Macaques Vaccinated with Simian Immunodeficiency Virus SIVmac239Δnef Delay Acquisition and Control Replication after Repeated Low-Dose Heterologous SIV Challenge

An effective human immunodeficiency virus (HIV) vaccine will likely need to reduce mucosal transmission and, if infection occurs, control virus replication. To determine whether our best simian immunodeficiency virus (SIV) vaccine can achieve these lofty goals, we vaccinated eight Indian rhesus macaques with SIVmac239Δnef and challenged them intrarectally (i.r.) with repeated low doses of the pathogenic heterologous swarm isolate SIVsmE660. We detected a significant reduction in acquisition of SIVsmE660 in comparison to that for naïve controls (log rank test; P = 0.023). After 10 mucosal challenges, we detected replication of the challenge strain in only five of the eight vaccinated animals. In contrast, seven of the eight control animals became infected with SIVsmE660 after these 10 challenges. Additionally, the SIVsmE660-infected vaccinated animals controlled peak acute virus replication significantly better than did the naïve controls (Mann-Whitney U test; P = 0.038). Four of the five SIVsmE660 vaccinees rapidly brought virus replication under control by week 4 postinfection. Unfortunately, two of these four vaccinated animals lost control of virus replication during the chronic phase of infection. Bulk sequence analysis of the circulating viruses in these animals indicated that recombination had occurred between the vaccine and challenge strains and likely contributed to the increased virus replication in these animals. Overall, our results suggest that a well-designed HIV vaccine might both reduce the rate of acquisition and control viral replication.The goals of any human immunodeficiency virus (HIV) vaccine are both to prevent infection and, if infection occurs, to control virus replication. If vaccinated individuals who become infected are able to reduce virus replication to extremely low or undetectable levels, they will live longer, healthier lives and will be less likely to transmit the virus to others (7, 16, 41). An HIV vaccine that successfully meets these two goals will therefore have a significant impact on slowing the spread of HIV (3).Live-attenuated simian immunodeficiency virus (SIV) vaccines have proven to be universally effective at protecting macaques against homologous virus challenges, regardless of the route of transmission (10, 21, 33, 36, 50, 51). For this reason, live-attenuated SIV vaccines are considered the “gold standard” of protection in the SIV/rhesus macaque model of HIV infection (25). Previously, we and others showed that SIVmac239Δnef-vaccinated animals can reduce plasma virus replication after intravenous (i.v.) inoculation with the uncloned heterologous swarm virus SIVsmE660 (43, 50). This vaccine-induced effect was most pronounced, particularly during acute infection, in animals expressing major histocompatibility complex (MHC) class I alleles (Mamu-A*01, -B*08, and -B*17) previously associated with control of pathogenic SIVmac239 replication (29, 38, 43, 52, 54). Despite these encouraging results for this subset of animals, and in contrast to previous studies using homologous virus challenges, most of the vaccinated animals failed to maintain control of virus replication of the challenge strain during the chronic phase of infection.There are several potential explanations for why SIVmac239Δnef vaccination was not as effective against i.v. exposure to the heterologous challenge virus (1, 43, 50). First, sequence variation between the vaccine and infecting strains may have rendered the vaccine-induced immune responses ineffective at controlling chronic-phase virus replication. Second, unlike the case in homologous SIVmac239 challenge studies using cloned viral stocks, the heterologous SIVsmE660 isolate contains many quasispecies within the inoculum (23, 49). Third, the heterologous challenges were administered i.v., thereby bypassing any potentially protective vaccine-induced immune responses at mucosal surfaces. All of the SIVsmE660 quasispecies in the inoculum therefore had the potential to infect cells and to establish a reservoir of viral diversity. This broad spectrum of viral diversity may have contributed to the decreased efficacy of SIVmac239Δnef-induced immune responses in protecting against heterologous virus replication after a high-dose i.v. challenge.Since a large i.v. dose of multiple quasispecies of heterologous virus might overwhelm any potentially protective vaccine-induced immune responses, we tested the possibility that SIVmac239Δnef vaccination may be more efficacious against a more physiologically relevant low-dose challenge. In the SIV/rhesus macaque model of HIV infection, repeated low doses of pathogenic SIV more accurately reflect human sexual transmission than a single high-dose i.v. challenge does (32). Keele et al. recently established that one to three virus strains typically cross mucosal barriers to establish HIV infections (22). We and others observed similar results using repeated-dose mucosal challenge of macaques (23, 49). This model therefore facilitates the testing of vaccines in a more physiologically relevant manner.     

Multi-Low-Dose Mucosal Simian Immunodeficiency Virus SIVmac239 Challenge of Cynomolgus Macaques Immunized with “Hyperattenuated” SIV Constructs

