Departments of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children’s Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Blood. 2012 Nov 22;120(22):4383-90. doi: 10.1182/blood-2012-06-437566. Epub 2012 Oct 1.
Despite potential clinical importance, target cells for mother-to-child transmission of HIV-1 have not yet been identified. Cord blood-derived CD4(+) T cells are largely naive and do not express CCR5, the mandatory coreceptor for transmitted HIV-1 R5 strains in infants. In the present study, we demonstrate that in the human fetal and infant gut mucosa, there is already a large subset of mucosal memory CD4(+)CCR5(+) T cells with predominantly a Th1 and Th17 phenotype. Using next-generation sequencing of the TCRβ chain, clonally expanded T cells as a hallmark for memory development predominated in the gut mucosa (30%), whereas few were found in the lymph nodes (1%) and none in cord blood (0%). The gut mucosal fetal and infant CD4(+) T cells were highly susceptible to HIV-1 without any prestimulation; pol proviral DNA levels were similar to infected phytohemagglutinin-stimulated adult PBMCs. In conclusion, in the present study, we show that extensive adaptive immunity is present before birth and the gut mucosa is the preferential site for memory CD4(+) T cells. These CD4(+)CCR5(+) T cells in the infant mucosa provide a large pool of susceptible cells for ingested HIV-1 at birth and during breastfeeding, indicating a mucosal route of mother-to-child transmission that can be targeted in prevention strategies.
尽管具有潜在的临床重要性,但 HIV-1 母婴传播的靶细胞尚未确定。脐带血来源的 CD4(+)T 细胞大多是幼稚的,不表达 CCR5,这是婴儿中传播的 HIV-1 R5 株的必需核心受体。在本研究中,我们证明在人类胎儿和婴儿肠道黏膜中,已经存在大量的黏膜记忆 CD4(+)CCR5(+)T 细胞,主要表现为 Th1 和 Th17 表型。使用 TCRβ 链的下一代测序,作为记忆发育标志的克隆扩增 T 细胞在肠道黏膜中占主导地位(30%),而在淋巴结中很少(1%),在脐带血中则没有(0%)。肠道黏膜中的胎儿和婴儿 CD4(+)T 细胞对 HIV-1 非常敏感,无需任何预先刺激;pol 前病毒 DNA 水平与感染植物血球凝集素刺激的成人 PBMCs 相似。总之,在本研究中,我们表明,广泛的适应性免疫在出生前就存在,肠道黏膜是记忆 CD4(+)T 细胞的首选部位。这些婴儿黏膜中的 CD4(+)CCR5(+)T 细胞为出生时和母乳喂养期间摄入的 HIV-1 提供了大量易感细胞,表明母婴传播的黏膜途径可以作为预防策略的靶点。
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