Multi-OMICS identification and validation of mechanisms triggered by Immune interventions aimed at reducing the size of the replication competent Reservoir

尽管抗逆转录病毒（ART）药物有效地控制了血浆病毒血症，但HIV潜伏感染细胞库 形成一个持久的水库，防止清除病毒感染的细胞。在停止ART治疗后， 即使在急性感染期间早期开始ART，这种储存器也会导致血浆病毒血症的快速反弹。 根除或永久性地沉默这一储存库是许多艾滋病毒治疗策略的重点。免疫功能障碍 包括受损的T细胞反应是HIV疾病的标志。免疫导向治疗策略寻求 克服这种失调以恢复正常的免疫功能并促进杀死HIV感染的细胞。的 迄今为止，基于免疫的治疗策略的有限临床疗效表明， 免疫功能比靶向T和B细胞。我们假设，激活和 恢复正常的先天和适应性免疫功能将更有效地减少艾滋病毒储存库， 为了验证这一假设，我们将采用一种扩展的多Omic 该平台由病毒学、免疫学和分子测定组成，以确定同时再感染的作用。 通过3种不同的治疗策略对HIV储库动力学的先天性和适应性免疫系统的激活 第一个策略（项目1）将研究联合治疗与抗逆转录病毒治疗（ART） Lefitolimod（先天免疫TLR 9激动剂）和广泛中和抗体促进HIV清除 通过引发先天免疫应答并使用Fc- 介导的先天免疫效应子功能。第二个战略（项目2）将测试如何封锁PD- 1/PD-L1信号传导轴通过单克隆抗体治疗导致炎性单核细胞/巨噬细胞增强 恢复CD 4和CD 8 T细胞功能。第三项战略（项目3）将研究如何植入 用表达CCR 5D32突变的同种异体造血干细胞或自体输注CCR 5 缺失的CD 4 + T细胞用HIV难治的功能性效应细胞重新填充免疫区室 感染导致杀死HIV宿主和缺乏病毒反弹。对于所有项目，我们将定义如何 由宿主和微生物代谢产物引起的宿主环境的差异调节了免疫调节。 确定的介导HIV储库清除和/或限制病毒反弹的机制。结果分析 将由专门的机器学习和建模核心执行。这个核心最终将负责 用于生成预测微生物组/代谢物特征的集成多Omic网络模型， 直接调节与减少HIV储库或病毒反弹相关的免疫机制; 在每个群组/项目内和跨项目，以确定多个战略的共同特征。我们的团队 的专家进行了广泛的合作，并处于独特的地位，以完成这一计划的目标。

In spite of antiretroviral (ART) drugs which effectively control plasma viremia, a pool of HIV latently infected cells form a persistent reservoir that prevents clearance of virally infected cells. Upon cessation of ART treatment, this reservoir leads to a rapid rebound in plasma viremia, even if ART is initiated early during acute infection. Eradicating or permanently silencing this reservoir is the focus of many HIV cure strategies. Immune dysfunction including impaired T cell responses are a hallmark of HIV disease. Immune directed cure strategies seek to overcome this dysregulation to restore normal immune function and promote killing of HIV infected cells. The limited clinical efficacy of immune-based cure strategies to date suggests that there may be more to restoring immune function than targeting T and B cells. We hypothesize that cure strategies which activate and restore normal innate and adaptive immune function will more effectively reduce the HIV reservoir and limit viral rebound after cessation of ART. To test this hypothesis, we will employ an expansive multi-Omic platform consisting of virological, immunological and molecular assays to define the role of simultaneous re- invigoration of the innate and adaptive immune systems by 3 distinct cure strategies on HIV reservoir dynamics and viral rebound after discontinuing ART. The first strategy (Project 1) will investigate how co-treatment with Lefitolimod (innate immune TLR9 agonist) and broadly neutralizing antibodies promotes clearance of the HIV reservoir by priming innate immune responses and providing the antibodies to target infected cells using Fc- mediated innate immune effector functions. The second strategy (Project 2) will test how blockade of the PD- 1/PD-L1 signaling axis by monoclonal antibody therapy leads to enhanced inflammatory monocyte/macrophage responses and restored CD4 and CD8 T cell function. The third strategy (Project 3) will study how engraftment with allogeneic hematopoietic stem cells expressing the CCR5D32 mutation or autologous infusion of CCR5 deleted CD4+ T cells repopulate the immune compartment with functional effector cells that are refractory to HIV infection leading to killing of the HIV reservoir and a lack of viral rebound. For all Projects, we will define how differences in the host environment resulting from host and microbial metabolites modulate the immunological mechanisms identified to mediate clearance of the HIV reservoir and/or limit viral rebound. Analysis of results will be performed by a dedicated Machine Learning and Modeling Core. This core will ultimately be responsible for generating integrated multi-Omic network models which predict the microbiome/metabolite features which directly regulate the immune mechanisms associated with reduction in either the HIV reservoir or viral rebound; both within each cohort/Project and across Projects to identify common features to multiple strategies. Our team of experts have collaborated extensively and are uniquely positioned to complete the goals of this program.