Hyperattenuated simian immunodeficiency virus SIVmac239-derived constructs Δ5-CMV and Δ6-CCI are an effort to render SIV incapable of, in practical terms, both reversion and recombination while maintaining the immune features of SIV as a retrovirus. Primary inoculation of cynomolgus macaques with 10⁸ 50% tissue culture infective doses (TCID₅₀) of Δ5-CMV or Δ6-CCI induced low-level humoral and cellular responses detectable in the absence of measureable in vivo replication. The first of three DNA boosts resulted in elevated gamma interferon (IFN-γ) enzyme-linked immunospot (ELISPOT) responses to Gag, Pol, and Env in the Δ5-CMV vaccine group compared to the Δ6-CCI vaccine group (P = 0.001). Weekly intrarectal challenge with a low dose of SIVmac239 followed by a dose escalation was conducted until all animals became infected. The mean peak viral load of the Δ5-CMV-vaccinated animals (3.7 × 10⁵ copies/ml) was ∼1 log unit lower than that of the control animals. More dramatically, the viral load set point of these animals was decreased by 3 log units compared to that of the controls (<50 versus 1.64 × 10⁴ copies/ml; P < 0.0001). Seventy-five percent (6/8) of vaccine recipients controlled virus below 1,000 copies/ml for at least 6 months, with a subset controlling virus and maintaining substantial CD4 T-cell counts for close to 2 years of follow-up. The correlates of protection from SIV disease progression may lie in the rapidity and protective value of immune responses that occur early in primary SIV infection. Prior immunization with hyperattenuated SIVmac239, even if sterilizing immunity is not achieved, may allow a more advantageous host response.To date, the most promising approach to inducing sterilizing immunity in the macaque model has been through the use of live attenuated virus (LAV) vaccines based on simian immunodeficiency virus (SIV). A major advantage of an attenuated virus strategy for the development of a human immunodeficiency virus (HIV) vaccine is the ability of attenuated viruses to induce broad and persistent immunity (29, 51). In particular, SIV strains engineered with deletions of nef (SIVΔnef) have afforded the most significant protection upon challenge with pathogenic SIV (13, 14, 29, 60, 65, 72). Numerous SIV-derived live attenuated vaccine models have been developed, many of which employ deletions in the viral accessory genes (3, 12, 14, 15, 25, 29, 30, 53, 64, 72). In many cases, vaccinations have been shown to substantially decrease viral burden during the acute phase of infection, maintain low to undetectable levels of virus during the chronic phase of infection, and limit the progression to AIDS. Although promising, a major caveat to the live attenuated virus vaccine approach is the potential for compensatory reversion and the observations that incompletely attenuated viruses may harbor residual pathogenicity (5, 10, 14). Even SIV constructs containing multiple deletions in nef, vpr, and the negative regulatory element (NRE) can cause AIDS-like disease in adult macaques and particularly in neonates (4, 5, 27, 53). This may be analogous to some human long-term nonprogressors infected by nef-deleted HIV variants in whom a slowly increasing viral burden has been accompanied by disease progression (22, 34, 37). Additional mutations can be engineered into vaccine vectors to generate highly attenuated viruses, but this often comes at the expense of their protective efficacy (8, 23, 30).We previously made two series of novel live attenuated SIV vaccine models (25) in which the simplified SIV constructs retain all the structural viral proteins but have inactivating mutations for all viral accessory genes. These constructs retain significant antigenicity, without the pathogenic effects associated with accessory viral factors, thus limiting or eliminating the potential for reversion (25).Whether administered parenterally or mucosally, conventional challenge trials in macaques have often utilized artificially high single-dose inocula in an effort to ensure that most, if not all, of the naive or placebo-immunized animal subjects become infected following a single exposure. The rationale for using a single massive challenge has been reconsidered in light of the possibility that vaccines with protective efficacy under physiologic challenge conditions may not identified. This practice is now being replaced by an approach designed to better approximate the relatively low in vivo acquisition rates following a single sexual exposure to HIV (21, 45, 69) and should provide a more realistic assessment of vaccine efficacy in “real-world” situations. Importantly, recent studies using this approach have demonstrated viremia of magnitude and kinetics comparable to that seen following single high-dose mucosal inocula (47), and this approach has been used successfully in more recent challenge trials (31, 70). Here we are assessing the safety, immunogenicity, and protective efficacy of two hyperattenuated SIV vaccine candidates following a multi-low-dose intrarectal challenge with highly pathogenic SIVmac239 in the cynomolgus macaque model.SIV-specific humoral immune responses were assessed at various time points postvaccination and postchallenge by Western blotting. Cellular immunogenicity was monitored by evaluation of peripheral T-cell responses (via gamma interferon [IFN-γ] enzyme-linked immunospot [ELISPOT] assay) following stimulation with peptide pools spanning the entire SIVmac239 proteome. The protective efficacy of the different vaccine candidates was assessed by classical endpoints, such as quantitative analysis of plasma viral load, quantitative immunophenotyping of lymphocytes, and clinical markers of disease progression. Even using extremely attenuated SIV constructs with only minimal evidence of replication, a modest immune response that can impact long-term disease progression is generated.     

Extralymphoid CD8+ T Cells Resident in Tissue from Simian Immunodeficiency Virus SIVmac239Δnef-Vaccinated Macaques Suppress SIVmac239 Replication Ex Vivo

