和功能来加强对HIV的治疗方法 通过PKC调节剂有效和安全地逆转潜伏期。我们将利用 我们用抗HIV CD4CAR T细胞构建的人源化小鼠模型来研究 自噬诱导对HIV‘先踢后杀’疗法的治疗潜力。我们的研究还将提供 CAR-T细胞免疫衰竭和自噬调节机制的研究进展 因此，它将产生广泛的影响，超出艾滋病毒治愈研究的范畴。

ABSTRACT Chimeric Antigen Receptor (CAR) T-cells have emerged as a promising immunotherapy in controlling HIV-1 infection. However, CAR-T cells are also subject to immune dysfunction/exhaustion mediated by persistent inflammation during chronic HIV infection. Strategies to prevent exhaustion/restore functions of anti- HIV CAR-T cell are critical for ultimately achieving HIV functional cure. Our preliminary studies have showed that autophagy induction can improve mitochondria function and promote CAR-T cell cytotoxic T lymphocyte activity in vitro. Importantly, we found that induction of autophagy can prevent excessive IFN-I signaling and in vivo treatment with autophagy inducer rapamycin in chronically HIV infected humanized mice can decrease inflammation, restore exhausted anti-viral T cell function, and reduce viral loads. In addition, we found that autophagy inducers such as rapamycin allow efficient HIV-1 latency reversal by PKC activator bryostatin-1 while reducing T cell activation associated immune toxicity. Therefore, we hypothesize that autophagy induction can enhance ‘kick and kill’ HIV cure approaches by improving the survival, persistence and function of anti-HIV CAR-T cells and facilitating effective and safe latency reversal by PKC modulators. We will utilize our well-established humanized mouse model engineered with anti-HIV CD4CAR T cells to investigate the therapeutic potentials of autophagy induction for HIV ‘kick and kill’ cure approaches. Our study will also provide mechanistic insights into the development of immune exhaustion and autophagy’s regulation of CAR-T cell function and will thus have a wide impact beyond HIV cure research.