Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institute of Health, Frederick, Maryland, 21702, United States.
Curr HIV Res. 2020;18(2):114-131. doi: 10.2174/1570162X18666200210121339.
The vast genetic variability of HIV has impeded efforts towards a cure for HIV. Lifelong administration of combined antiretroviral therapy (cART) is highly effective against HIV and has markedly increased the life expectancy of HIV infected individuals. However, the long-term usage of cART is associated with co-morbidities and the emergence of multidrug-resistant escape mutants necessitating the development of alternative approaches to combat HIV/AIDS. In the past decade, the development of single-cell antibody cloning methods has facilitated the characterization of a diverse array of highly potent neutralizing antibodies against a broad range of HIV strains. Although the passive transfer of these broadly neutralizing antibodies (bnAbs) in both animal models and humans has been shown to elicit significant antiviral effects, long term virologic suppression requires repeated administration of these antibodies. Adeno-associated virus (AAV) mediated antibody gene transfer provides a long-term expression of these antibodies from a single administration of the recombinant vector. Therefore, this vectored approach holds promises in the treatment and prevention of a chronic disease like HIV infection. Here, we provide an overview of HIV genetic diversity, AAV vectorology, and anti-HIV bnAbs and summarize the promises and challenges of the application of AAV in the delivery of bnAbs for HIV prevention and therapy.
HIV 的巨大遗传变异性阻碍了治愈 HIV 的努力。联合抗逆转录病毒疗法 (cART) 的终身应用对 HIV 非常有效,显著提高了 HIV 感染者的预期寿命。然而,cART 的长期使用与合并症有关,并且出现了需要开发替代方法来对抗 HIV/AIDS 的多药耐药逃逸突变体。在过去十年中,单细胞抗体克隆方法的发展促进了对广泛的 HIV 株具有高度强效中和作用的多样化抗体的表征。尽管在动物模型和人类中被动转移这些广泛中和抗体 (bnAbs) 已显示出显著的抗病毒作用,但长期病毒学抑制需要重复给予这些抗体。腺相关病毒 (AAV) 介导的抗体基因转移可通过单次给予重组载体实现这些抗体的长期表达。因此,这种载体方法在治疗和预防像 HIV 感染这样的慢性疾病方面具有广阔的前景。在这里,我们提供了 HIV 遗传多样性、AAV 病毒学和抗 HIV bnAbs 的概述,并总结了 AAV 在递送 bnAbs 用于 HIV 预防和治疗方面的应用的前景和挑战。