Live-attenuated vaccination with simian immunodeficiency virus (SIV) SIVmac239Δnef is the most successful vaccine product tested to date in macaques. However, the mechanisms that explain the efficacy of this vaccine remain largely unknown. We utilized an ex vivo viral suppression assay to assess the quality of the immune response in SIVmac239Δnef-immunized animals. Using major histocompatibility complex-matched Mauritian cynomolgus macaques, we did not detect SIV-specific functional immune responses in the blood by gamma interferon (IFN-γ) enzyme-linked immunospot assay at select time points; however, we found that lung CD8⁺ T cells, unlike blood CD8⁺ T cells, effectively suppress virus replication by up to 80%. These results suggest that SIVmac239Δnef may be an effective vaccine because it elicits functional immunity at mucosal sites. Moreover, these results underscore the limitations of relying on immunological measurements from peripheral blood lymphocytes in studies of protective immunity to HIV/SIV.Despite over 25 years of intensive research, efforts to develop a successful prophylactic HIV vaccine have failed (6, 39). The extraordinary difficulty of developing an HIV vaccine underscores the fact that the elements comprising an effective immune response directed against HIV are poorly understood. Simian immunodeficiency virus (SIV) infection of Mauritian cynomolgus macaques (MCM) provides the best model for unraveling the correlates of protection against SIV. With SIV infection of MCM, we can select the timing, route, dose, and sequence of the infecting virus. Additionally, the limited genetic diversity of MCM facilitates selection of genetically matched individuals that can be monitored throughout the acute phase of infection and enables more frequent and invasive sampling, especially of mucosal sites.Macaques infected with live-attenuated SIV, like SIVmac239Δnef, exhibit robust protection from pathogenic SIV infection (8, 10, 20, 25, 29, 35, 40, 44, 49, 53). While previous studies have included considerable heterogeneity in the strain of attenuated SIV, challenge strain, and macaque species used, they demonstrate collectively the broad spectrum of attenuated SIVs that effectively protect macaques against pathogenic challenge. Several studies have also shown that attenuated SIV effectively protects cynomolgus macaques against pathogenic challenge using an SIVmac239C8 virus (1-3). Like SIVmac239Δnef, this virus has a deletion in the nef gene, but this deletion is a considerably smaller 12-bp deletion than the 182-bp deletion in SIVmac239Δnef (24). Importantly, there are no studies that establish the protective efficacy of SIVmac239Δnef in MCM. Nevertheless, peak SIVmac239Δnef viral loads in MCM parallel the range established in rhesus macaques, between 3.2 × 10³ and 9.4 × 10⁵ (35), but fall below peak loads established in a separate study (8). The differences observed between the rhesus macaque study and our own could be due to differences in challenge dose. Long-term control of SIVmac239Δnef in MCM is also similar to that in rhesus macaques (35). It is critical to understand why live-attenuated SIV vaccines are so effective, with the ultimate goal of using these principals to develop a vaccine that is safe for use in humans.There are several plausible explanations for why live-attenuated SIV vaccines provide effective protection against challenge with pathogenic SIV. These explanations range from viral interference to a robust vaccine-elicited immune response (19, 43, 45, 47). We currently understand several aspects of live-attenuated vaccination with SIVmac239Δnef. First, there is an inverse relationship between the degree of attenuation and the level of protection (21). This relationship suggests that vigorous viral replication is important for the generation of an effective anti-SIV immune response. Second, the greater the sequence diversity between the vaccine strain and the challenge strain, the weaker is the protection provided by the vaccine (53). This demonstrates that an adaptive immune response that recognizes similar epitopes or virus features between the vaccine and challenge strains is necessary for protection in this model. Finally, vaccination with live-attenuated SIV requires a 15- to 20-week induction phase to achieve protection in the majority of animals (8). Thus, there is a direct relationship between the time postvaccination and the degree of protection between 0 and 20 weeks postvaccination. This temporal relationship suggests that a fully developed memory response is required to protect against pathogenic SIV challenge. Together, these observations argue that SIV-specific CD8⁺ T-lymphocyte responses might be important in protection as these responses would be less useful in the setting of heterologous virus challenge and require both robust viral replication and time to develop. Such responses, however, can be weak to nonexistent in the blood of vaccinated animals and frequently do not correlate with disease progression, leading some investigators to question their importance in protective immunity (25, 29, 45, 46). We hypothesize that continued replication of live-attenuated SIV in the mucosal tissues may lead to effective, compartmentalized memory T-cell responses that are important in controlling pathogenic SIV challenge.It is possible that prophylactic mucosal immunity is required to prevent viral replication soon after SIV infection and to minimize the destruction of mucosal immune cells that occurs within the first 3 weeks of SIV infection (9, 22, 26, 30). Initial depletion of effector memory CD4⁺ T cells in the gut-associated lymphoid tissue (GALT) combined with continuous viral replication leads to prolonged immune activation, eventual depletion of central memory CD4⁺ T cells, and the development of AIDS. An effective mucosal immune response elicited by live-attenuated SIV vaccination may prevent the initial CD4⁺ T-cell depletion from the gut. Several recent studies confirm a critical protective role for CD8⁺ T cells in the genital tract after vaccination with SHIV89.6, demonstrating that a mucosal immune response is capable of protecting against or ameliorating SIV infection (14-16, 48). Another study has also demonstrated the presence of high-frequency, polyfunctional T-cell responses in the mucosal tissues of elite controllers, i.e., individuals who maintain plasma viral loads below 75 copies/ml, compared to blood from the same individual, tissues of noncontrollers, and antiretroviral drug-treated patients. This study also provides a correlation between mucosal CD8⁺ T-cell responses and HIV control (12).While studying gut mucosal tissues is clearly an important part of understanding HIV/SIV pathology, there are several challenges to this undertaking. First, accessing gut tissues requires invasive sampling procedures, which are primarily limited to biopsy or time-of-death studies. Biopsies are often limited in number throughout the life span of an animal, while routine necropsy is cost-prohibitive for macaque studies. Second, these tissues are nonsterile. The digestive tract is teeming with floras that contaminate experiments requiring long-term cell culture. Finally, biopsies of mucosal tissues yield very few cells. These low cell numbers make ex vivo experiments very difficult or impossible to perform. Investigators have developed techniques to assess gut mucosal lymphocyte function by expanding these cells in vitro under sterile conditions with antibiotics and then using them in enzyme-linked immunospot assays (ELISPOT) or intracellular cytokine secretion (ICS) assays (18, 42). However, these experiments still suffer from two problems: (i) cells are altered in vitro, which may change their functional capacity; and, (ii) these experiments still rely on indirect measures of CD8⁺ T-cell function. These difficulties have limited research on mucosal CD8⁺ T-cell immunity during SIV infection.In light of these challenges, we decided to focus on the lung mucosal tissue, using CD8⁺ T cells isolated from bronchoalveolar lavage fluid (BAL). BAL samples lung mucosa where there are a large number of resident lymphocytes that encounter respiratory pathogens. Furthermore, BAL provides a minimally invasive sampling of a mucosal tissue that can be performed frequently, and BAL harbors effector T cells similar to GALT (32). These factors make the lung an ideal site for sampling mucosal CD8⁺ T cells.We modified an ex vivo viral suppression assay that tests the ability of CD8⁺ T cells to prevent viral replication in MCM (7, 27, 28, 36, 51, 54, 55). Using this approach, we compared the suppressive capacity of CD8⁺ T cells isolated from lung and blood, and we found that CD8⁺ T cells from the lung are more effective at suppressing viral replication than CD8⁺ T cells from the blood. This assay does not manipulate lung lymphocytes in vitro and provides a direct measure of CD8⁺ T-cell function. Furthermore, our data support the idea that CD8⁺ T cells in blood and mucosal tissue are not functionally equivalent, that blood lymphocytes are not a perfect surrogate for mucosal lymphocytes, and that mucosal T cells attenuate SIV replication to a greater extent than blood T cells.     

