Priscilla Biswas

Monocyte-derived macrophages and myeloid cell lines as targets of HIV-1 replication and persistence

HIV infection of mononuclear phagocytes (MP), mostly as tissue macrophages, is a dominant feature in the pathogenesis of HIV disease and its progression to AIDS. Although the general mechanism of infection is not dissimilar to that of CD4+ T lymphocytes occurring via interaction of the viral envelope with CD4 and a chemokine receptor (usually CCR5), other features are peculiar to MP infection. Among others, the long‐term persistence of productive infection, sustained by the absence of substantial cell death, and the capacity of the virions to bud and accumulate in intracellular multivescicular bodies (MVB), has conferred to MP the role of “Trojan horses” perpetuating the chronic state of infection. Because the investigation of tissue macrophages is often very difficult for both ethical and practical reasons of accessibility, most studies of in vitro infection rely upon monocyte‐derived macrophages (MDM), a methodology hampered by inter‐patient variability and lack of uniformity of experimental protocols. A number of cell lines, mostly Mono Mac, THP‐1, U937, HL‐60, and their derivative chronically infected counterparts (such as U1 and OM‐10.1 cell lines) have complemented the MDM system of infection providing useful information on the features of HIV replication in MP. This article describes and compares the most salient features of these different cellular models of MP infection by HIV.

Interferons in the pathogenesis and treatment of human immunodeficiency virus infection

There still remains several unanswered questions concerning the pathogenesis of human immunodeficiency virus (HIV) infection. Interferons (IFNs), as well as other cytokines, are both dysregulated in HIV infection and serve as effector molecules that modulate the replicative capacity of HIV. Acid-labile IFN-alpha, an aberrant form of interferon earlier described in certain autoimmune diseases, has been detected in HIV-infected individuals. Conversely, a deficient expression of IFN-alpha may occur usually associated with HIV disease. Although conflicting findings have been reported on whether IFN-gamma, a product of activated T and natural killer (NK) cells, is elevated in the peripheral blood (PB) compartment, high levels of its expression have been observed in the germinal centers of the lymph nodes during HIV disease. IFN-alpha and IFN-beta have shown potent anti-retroviral effects in several in vitro systems of both acute and chronic HIV infection. These findings have served as the basis of the rationale for their therapeutic application, resulting in some positive effects at least in those patients with relatively high CD4+ T cell counts and healthy immune functions. Furthermore, IFN-alpha has shown important therapeutic effects on HIV-associated Kaposis sarcoma (KS). Both suppressive and inductive effects on HIV replication in vitro have been described for IFN-gamma, whereas no clear clinical benefits have been reported following its administration to HIV-infected individuals. In conclusion, IFNs are involved in several pathogenic aspects of HIV infection and AIDS, and certain IFNs may serve as important tools to limit the spread of the virus and the progression of disease.

Role of pro-inflammatory cytokines and beta-chemokines in controlling HIV replication.

Several members of the cytokine network play an important role in controlling the replication of the human immunodeficiency virus (HIV) in several experimental systems. Their effects can be categorized in the following three functional groups: (1) HIV‐inductive cytokines; (2) HIV‐suppressive cytokines; (3) cytokines with both activating and inhibiting capacities. Studies on the mechanism of action of these molecules have highlighted the fact that several steps of the retrovirus life cycle, from binding to budding of progeny virions from the infected cell, are affected by cytokines. This general concept has been recently substantiated by the discovery that certain β‐chemokines can act as blockers of viral entry by interfering with HIV coreceptors. Finally, it is important to recognize that cytokines have gone beyond their role as potential pathogenetic or protective endogenous cofactors in HIV replication and disease progression, and are becoming experimental therapeutic agents for HIV disease, best illustrated thus far by the case of interleukin‐2. J. Leukoc. Biol. 62: 34–40; 1997.

The appealing story of HIV entry inhibitors : from discovery of biological mechanisms to drug development.

Current therapeutic intervention in HIV infection relies upon 20 different drugs. Despite the impressive efficacy shown by these drugs, we are confronted with an unexpected frequency of adverse effects, such as mitochondrial toxicity and lipodystrophy, and resistance, not only to individual drugs but to entire drug classes.Thus, there is now a great need for new antiretroviral drugs with reduced toxicity, increased activity against drug-resistant viruses and a greater capacity to reach tissue sanctuaries of the virus. Two different HIV molecules have been selected as targets of drug inhibition so far: reverse transcriptase and protease. Drugs that target the interactions between the HIV envelope and the cellular receptor complex are a ‘new entry’ into the scenario of HIV therapy and have recently raised great interest because of their activity against multidrug-resistant viruses.There are several compounds that are at different developmental stages in the pipeline to counter HIV entry, among them: (i) the attachment inhibitor dextrin-2-sulfate; (ii) the inhibitors of the glycoprotein (gp) 120/CD4 interaction PRO 542, TNX 355 and BMS 488043; (iii) the co-receptor inhibitors subdivided in those targeting CCR5 (SCH 417690 [SCHD], UK 427857 GW 873140, PRO 140, TAK 220, AMD 887) and those targeting CXCR4 (AMD 070, KRH 2731); and (iv) the fusion inhibitors enfuvirtide (T-20) and tifuvirtide (T-1249).The story of the first of these drugs, enfuvirtide, which has successfully completed phase III clinical trials, has been approved by the US FDA and by the European Medicines Agency, and is now commercially available worldwide, is an example of how the knowledge of basic molecular mechanisms can rapidly translate into the development of clinically effective molecules.

