University of Miami Miller School of Medicine, Miami, Florida, United States of America.
PLoS Pathog. 2013;9(7):e1003471. doi: 10.1371/journal.ppat.1003471. Epub 2013 Jul 4.
In pathogenic HIV and SIV infections of humans and rhesus macaques (RMs), preferential depletion of CD4⁺ Th17 cells correlates with mucosal immune dysfunction and disease progression. Interleukin (IL)-21 promotes differentiation of Th17 cells, long-term maintenance of functional CD8⁺ T cells, and differentiation of memory B cells and antibody-secreting plasma cells. We hypothesized that administration of IL-21 will improve mucosal function in the context of pathogenic HIV/SIV infections. To test this hypothesis, we infected 12 RMs with SIV(mac239) and at day 14 post-infection treated six of them with rhesus rIL-21-IgFc. IL-21-treatment was safe and did not increase plasma viral load or systemic immune activation. Compared to untreated animals, IL-21-treated RMs showed (i) higher expression of perforin and granzyme B in total and SIV-specific CD8⁺ T cells and (ii) higher levels of intestinal Th17 cells. Remarkably, increased levels of Th17 cells were associated with reduced levels of intestinal T cell proliferation, microbial translocation and systemic activation/inflammation in the chronic infection. In conclusion, IL-21-treatment in SIV-infected RMs improved mucosal immune function through enhanced preservation of Th17 cells. Further preclinical studies of IL-21 may be warranted to test its potential use during chronic infection in conjunction with antiretroviral therapy.
在人类和恒河猴(RMs)的致病性 HIV 和 SIV 感染中,CD4⁺Th17 细胞的优先耗竭与黏膜免疫功能障碍和疾病进展相关。白细胞介素(IL)-21 促进 Th17 细胞的分化、CD8⁺T 细胞的长期维持以及记忆 B 细胞和分泌抗体的浆细胞的分化。我们假设 IL-21 的给药将改善致病性 HIV/SIV 感染情况下的黏膜功能。为了验证这一假设,我们用 SIV(mac239)感染了 12 只 RMs,并在感染后第 14 天对其中 6 只用重组恒河猴 IL-21-IgFc 进行了治疗。IL-21 治疗是安全的,不会增加血浆病毒载量或全身免疫激活。与未治疗的动物相比,IL-21 治疗的 RMs 表现出(i)总 CD8⁺T 细胞和 SIV 特异性 CD8⁺T 细胞中穿孔素和颗粒酶 B 的表达更高,以及(ii)肠道 Th17 细胞水平更高。值得注意的是,Th17 细胞水平的增加与慢性感染中肠道 T 细胞增殖、微生物易位和全身激活/炎症的减少相关。总之,IL-21 治疗可通过增强 Th17 细胞的保存来改善 SIV 感染的 RMs 中的黏膜免疫功能。进一步的 IL-21 临床前研究可能是必要的,以测试其在慢性感染期间与抗逆转录病毒疗法联合使用的潜力。