Is the Gut the Major Source of Virus in Early Simian Immunodeficiency Virus Infection?

The acute phases of human immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV) infection are characterized by rapid and profound depletion of CD4⁺ T cells from the guts of infected individuals. The large number of CD4⁺ T cells in the gut (a large fraction of which are activated and express the HIV/SIV coreceptor CCR5), the high level of infection of these cells, and the temporal coincidence of this CD4⁺ T-cell depletion with the peak of virus in plasma in acute infection suggest that the intestinal mucosa may be the major source of virus driving the peak viral load. Here, we used data on CD4⁺ T-cell proportions in the lamina propria of the rectums of SIV-infected rhesus macaques (which progress to AIDS) and sooty mangabeys (which do not progress) to show that in both species, the depletion of CD4⁺ T cells from this mucosal site and its maximum loss rate are often observed several days before the peak in viral load, with few CD4⁺ T cells remaining in the rectum by the time of peak viral load. In contrast, the maximum loss rate of CD4⁺ T cells from bronchoalveolar lavage specimens and lymph nodes coincides with the peak in virus. Analysis of the kinetics of depletion suggests that, in both rhesus macaques and sooty mangabeys, CD4⁺ T cells in the intestinal mucosa are a highly susceptible population for infection but not a major source of plasma virus in acute SIV infection.The acute phase of human immunodeficiency virus (HIV) infection is characterized by moderate CD4⁺ T-cell depletion in blood, followed by a transient partial restoration of CD4⁺ T-cell numbers and eventually by a slow long-term CD4⁺ T-cell decline in the chronic phase that lasts for several years. Studies of CD4⁺ T-cell depletion in mucosal sites, often conducted with simian immunodeficiency virus (SIV)-infected macaques, have demonstrated that mucosal CD4⁺ T-cell depletion is more rapid and profound (3, 10, 13, 19, 21). The severe depletion of cells in the gut in early infection is thought to be driven in part by the phenotype of the cells present, which are predominantly CCR5⁺ and in general more activated than their circulating counterparts. As such, these mucosal CD4⁺ T cells are highly susceptible to productive infection with the dominant CCR5-tropic strains of HIV and SIV present in early infection (20). The rapid depletion of CD4⁺ T cells at mucosal sites is accompanied by relatively high numbers of infected cells (10, 13) and is temporally associated with the peak viral load in plasma, suggesting that the infection of mucosal CD4⁺ T cells may be responsible for the majority of virus replication occurring during acute infection (10, 15, 21, 22).The size of the CD4⁺ T-cell pool in the gut is a matter of some controversy, with estimates ranging from ∼5 to 50% of the total body pool of these cells (reviewed in reference 5). Regardless of the precise numbers, the gut (and particularly the mucosal lamina propria) contains a significant proportion of the body CD4⁺ CCR5⁺ memory T cells, which are depleted very early in infection. However, whether CD4⁺ T cells in the gut are merely a target of early infection or whether they are a major driver of early viral growth and peak viral loads in acute infection is unclear. Here we use a combination of experimental data and modeling to demonstrate that the gut is unlikely to be a major source of virus production in acute SIV infection.     