Access denied? The status of co-receptor inhibition to counter HIV entry.

As resistance and long-term metabolic abnormalities hamper the efficacy of previous drugs against HIV-1, targeting of HIV co-receptors represents an exciting new frontier for antiretroviral therapeutics. CCR5 inhibitors are most likely to be the new available drugs within the class of entry inhibitors. This paper reviews the most recent clinical data available on the small-molecule compounds vicriviroc and maraviroc and on the antibodies PRO 140 and CCR5mAb004, as well as some novel genetic approaches. A thorough overview of the many challenges, past, present and future, that CCR5 inhibitors encounter during their development pathway is then presented. Possible immunologic consequences are also discussed. It could be foreseen that the benefit for HIV-infected individuals derived by the use of these potential novel drugs will outweigh the costs/risks intrinsically present in every new therapeutic approach.

Identification of the platelet-derived chemokine CXCL4/PF-4 as a broad-spectrum HIV-1 inhibitor.

The natural history of HIV-1 infection is highly variable in different individuals, spanning from a rapidly progressive course to a long-term asymptomatic infection. A major determinant of the pace of disease progression is the in vivo level of HIV-1 replication, which is regulated by a complex network of cytokines and chemokines expressed by immune and inflammatory cells. The chemokine system is critically involved in the control of HIV-1 replication by virtue of the role played by specific chemokine receptors, most notably CCR5 and CXCR4, as cell-surface coreceptors for HIV-1 entry; hence, the chemokines that naturally bind such coreceptors act as endogenous inhibitors of HIV-1. Here, we show that the CXC chemokine CXCL4 (PF-4), the most abundant protein contained within the α-granules of platelets, is a broad-spectrum inhibitor of HIV-1 infection. Unlike other known HIV-suppressive chemokines, CXCL4 inhibits infection by the majority of primary HIV-1 isolates regardless of their coreceptor-usage phenotype or genetic subtype. Consistent with the lack of viral phenotype specificity, blockade of HIV-1 infection occurs at the level of virus attachment and entry via a unique mechanism that involves direct interaction of CXCL4 with the major viral envelope glycoprotein, gp120. The binding site for CXCL4 was mapped to a region of the gp120 outer domain proximal to the CD4-binding site. The identification of a platelet-derived chemokine as an endogenous antiviral factor may have relevance for the pathogenesis and treatment of HIV-1 infection.

Engagement of CD30 shapes the secretion of cytokines by human γ δ T cells

CD30 is a member of the TNF receptor superfamily, previously shown to be expressed on Hodgkins lymphoma cells and on normal activated lymphocytes. We here show that CD30 is highly expressed on recently activated human γ δ T cells. Elevated surface levels of this molecule persisted in long‐term cultures of γ δ cells, without further cell stimulation. CD30 acted as a co‐stimulus in γ δ T cells by potentiating the intracellular Ca2+ fluxes induced by CD3 cross‐linking. The engagement of CD30 enhanced the expression of several cytokines induced upon CD3 stimulation such as IL‐4 and IFN‐γ but not IL‐10. The CC chemokines RANTES and macrophage inflammatory protein‐1β were constitutively expressed and not affected by stimulation. The inducible expression of the neutrophil chemoattractant IL‐8 was enhanced by CD30 co‐stimulation, as well as that of the CC chemokines I‐309 and MDC, whereas the secretion of the monocyte chemotactic protein‐1 was not detected. Triggering of CD30 may therefore modulate the expression of several cytokines released by γ δ cells; the expression of its physiologic ligand by APC and neutrophils at the site of infection may contribute to determine the outcome of an immune response.

