Determining the relative contribution of CD4 T cells and macrophages to HIV persistence and rebound

确定 CD4 T 细胞和巨噬细胞对 HIV 持续存在和反弹的相对贡献

• 批准号: 10082887
• 负责人: JACOB D ESTES
• 金额: $ 80.53万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10082887
• 关键词: Achievement; Acquired Immunodeficiency Syndrome; Address; Adherence; Age; Anatomy; Autopsy; Biological Markers; Blood; Brain; CCR5 gene; CD4 Positive T Lymphocytes; CXCR4 gene; Cell physiology; Cells; Clinical Trials; Collection; Controlled Study; Cues; DNA; Data; Detection; Development; Disease Progression; Disease remission; Enrollment; Equilibrium; Fingerprint; Genetic Fingerprintings; Goals; HIV; HIV Infections; In Vitro; Individual; Infection; Inflammation; Interruption; Intervention; Kinetics; Location; Longevity; Macaca mulatta; Mediating; Modeling; Nature; Neuraxis; Neuropathogenesis; Phagocytosis; Primates; Recording of previous events; Regimen; Research; Research Personnel; Residual state; Resistance; Rest; Role; SIV; Specimen; T-Cell Depletion; Time; Tissues; Variant; Viral; Viral Genome; Viral Load result; Viral reservoir; Virion; Virus; Virus Latency; Virus Replication; Work; animal resource; antiretroviral therapy; brain tissue; clinically relevant; cost; design; in vivo; insight; macrophage; memory CD4 T lymphocyte; multidisciplinary; novel; novel strategies; novel therapeutics; peer; side effect; social stigma; success; synergism; viral DNA; viral RNA; viral rebound

Abstract Despite its success at suppressing viral loads, antiretroviral therapy (ART) cannot eradicate HIV infection. The main obstacle to curing HIV infection is the ability of the virus to persist under suppressive ART in reservoirs of latently infected cells, which are established early after infection and supports rebound to pre-treatment levels if ART is interrupted. Despite the extraordinary challenge of persistent virus reservoirs, a few cases have recently proved that prolonged viral remission after analytical therapy interruption (ATI) is possible. Unfortunately, the specific mechanisms regulating HIV rebound remain very poorly understood, thus critically limiting the development of novel therapeutic strategies aimed at eradication or remission of HIV infection. In this project, we have assembled a multidisciplinary team of investigators to address directly in vivo how the size and relative distribution of the reservoir in CD4 T cells and macrophages govern (i) the anatomic location of persistent viral reservoirs; (ii) the exent of residual inflammation and neuropathogenesis; and (iii) the time and extent of viral rebound after ATI. Specifically, we propose to alter directly in vivo and in a highly relevant model for HIV infection (i.e., the SIV infection of rhesus macaques; RMs) the overall size of virus reservoirs and its distribution between CD4 T cells and macrophages. These goals will be achieved (i) by using the well-established model of ART-treated, SIV-infected RMs; (ii) by using a SIV swarm that allows tracking of multiple viral variants; and (iii) by performing in vivo Ab-mediated CD4 T cell depletion before SIV infection and after SIV-infection during suppressive ART. We will determine how the planned in vivo depleting interventions alter the distribution of viral reservoirs between CD4 T cells and macrophages; impact the kinetics and extent of viral rebound following ATI; and influence the cellular nature and genetic fingerprinting of the rebounding virus. Finally, we will investigate the mechanisms favoring SIV infection and persistence in macrophages when CD4 T cells are depleted. We believe that the complementary, comprehensive, highly synergistic, and rigourosly controlled studies that we propose will provide unprecedented, novel insights into (i) understanding how the cellular nature of the viral reservoir regulate residual inflammation and viral persistence on ART and viral rebound after ATI, and (2) the direct role of macrophages in harboring replication competent virus during long-term ART and contributing to viral rebound after ATI. Critical for our aims, the SIV/RM model allows for investigating the CD4 T cells versus macrophages contribution to viral reservoir not only in blood, but also in a large number of tissues collected longitudinally and at necropsy, including CSF and brain tissues. These achievements will inform efforts to design novel therapeutic strategies aimed at achieving prolonged viral remission of HIV infection.

摘要 尽管抗逆转录病毒疗法(ART)在抑制病毒载量方面取得了成功，但它不能根除艾滋病毒感染。这个 治愈艾滋病毒感染的主要障碍是病毒在抑制技术的作用下在 潜伏感染细胞，在感染后早期建立，支持反弹到治疗前的水平 如果艺术被打断。尽管持久性病毒库面临着非同寻常的挑战，但仍有少数病例 最近证明，分析治疗中断(ATI)后病毒长期缓解是可能的。 不幸的是，调控艾滋病毒反弹的具体机制仍然知之甚少，因此至关重要 限制旨在根除或缓解艾滋病毒感染的新治疗策略的开发。在……里面 在这个项目中，我们已经组建了一个多学科的研究团队，直接在体内解决如何 CD4T细胞和巨噬细胞内贮存库的大小和相对分布决定了(I)解剖 持续病毒库的位置；(Ii)存在残余炎症和神经发病； 以及(Iii)ATI后病毒反弹的时间和程度。具体地说，我们建议在体内直接改变和 在一个与艾滋病毒感染高度相关的模型中(即恒河猴的SIV感染；RMS)， 病毒库及其在CD4T细胞和巨噬细胞间的分布这些目标将通过以下方式实现： 使用经过ART治疗的、感染SIV的RMS的良好模型；(Ii)通过使用SIV群来允许 跟踪多种病毒变体；以及(Iii)在SIV之前进行体内抗体介导的CD4T细胞耗尽 在抑制ART期间感染和SIV感染后。我们将确定计划中的体内消耗如何 干预改变了CD4T细胞和巨噬细胞之间的病毒库分布；影响 ATI后病毒反弹的动力学和程度；并影响ATI的细胞性质和遗传指纹 反弹病毒。最后，我们将探讨SIV感染和持续存在的机制。 当CD4T细胞耗尽时，巨噬细胞。 我们认为，补充、全面、高度协同和严格控制的研究 我们提出将提供前所未有的、新颖的见解来(I)理解病毒的细胞性质 水库调节ART后的残余炎症和病毒持久性以及ATI后的病毒反弹，以及(2) 巨噬细胞在长期抗逆转录病毒治疗中对携带复制能力病毒的直接作用 ATI后病毒反弹。对我们的目标至关重要的是，SIV/RM模型允许研究CD4T细胞与 巨噬细胞不仅在血液中，而且在收集的大量组织中也为病毒库做出了贡献 纵向和尸检，包括脑脊液和脑组织。这些成就将为以下努力提供信息 设计新的治疗策略，旨在实现艾滋病毒感染的长期病毒缓解。