Integrin α4β7 Is Downregulated on the Surfaces of Simian Immunodeficiency Virus SIVmac239-Infected Cells

Simian immunodeficiency virus (SIV) and human immunodeficiency virus (HIV) infection results in an early and enduring depletion of intestinal CD4⁺ T cells. SIV and HIV bind integrin α4β7, thereby facilitating infection of lymphocytes that home to the gut-associated lymphoid tissue (GALT). Using an ex vivo flow cytometry assay, we found that SIVmac239-infected cells expressed significantly lower levels of integrin α4β7 than did uninfected cells. This finding suggested a potential viral effect on integrin α4β7 expression. Using an in vitro model, we confirmed that integrin α4β7 was downregulated on the surfaces of SIVmac239-infected cells. Further, modulation of integrin α4β7 was dependent on de novo synthesis of viral proteins, but neither cell death, the release of a soluble factor, nor a change in activation state was involved. Downregulation of integrin α4β7 may have an unappreciated role in the CD4 depletion of the mucosal-associated lymphoid compartments, susceptibility to superinfection, and/or immune evasion.Infection of macaques with simian immunodeficiency virus (SIV) and humans with human immunodeficiency virus (HIV), regardless of the route of transmission, results in early establishment of infection in the gut-associated lymphoid tissue (GALT) (3, 23, 25). Consequently, the CD4⁺ T cells of the GALT are depleted, and intestinal integrity is compromised (4, 21, 37). The mechanism of GALT depletion, as well as the mechanism of viral localization to the GALT, remains poorly understood.GALT localization is mediated, at least in part, by integrins, a large family of “sticky” cell surface proteins (24, 35, 36). Integrins facilitate conversation between the environment and a cell, thereby influencing cellular adhesion, trafficking, proliferation, and signaling. Consequently, numerous viruses, despite having a small number of proteins, have developed mechanisms to exploit integrins and hence cellular processes, in order to facilitate viral replication and immune evasion (17, 24, 34, 36). Examples of such viruses include human cytomegalovirus (39), rotavirus (14), and SIV/HIV (40). One well-studied integrin, α4β7, mediates migration of lymphocytes to the GALT (31, 33). In 2008, Arthos et al. demonstrated that HIV-1 glycoprotein, gp120, binds integrin α4β7, facilitating infection of CD4⁺ T cells and increasing viral replication efficiency (1).Recent in vivo studies have revealed that CD4⁺ T cells expressing high amounts of integrin α4β7 (integrin α4β7 high) are preferentially infected during acute SIV infection (15, 38). In addition, integrin α4β7 high CD4⁺ T cells contain greater than one provirus per cell during peak viral infection, suggesting that the cells are unusually susceptible to superinfection. Unexpectedly, superinfection is not observed in integrin α4β7 high CD4⁺ T cells after peak viral infection (15). Integrin α4β7 high-expressing CD4⁺ T cells are also depleted from the circulation parallel to the loss of intestinal CD4⁺ cells, suggesting a fundamental role for integrin α4β7 in SIV pathogenesis (38). The mechanism underlying the depletion of integrin α4β7 high-expressing cells and whether SIV-infected cells are directly or indirectly involved remain unknown. Thus, understanding the single-cell dynamics of integrin α4β7 during SIV infection may improve our understanding of SIV and HIV pathogenesis and clarify the role of integrin α4β7 signaling in mucosal trafficking.To examine the single-cell dynamics of integrin α4β7 expression during SIV infection, we used a novel, ex vivo, flow cytometry assay (M. Reynolds, unpublished data). We observed that infected, Gag p27⁺ cells expressed significantly (P = 0.0085) lower levels of integrin α4β7 than uninfected, CD4⁺ T cells from the same animal, at the same time point. Thus, we hypothesized that SIV decreases integrin α4β7 expression on the surfaces of virus-infected cells. In vitro, integrin α4β7 expression was downregulated on SIVmac239-infected cells as rapidly as 24 h postinfection. Unexpectedly, integrin α4β7 levels were also perturbed on uninfected cells with an increase in number of cells with intermediate integrin α4β7 expression. The modulation of integrin α4β7 was dependent on de novo synthesis of a viral protein(s), but neither cell death, release of a soluble factor, nor a change in activation state were involved. Combined, this finding suggests an as-yet-unidentified viral effect on integrin α4β7 that may influence depletion of the mucosal associated lymphoid compartments, susceptibility to superinfection, and/or immune evasion during SIV infection.     

Adoptive Transfer of Lymphocytes Isolated from Simian Immunodeficiency Virus SIVmac239Δnef-Vaccinated Macaques Does Not Affect Acute-Phase Viral Loads but May Reduce Chronic-Phase Viral Loads in Major Histocompatibility Complex-Matched Recipients

The live attenuated simian immunodeficiency virus (SIV) SIVmac239Δnef is the most effective SIV/human immunodeficiency virus (HIV) vaccine in preclinical testing. An understanding of the mechanisms responsible for protection may provide important insights for the development of HIV vaccines. Leveraging the uniquely restricted genetic diversity of Mauritian cynomolgus macaques, we performed adoptive transfers between major histocompatibility complex (MHC)-matched animals to assess the role of cellular immunity in SIVmac239Δnef protection. We vaccinated and mock vaccinated donor macaques and then harvested between 1.25 × 10⁹ and 3.0 × 10⁹ mononuclear cells from multiple tissues for transfer into 12 naive recipients, followed by challenge with pathogenic SIVmac239. Fluorescently labeled donor cells were detectable for at least 7 days posttransfer and trafficked to multiple tissues, including lung, lymph nodes, and other mucosal tissues. There was no difference between recipient macaques'' peak or postpeak plasma viral loads. A very modest difference in viral loads during the chronic phase between vaccinated animal cell recipients and mock-vaccinated animal cell recipients did not reach significance (P = 0.12). Interestingly, the SIVmac239 challenge virus accumulated escape mutations more rapidly in animals that received cells from vaccinated donors. These results may suggest that adoptive transfers influenced the course of infection despite the lack of significant differences in the viral loads among animals that received cells from vaccinated and mock-vaccinated donor animals.     

