U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.
J Virol. 2018 Nov 12;92(23). doi: 10.1128/JVI.01143-18. Print 2018 Dec 1.
To date, six vaccine strategies have been evaluated in clinical trials for their efficacy at inducing protective immune responses against HIV infection. However, only the ALVAC-HIV/AIDSVAX B/E vaccine (RV144 trial) has demonstrated protection, albeit modestly (31%; = 0.03). One potential correlate of protection was a low-frequency HIV-specific CD4 T cell population with diverse functionality. Although CD4 T cells, particularly T follicular helper (Tfh) cells, are critical for effective antibody responses, most studies involving HIV vaccines have focused on humoral immunity or CD8 T cell effector responses, and little is known about the functionality and frequency of vaccine-induced CD4 T cells. We therefore assessed responses from several phase I/II clinical trials and compared them to responses to natural HIV-1 infection. We found that all vaccines induced a lower magnitude of HIV-specific CD4 T cell responses than that observed for chronic infection. Responses differed in functionality, with a CD40 ligand (CD40L)-dominated response and more Tfh cells after vaccination, whereas chronic HIV infection provoked tumor necrosis factor alpha (TNF-α)-dominated responses. The vaccine delivery route further impacted CD4 T cells, showing a stronger Th1 polarization after dendritic cell delivery than after intramuscular vaccination. In prime/boost regimens, the choice of prime and boost influenced the functional profile of CD4 T cells to induce more or less polyfunctionality. In summary, vaccine-induced CD4 T cell responses differ remarkably between vaccination strategies, modes of delivery, and boosts and do not resemble those induced by chronic HIV infection. Understanding the functional profiles of CD4 T cells that best facilitate protective antibody responses will be critical if CD4 T cell responses are to be considered a clinical trial go/no-go criterion. Only one HIV-1 candidate vaccine strategy has shown protection, albeit marginally (31%), against HIV-1 acquisition, and correlates of protection suggested that a multifunctional CD4 T cell immune response may be important for this protective effect. Therefore, the functional phenotypes of HIV-specific CD4 T cell responses induced by different phase I and phase II clinical trials were assessed to better show how different vaccine strategies influence the phenotype and function of HIV-specific CD4 T cell immune responses. The significance of this research lies in our comprehensive comparison of the compositions of the T cell immune responses to different HIV vaccine modalities. Specifically, our work allows for the evaluation of vaccination strategies in terms of their success at inducing Tfh cell populations.
迄今为止,已有六种疫苗策略在临床试验中评估了其诱导针对 HIV 感染的保护性免疫应答的功效。然而,只有 ALVAC-HIV/AIDSVAX B/E 疫苗(RV144 试验)显示出适度的保护作用(31%;=0.03)。一种潜在的保护相关性是具有多种功能的低频 HIV 特异性 CD4 T 细胞群体。尽管 CD4 T 细胞,特别是滤泡辅助性 T 细胞(Tfh)细胞,对于有效的抗体应答至关重要,但大多数涉及 HIV 疫苗的研究都集中在体液免疫或 CD8 T 细胞效应应答上,而对于疫苗诱导的 CD4 T 细胞的功能和频率知之甚少。因此,我们评估了几项 I/II 期临床试验的反应,并将其与对自然 HIV-1 感染的反应进行了比较。我们发现,所有疫苗诱导的 HIV 特异性 CD4 T 细胞反应的幅度均低于慢性感染观察到的幅度。反应在功能上有所不同,疫苗接种后 CD40 配体(CD40L)主导的反应和更多的 Tfh 细胞,而慢性 HIV 感染则引发肿瘤坏死因子-α(TNF-α)主导的反应。疫苗接种途径进一步影响 CD4 T 细胞,与肌内接种相比,树突状细胞接种后 Th1 极化更强。在初免/加强方案中,初免和加强的选择会影响 CD4 T 细胞的功能谱,从而诱导更多或更少的多功能性。总之,疫苗接种策略、接种方式和加强方式之间的 CD4 T 细胞反应差异很大,与慢性 HIV 感染诱导的反应不同。如果要将 CD4 T 细胞反应视为临床试验的“行/不行”标准,则了解最有利于保护性抗体应答的 CD4 T 细胞的功能特征将至关重要。只有一种 HIV-1 候选疫苗策略显示出对 HIV-1 获得的保护作用(31%),尽管作用不大,并且保护相关性表明,多功能性 CD4 T 细胞免疫应答可能对这种保护作用很重要。因此,评估了不同 I 期和 II 期临床试验中诱导的 HIV 特异性 CD4 T 细胞反应的功能表型,以更好地展示不同的疫苗策略如何影响 HIV 特异性 CD4 T 细胞免疫应答的表型和功能。这项研究的意义在于我们对不同 HIV 疫苗模式的 T 细胞免疫反应成分进行了全面比较。具体来说,我们的工作可以根据诱导 Tfh 细胞群体的能力来评估疫苗接种策略的成功。
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