The Binding Subunit of Pertussis Toxin Inhibits HIV Replication in Human Macrophages and Virus Expression in Chronically Infected Promonocytic U1 Cells

We have recently shown that the binding subunit of pertussis toxin (PTX-B) inhibits the entry and replication of macrophage-tropic (R5) HIV-1 strains in activated primary T lymphocytes. Furthermore, PTX-B suppressed the replication of T cell-tropic (X4) viruses at a postentry level in the same cells. In this study we demonstrate that PTX-B profoundly impairs entry and replication of the HIV-1ADA (R5), as well as of HIV pseudotyped with either murine leukemia virus or vesicular stomatitis virus envelopes, in primary monocyte-derived macrophages. In addition, PTX-B strongly inhibited X4 HIV-1 replication in U937 promonocytic cells and virus expression in the U937-derived chronically infected U1 cell line stimulated with cytokines such as TNF-α and IL-6. Of interest, TNF-α-mediated activation of the cellular transcription factor NF-κB was unaffected by PTX-B. Therefore, PTX-B may represent a novel and potent inhibitor of HIV-1 replication to be tested for efficacy in infected individuals. In support of this proposition, a genetically modified mutant of PTX (PT-9K/129G), which is safely administered for prevention of Bordetella pertussis infection, showed an in vitro anti-HIV profile superimposable to that of PTX-B.

The intracellular detection of MIP-1beta enhances the capacity to detect IFN-gamma mediated HIV-1-specific CD8 T-cell responses in a flow cytometric setting providing a sensitive alternative to the ELISPOT.

BackgroundT-cell mediated immunity likely plays an important role in controlling HIV-1 infection and progression to AIDS. Several candidate vaccines against HIV-1 aim at stimulating cellular immune responses, either alone or together with the induction of neutralizing antibodies, and assays able to measure CD8 and CD4 T-cell responses need to be implemented. At present, the IFN-γ-based ELISPOT assay is considered the gold standard and it is broadly preferred as primary assay for detection of antigen-specific T-cell responses in vaccine trials. However, in spite of its high sensitivity, the measurement of the sole IFN-γ production provides limited information on the quality of the immune response. On the other hand, the introduction of polychromatic flow-cytometry-based assays such as the intracellular cytokine staining (ICS) strongly improved the capacity to detect several markers on a single cell level.ResultsThe cumulative analysis of 275 samples from 31 different HIV-1 infected individuals using an ICS staining procedure optimized by our laboratories revealed that, following antigenic stimulation, IFN-γ producing T-cells were also producing MIP-1β whereas T-cells characterized by the sole production of IFN-γ were rare. Since the analysis of the combination of two functions decreases the background and the measurement of the IFN-γ+ MIP-1β+ T-cells was equivalent to the measurement of the total IFN-γ+ T-cells, we adopted the IFN-γ+ MIP-1β+ data analysis system to evaluate IFN-γ-based, antigen-specific T-cell responses. Comparison of our ICS assay with ELISPOT assays performed in two different experienced laboratories demonstrated that the IFN-γ+ MIP-1β+ data analysis system increased the sensitivity of the ICS up to levels comparable to the sensitivity of the ELISPOT assay.ConclusionThe IFN-γ+ MIP-1β+ data evaluation system provides a clear advantage for the detection of low magnitude HIV-1-specific responses. These results are important to guide the choice for suitable highly sensitive immune assays and to build reagent panels able to accurately characterize the phenotype and function of responding T-cells. More importantly, the ICS assay can be used as primary assay to evaluate HIV-1-specific responses without losing sensitivity in comparison to the ELISPOT assay.

Skewing of cytotoxic activity and chemokine production, but not of chemokine receptor expression, in human type-1/-2 γ δ T lymphocytes

Human Vγ9/Vδ2+ T lymphocytes participate in the immune response against intracellular pathogens through the secretion of type‐1 cytokines and chemokines and by killing of infected cells. Little is known of the effects by type‐2 differentiation of γ δ cells on these functions. Here, we report that bona fide naive cord blood‐derived γ δ lymphocytesexpanded in vitro with the mycobacterial antigen isopentenyl pyrophosphate (IPP) can be differentiated as either type‐1 or type‐2 cells, in the presence of an appropriate cytokine milieu. Instead, peripheral γ δ cells from PPD‐negative healthy adults displayed a type‐1 cytokine profile, i.e. IPP‐stimulated secretion of IFN‐γ, but not of IL‐4 and IL‐10. Moreover, they released the macrophage inflammatory protein (MIP)‐1β, but not IL‐8 nor the Th2 chemoattractants I‐309 and TARC (thymus and activation‐regulated chemokine). This cytokine profile was not significantly affected by in vitro culture in Th2 polarizing conditions. Only in one case out of seven were peripheral γ δ cells fully differentiated to type‐2 lymphocytes, characterized by sustained IL‐4 and IL‐10 production, along with secretion of substantial amounts of IL‐8, I‐309 and TARC. Type‐2 γ δ T lymphocytes preferentially expressed the co‐stimulatory molecule CD30; conversely, no skewing in chemokine receptor expression was observed. Both polarized populations displayed high levels of CXCR3 in the absence of CCR3, CCR4 and CCR5. Finally, type‐1, but not type‐2, γ δ T lymphocytes killed IPP‐pulsed U937 cells and displayed elevated perforin content. Overall, our data suggest that type‐2 differentiation of γ δ T lymphocytes profoundly affects both their effector functions and their potential to recruit the appropriate leukocyte subsets to the sites of inflammation.