Divergent Kinetics of Proliferating T Cell Subsets in Simian Immunodeficiency Virus (SIV) Infection: SIV Eliminates the “First Responder” CD4+ T Cells in Primary Infection

Although increased lymphocyte turnover in chronic human immunodeficiency virus and simian immunodeficiency virus (SIV) infection has been reported in blood, there is little information on cell turnover in tissues, particularly in primary SIV infection. Here we examined the levels of proliferating T cell subsets in mucosal and peripheral lymphoid tissues of adult macaques throughout SIV infection. To specifically label cells in S-phase division, all animals were inoculated with bromodeoxyuridine 24 h prior to sampling. In healthy macaques, the highest levels of proliferating CD4⁺ and CD8⁺ T cells were in blood and, to a lesser extent, in spleen. Substantial percentages of proliferating cells were also found in intestinal tissues, including the jejunum, ileum, and colon, but very few proliferating cells were detected in lymph nodes (axillary and mesenteric). Moreover, essentially all proliferating T cells in uninfected animals coexpressed CD95 and many coexpressed CCR5 in the tissues examined. Confocal microscopy also demonstrated that proliferating cells were substantial viral target cells for SIV infection and viral replication. After acute SIV infection, percentages of proliferating CD4⁺ and CD8⁺ T cells were significantly higher in tissues of chronically infected macaques and macaques with AIDS than in those of the controls. Surprisingly, however, we found that proliferating CD4⁺ T cells were selectively decreased in very early infection (8 to 10 days postinoculation [dpi]). In contrast, levels of proliferating CD8⁺ T cells rapidly increased after SIV infection, peaked by 13 to 21 dpi, and thereafter remained significantly higher than those in the controls. Taken together, these findings suggest that SIV selectively infects and destroys dividing, nonspecific CD4⁺ T cells in acute infection, resulting in homeostatic changes and perhaps continuing loss of replication capacity to respond to nonspecific and, later, SIV-specific antigens.     

Evidence of Early B-Cell Dysregulation in Simian Immunodeficiency Virus Infection: Rapid Depletion of Na?ve and Memory B-Cell Subsets with Delayed Reconstitution of the Na?ve B-Cell Population

