Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA.
J Virol. 2019 Mar 5;93(6). doi: 10.1128/JVI.02051-18. Print 2019 Mar 15.
Curing HIV infection has been thwarted by the persistent reservoir of latently infected CD4 T cells, which reinitiate systemic infection after antiretroviral therapy (ART) interruption. To evaluate reservoir depletion strategies, we developed a novel preclinical model consisting of immunodeficient mice intrasplenically injected with peripheral blood mononuclear cells (PBMC) from long-term ART-suppressed HIV-infected donors. In the absence of ART, these mice developed rebound viremia which, 2 weeks after PBMC injection, was 1,000-fold higher (mean = 9,229,281 HIV copies/ml) in mice injected intrasplenically than in mice injected intraperitoneally (mean = 6,838 HIV copies/ml) or intravenously (mean = 591 HIV copies/ml). One week after intrasplenic PBMC injection, hybridization of the spleen demonstrated extensive disseminated HIV infection, likely initiated from -reactivated primary latently infected cells. The time to viremia was delayed significantly by treatment with a broadly neutralizing antibody, 10-1074, compared to treatment with 10-1074-FcR, suggesting that 10-1074 mobilized Fc-mediated effector mechanisms to deplete the replication-competent reservoir. This was supported by phylogenetic analysis of Env sequences from viral-outgrowth cultures and untreated, 10-1074-treated, or 10-1074-FcR-treated mice. The predominant sequence cluster detected in viral-outgrowth cultures and untreated mouse plasma was significantly reduced in the plasma of 10-1074-treated mice, whereas two new clusters emerged that were not detected in viral-outgrowth cultures or plasma from untreated mice. These new clusters lacked mutations associated with 10-1074 resistance. Taken together, these data indicated that 10-1074 treatment depletes the reservoir of latently infected cells harboring replication competent HIV. Furthermore, this mouse model represents a new approach for the preclinical evaluation of new HIV cure strategies. Sustained remission of HIV infection is prevented by a persistent reservoir of latently infected cells capable of reinitiating systemic infection and viremia. To evaluate strategies to reactivate and deplete this reservoir, we developed and characterized a new humanized mouse model consisting of highly immunodeficient mice intrasplenically injected with peripheral blood mononuclear cells from long-term ART-suppressed HIV-infected donors. Reactivation and dissemination of HIV infection was visualized in the mouse spleens in parallel with the onset of viremia. The applicability of this model for evaluating reservoir depletion treatments was demonstrated by establishing, through delayed time to viremia and phylogenetic analysis of plasma virus, that treatment of these humanized mice with a broadly neutralizing antibody, 10-1074, depleted the patient-derived population of latently infected cells. This mouse model represents a new approach for the preclinical evaluation of new HIV cure strategies.
治愈 HIV 感染一直受到潜伏感染的 CD4 T 细胞持续储库的阻碍,这些细胞在抗逆转录病毒治疗(ART)中断后会重新引发全身感染。为了评估储库耗竭策略,我们开发了一种新的临床前模型,该模型由免疫缺陷小鼠组成,这些小鼠脾内注射来自长期接受 ART 抑制的 HIV 感染者的外周血单核细胞(PBMC)。在没有 ART 的情况下,这些小鼠会出现病毒血症反弹,在 PBMC 注射后 2 周,脾内注射的小鼠病毒血症水平比腹腔内注射(平均= 6838 HIV 拷贝/ml)或静脉内注射(平均= 591 HIV 拷贝/ml)的小鼠高 1000 倍(平均= 9229281 HIV 拷贝/ml)。脾内注射 PBMC 1 周后,杂交显示脾脏广泛存在 HIV 感染,可能是由重新激活的原发性潜伏感染细胞引发的。与用 10-1074-FcR 治疗相比,用广泛中和抗体 10-1074 治疗显著延迟了病毒血症的出现时间,这表明 10-1074 动员了 Fc 介导的效应机制来耗竭有复制能力的储库。这得到了从病毒扩增培养物和未经处理、用 10-1074 处理或用 10-1074-FcR 处理的小鼠中Env 序列的系统发育分析的支持。在未经处理、用 10-1074 处理或用 10-1074-FcR 处理的小鼠的病毒扩增培养物和未处理的血浆中检测到的主要序列簇在 10-1074 处理的小鼠血浆中显著减少,而在未经处理的小鼠的病毒扩增培养物或血浆中没有检测到两个新的簇。这些新的聚类缺乏与 10-1074 耐药性相关的突变。总的来说,这些数据表明,10-1074 治疗可耗竭潜伏感染细胞储库,这些细胞携带具有复制能力的 HIV。此外,这种小鼠模型代表了一种新的方法,可用于临床前评估新的 HIV 治愈策略。HIV 感染的持续缓解受到潜伏感染细胞储库的阻碍,这些细胞能够重新引发全身感染和病毒血症。为了评估重新激活和耗竭该储库的策略,我们开发并表征了一种新的人源化小鼠模型,该模型由脾内注射来自长期接受 ART 抑制的 HIV 感染者的外周血单核细胞的高度免疫缺陷小鼠组成。在小鼠脾脏中观察到 HIV 感染的重新激活和传播,同时伴随着病毒血症的出现。通过延迟病毒血症的出现时间和对血浆病毒的系统发育分析,证明了用广泛中和抗体 10-1074 治疗这些人源化小鼠可耗尽患者来源的潜伏感染细胞储库,从而证明了该模型在评估储库耗竭治疗中的适用性。这种小鼠模型代表了一种新的方法,可用于临床前评估新的 HIV 治愈策略。
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