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N-803 治疗感染 SIV 的非人类灵长类动物的数学模型。

Mathematical modeling of N-803 treatment in SIV-infected non-human primates.

机构信息

Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, United States of America.

Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.

出版信息

PLoS Comput Biol. 2021 Jul 28;17(7):e1009204. doi: 10.1371/journal.pcbi.1009204. eCollection 2021 Jul.

Abstract

Immunomodulatory drugs could contribute to a functional cure for Human Immunodeficiency Virus (HIV). Interleukin-15 (IL-15) promotes expansion and activation of CD8+ T cell and natural killer (NK) cell populations. In one study, an IL-15 superagonist, N-803, suppressed Simian Immunodeficiency Virus (SIV) in non-human primates (NHPs) who had received prior SIV vaccination. However, viral suppression attenuated with continued N-803 treatment, partially returning after long treatment interruption. While there is evidence of concurrent drug tolerance, immune regulation, and viral escape, the relative contributions of these mechanisms to the observed viral dynamics have not been quantified. Here, we utilize mathematical models of N-803 treatment in SIV-infected macaques to estimate contributions of these three key mechanisms to treatment outcomes: 1) drug tolerance, 2) immune regulation, and 3) viral escape. We calibrated our model to viral and lymphocyte responses from the above-mentioned NHP study. Our models track CD8+ T cell and NK cell populations with N-803-dependent proliferation and activation, as well as viral dynamics in response to these immune cell populations. We compared mathematical models with different combinations of the three key mechanisms based on Akaike Information Criterion and important qualitative features of the NHP data. Two minimal models were capable of reproducing the observed SIV response to N-803. In both models, immune regulation strongly reduced cytotoxic cell activation to enable viral rebound. Either long-term drug tolerance or viral escape (or some combination thereof) could account for changes to viral dynamics across long breaks in N-803 treatment. Theoretical explorations with the models showed that less-frequent N-803 dosing and concurrent immune regulation blockade (e.g. PD-L1 inhibition) may improve N-803 efficacy. However, N-803 may need to be combined with other immune therapies to countermand viral escape from the CD8+ T cell response. Our mechanistic model will inform such therapy design and guide future studies.

摘要

免疫调节药物可能有助于实现人类免疫缺陷病毒 (HIV) 的功能性治愈。白细胞介素-15 (IL-15) 可促进 CD8+T 细胞和自然杀伤 (NK) 细胞群体的扩增和激活。在一项研究中,一种 IL-15 超级激动剂 N-803 抑制了接受过 SIV 疫苗接种的非人类灵长类动物 (NHPs) 中的 SIV。然而,随着持续的 N-803 治疗,病毒抑制减弱,在长时间的治疗中断后部分恢复。虽然有证据表明存在药物耐受、免疫调节和病毒逃逸,但这些机制对观察到的病毒动力学的相对贡献尚未量化。在这里,我们利用 SIV 感染猕猴的 N-803 治疗数学模型来估计这三种关键机制对治疗结果的贡献:1)药物耐受,2)免疫调节和 3)病毒逃逸。我们根据上述 NHP 研究中的病毒和淋巴细胞反应对模型进行了校准。我们的模型跟踪 N-803 依赖性增殖和激活的 CD8+T 细胞和 NK 细胞群体,以及这些免疫细胞群体对病毒动力学的响应。我们根据 Akaike 信息准则和 NHP 数据的重要定性特征,比较了具有不同三种关键机制组合的数学模型。两个最小模型能够重现观察到的 N-803 对 SIV 的反应。在这两种模型中,免疫调节强烈降低细胞毒性细胞的激活,从而使病毒反弹。长期药物耐受或病毒逃逸(或其组合)可以解释 N-803 治疗中断期间病毒动力学的变化。通过模型进行的理论探讨表明,较少频繁的 N-803 给药和同时的免疫调节阻断(例如 PD-L1 抑制)可能提高 N-803 的疗效。然而,N-803 可能需要与其他免疫疗法结合使用,以抵消 CD8+T 细胞反应中病毒的逃逸。我们的机制模型将为这种治疗设计提供信息,并指导未来的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9905/8351941/c8f50e5eb4f8/pcbi.1009204.g001.jpg

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