Despite eliciting a robust antibody response in humans, several studies in human immunodeficiency virus (HIV)-infected patients have demonstrated the presence of B-cell deficiencies during the chronic stage of infection. While several explanations for the HIV-induced B-cell deficit have been proposed, a clear mechanistic understanding of this loss of B-cell functionality is not known. This study utilizes simian immunodeficiency virus (SIV) infection of rhesus macaques to assess B-cell population dynamics beginning at the acute phase and continuing through the chronic phase of infection. Flow cytometric assessment demonstrated a significant early depletion of both naïve and memory B-cell subsets in the peripheral blood, with differential kinetics for recovery of these populations. Furthermore, the altered numbers of naïve and memory B-cell subsets in these animals corresponded with increased B-cell activation and altered proliferation profiles during the acute phase of infection. Finally, all animals produced high titers of antibody, demonstrating that the measurement of virus-specific antibody responses was not an accurate reflection of alterations in the B-cell compartment. These data indicate that dynamic B-cell population changes in SIV-infected macaques arise very early after infection at the precise time when an effective adaptive immune response is needed.Effective B-cell responses result in the generation of memory B-cell populations which are able to proliferate and produce antibodies that can control primary and secondary insults by microbial pathogens (2). Impaired maturation and timing of B-cell-mediated immune responses result in the production of ineffective antibodies, which are unable to control infection and may result in the persistence of the pathogen (36). Although human immunodeficiency virus (HIV) infection generally elicits high-titer antibodies, virus-specific titers do not correlate with delayed clinical progression, suggesting that antibodies produced during HIV infection are not sufficient to provide long-term viral control (6). Ineffective antibody production in the context of HIV infection could be a result of numerous T-cell and B-cell abnormalities induced either directly or indirectly through infection. B-cell perturbations, characterized during chronic infection, include hypergammaglobulinemia (11, 31), a diminished in vitro response to mitogenic stimulation (10, 37), diminished antibody responses to vaccination (15, 23), and loss of memory B-cell subsets (3, 10, 37). It is highly likely that these B-cell abnormalities are linked with the inability of HIV-infected individuals to form effective antibody responses to HIV and opportunistic pathogens.B-cell perturbations during acute HIV infection may lead to dysfunctions observed during chronic infection. Despite numerous reports that hypothesized that B-cell phenotypic and functional abnormalities arise due to the effects of chronic infection, a limited number of acute infection studies have provided evidence that B-cell dysfunctions may be initiated much earlier. Studies by De Milito et al. and others have reported a decrease in CD27⁺ B cells associated with chronic HIV infection (3, 4, 10-12, 15, 30, 31, 36-38, 40). The reduction of this population may explain the diminished antibody responses to non-HIV antigens present in HIV-infected individuals. However, the mechanism for this loss of memory B cells during chronic infection is unclear. One possibility is that B-cell losses are related to reduced T-cell numbers. In a study by Titanji et al., a strong correlation between the number of CD4 T cells and the percentage of memory B cells was reported in chronic HIV infection (37). Conversely, others have reported that no correlation was found between CD4 numbers and memory B-cell numbers (3, 10). Interestingly, reductions in percentages of B cells, increased expression of Fas on B cells, increased total plasma IgG levels, a decreased percentage of IgM memory B cells, and decreased B-cell responses to antigenic stimulation have been shown to occur within 6 months of HIV infection (36, 37). Disruption of germinal centers in the gut during acute HIV infection may also compromise the humoral immune response (20). While these studies provide insight into virus-induced changes in the B-cell compartment during infection, it is difficult to ascertain precisely when these changes occur, due to limitations in sample size and numbers during this early period of infection. The conflicting reports reflect the high amount of variability present in human HIV infection and illuminate the need for a model to study B-cell populations in which experimental parameters can be more rigorously controlled. An understanding of the effects of HIV on the B-cell population during this critical early phase of infection is needed to determine how the initial interactions between virus and host immune system set the stage for long-term disease progression in the infected host. The simian immunodeficiency virus (SIV)/macaque model provides a system in which to ask these questions.Studies in SIV-infected macaques have demonstrated that the number of total B (CD20⁺) cells in the periphery decreases dramatically during the acute phase of infection (13, 24). The loss of these cells coincides with a similar depletion of peripheral CD4 T cells and is associated with primary viremia. Interestingly, the loss of total B cells is greater in magnitude than the loss of CD4⁺ T cells (24). In order to understand how these cells are being depleted, it is necessary to characterize B-cell subsets during SIV infection in the macaque. The present study was designed to assess phenotypic changes in B-cell numbers during the acute phase of SIV infection, both in the total B-cell population as well as in B-cell subsets. Our results identified early, rapid changes in B-cell subsets that were not apparent in analysis of the total B-cell population. Specifically, we identified a significant depletion from the periphery of both the naïve (CD20⁺ CD27⁻) and memory (CD20⁺ CD27⁺) B-cell populations during acute infection and increased total B-cell population activation that may be related to ineffective antibody production commonly associated with SIV infection. Furthermore, the data demonstrate that measurement of envelope-specific antibody responses was not a sensitive reflection of SIV effects on B-cell subsets. These data provide novel information about the timing and dynamics of phenotypic changes in the B-cell compartment during SIV infection that may be associated with functional changes observed later in chronic infection. These results can be used to tailor therapeutic treatments designed to preserve the B-cell compartment early in SIV/HIV infection.     

Suppression of Transforming Growth Factor β Receptor 2 and Smad5 Is Associated with High Levels of MicroRNA miR-155 in the Oral Mucosa during Chronic Simian Immunodeficiency Virus Infection

Chronic human immunodeficiency virus and simian immunodeficiency virus (HIV and SIV) infections are characterized by mucosal inflammation in the presence of anti-inflammatory cytokines such as transforming growth factor β (TGFβ). The mechanisms for refractiveness to TGFβ are not clear. Here we show that the expression of microRNA miR-155 was significantly upregulated in the oropharyngeal mucosa during chronic SIV infection and was coincident with downregulation of TGFβ receptor 2 (TGFβ-R2) and SMAD5, key TGFβ signaling genes that harbor putative target sites for miR-155. Ectopic expression of miR-155 in vitro was found to significantly downregulate TGFβ-R2 and Smad5 expression, suggesting a role for miR-155 in the suppression of TGFβ-R2 and SMAD5 genes in vivo. The downregulation of TGFβ signaling genes by miR-155 likely contributes to the nonresponsiveness to TGFβ during SIV infection and may inadvertently aid in increased immune activation during HIV and SIV infections.     

Analysis of Minimal Functions of Simian Virus 40 III. Evidence for “Host Cell Repair” of Oncogenicity and Infectivity of UV-Irradiated Simian Virus 40

The in vitro transforming capacity of simian virus 40 (SV40) for Syrian hamster cells is highly resistant to inactivation by UV light in comparison to infectivity. In the same cell system, we demonstrated a "host cell repair mechanism" sensitive to caffeine which is, to a large extent, responsible for the high resistance to UV inactivation of the transforming capacity of SV40. The survival of infectivity of UV-irradiated SV40 in CV-1 cells was also sensitive to caffeine, again indicating host cell repair. On the other hand, depression of normal cell DNA synthesis by hydroxyurea during the first 24 h postinfection only modestly reduced, and to a similar extent, the transforming capacity of UV-irradiated and nonirradiated SV40.     

Early Pattern of Epstein-Barr Virus Infection in Gastric Epithelial Cells by “Cell-in-cell”

Epstein-Barr virus(EBV)is an important human dsDNA virus,which has been shown to be associated with several malignancies including about 10%of gastric carcinomas.How EBV enters an epithelial cell has been an interesting project for investigation."Cell-in-cell"infection was recently reported an efficient way for the entry of EBV into nasopharynx epithelial cells.The present approach was to explore the feasibility of this mode for EBV infection in gastric epithelial cells and the dynamic change of host inflammatory reaction.The EBV-positive lymphoblastic cells of Akata containing a GFP tag in the viral genome were co-cultured with the gastric epithelial cells(GES-1).The infection situation was observed under fluorescence and electron microscopies.Real-time quantitative PCR and Western-blotting assay were employed to detect the expression of a few specific cytokines and inflammatory factors.The results demonstrated that EBV could get into gastric epithelial cells by"cell-in-cell"infection but not fully successful due to the host fighting.IL-1β,IL-6 and IL-8 played prominent roles in the cellular response to the infection.The activation of NF-κB and HSP70 was also required for the host antiviral response.The results imply that the gastric epithelial cells could powerfully resist the virus invader via cell-in-cell at the early stage through inflammatory and innate immune responses.     

Lipid Peroxidation and Total Cholesterol in HAART-Na?ve Patients Infected with Circulating Recombinant Forms of Human Immunodeficiency Virus Type-1 in Cameroon

Background

HIV infection has commonly been found to affect lipid profile and antioxidant defense.

Objectives

To determine the effects of Human Immunodeficiency Virus (HIV) infection and viral subtype on patient’s cholesterol and oxidative stress markers, and determine whether in the absence of Highly Active Antiretroviral Therapy (HAART), these biochemical parameters could be useful in patient’s management and monitoring disease progression in Cameroon. For this purpose, we measured total cholesterol (TC), LDL cholesterol (LDLC), HDL cholesterol (HDLC), total antioxidant ability (TAA), lipid peroxidation indices (LPI), and malondialdehyde (MDA) in HIV negative persons and HIV positive HAART-naïve patients infected with HIV-1 group M subtypes.

Methods

We measured serum TC, LDLC, HDLC, plasma MDA, and TAA concentrations, and calculated LPI indices in 151 HIV-positive HAART-naïve patients and 134 seronegative controls. We also performed gene sequence analysis on samples from 30 patients to determine the effect of viral genotypes on these biochemical parameters. We also determined the correlation between CD4 cell count and the above biochemical parameters.

Results

We obtained the following controls/patients values for TC (1.96±0.54/1. 12±0. 48 g/l), LDLC (0. 67±0. 46/0. 43±0. 36 g/l), HDLC (105. 51±28. 10/46. 54±23. 36 mg/dl) TAA (0. 63±0. 17/0. 16±0. 16 mM), MDA (0. 20±0. 07/0. 41±0. 10 µM) and LPI (0. 34±0. 14/26. 02±74. 40). In each case, the difference between the controls and patients was statistically significant (p<0.05). There was a positive and statistically significant Pearson correlation between CD4 cell count and HDLC (r = +0.272; p<0.01), TAA (r = +0.199; p<0.05) and a negative and statistically significant Pearson correlation between CD4 cell count and LPI (r = −0.166; p<0.05). Pearson correlation between CD4 cell count and TC, CD4cell count and LDLC was positive but not statistically significant while it was negative but not statistically significant with MDA. The different subtypes obtained after sequencing were CRF02_AG (43.3%), CRF01_AE (20%), A1 (23.3%), H (6.7%), and G (6.7%). None of the HIV-1 subtypes significantly influenced the levels of the biochemical parameters, but by grouping them as pure subtypes and circulating recombinant forms (CRFs), the CRF significantly influenced TC levels. TC was significantly lower in patients infected with CRF (0.87±0.27 g/l) compared to patients infected with pure HIV-1 subtypes (1.32±0.68 g/l) (p<0.017). MDA levels were also significantly higher in patients infected with HIV-1CRF01_AE (0.50±0.10 µM), compared to patients infected with CRF02_AG (0. 38±0. 08 µM) (p<0.018).

Conclusion

These results show that HIV infection in Cameroon is associated with significant decrease in TAA, LDLC, HDLC and TC, and increased MDA concentration and LPI indices which seem to be linked to the severity of HIV infection as assessed by CD4 cell count. The data suggests increased oxidative stress and lipid peroxidation in HIV-infected patients in Cameroon, and an influence of CRFs on TC and MDA levels.     

Infection Dynamics of the Tick-Borne Pathogen “Candidatus Neoehrlichia mikurensis” and Coinfections with Borrelia afzelii in Bank Voles in Southern Sweden

The tick-borne bacterium “Candidatus Neoehrlichia mikurensis” has recently been recognized as a human pathogen. Together with Borrelia afzelii, it is one of the most common pathogens found in the tick Ixodes ricinus. Here, we compared the epidemiologies of “Ca. Neoehrlichia mikurensis” and B. afzelii by longitudinal sampling from May to September in one of their most abundant vertebrate hosts, the bank vole (Myodes glareolus), using real-time PCR for detection and quantification. The prevalences of “Ca. Neoehrlichia mikurensis” and B. afzelii were determined to be 19% (50/261) and 22% (56/261), respectively. The prevalence of “Ca. Neoehrlichia mikurensis” increased significantly during the sampling season. The clearance rate of “Ca. Neoehrlichia mikurensis” was significantly higher than that of B. afzelii. We found a high frequency of double infections; 46% of all samples infected with “Ca. Neoehrlichia mikurensis” also had a coinfection with B. afzelii. The frequency of coinfections was significantly higher than expected from the prevalence of each pathogen. The high level of coinfections can be caused by interactions between the pathogens or might reflect variation in general susceptibility among voles.