Ferrari Brian, Da Silva Amanda Cabral, Liu Ken H, Saidakova Evgeniya V, Korolevskaya Larisa B, Shmagel Konstantin V, Shive Carey, Pacheco Sanchez Gabriela, Retuerto Mauricio, Sharma Ashish Arunkumar, Ghneim Khader, Noel-Romas Laura, Rodriguez Benigno, Ghannoum Mahmoud A, Hunt Peter P, Deeks Steven G, Burgener Adam D, Jones Dean P, Dobre Mirela A, Marconi Vincent C, Sekaly Rafick-Pierre, Younes Souheil-Antoine
Department of Medicine, Division of Infectious Diseases and HIV Medicine, Center for AIDS Research, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Department of Pathology, Pathology Advanced Translational Research (PATRU), School of Medicine and.
J Clin Invest. 2022 May 2;132(9). doi: 10.1172/JCI149571.
People living with HIV (PLWH) who are immune nonresponders (INRs) are at greater risk of comorbidity and mortality than are immune responders (IRs) who restore their CD4+ T cell count after antiretroviral therapy (ART). INRs have low CD4+ T cell counts (<350 c/μL), heightened systemic inflammation, and increased CD4+ T cell cycling (Ki67+). Here, we report the findings that memory CD4+ T cells and plasma samples of INRs from several cohorts are enriched in gut-derived bacterial solutes p-cresol sulfate (PCS) and indoxyl sulfate (IS) that both negatively correlated with CD4+ T cell counts. In vitro PCS or IS blocked CD4+ T cell proliferation, induced apoptosis, and diminished the expression of mitochondrial proteins. Electron microscopy imaging revealed perturbations of mitochondrial networks similar to those found in INRs following incubation of healthy memory CD4+ T cells with PCS. Using bacterial 16S rDNA, INR stool samples were found enriched in proteolytic bacterial genera that metabolize tyrosine and phenylalanine to produce PCS. We propose that toxic solutes from the gut bacterial flora may impair CD4+ T cell recovery during ART and may contribute to CD4+ T cell lymphopenia characteristic of INRs.
与抗逆转录病毒疗法(ART)后恢复CD4+ T细胞计数的免疫应答者(IR)相比,免疫无应答者(INR)的HIV感染者(PLWH)患合并症和死亡的风险更高。INR的CD4+ T细胞计数较低(<350个/μL),全身炎症加剧,CD4+ T细胞循环(Ki67+)增加。在此,我们报告了以下发现:来自几个队列的INR的记忆CD4+ T细胞和血浆样本中富含肠道来源的细菌溶质对甲酚硫酸盐(PCS)和吲哚硫酸盐(IS),这两者均与CD4+ T细胞计数呈负相关。在体外,PCS或IS可阻断CD4+ T细胞增殖,诱导细胞凋亡,并减少线粒体蛋白的表达。电子显微镜成像显示,在用PCS孵育健康记忆CD4+ T细胞后,线粒体网络出现了与INR中发现的类似扰动。使用细菌16S rDNA,发现INR粪便样本中富含将酪氨酸和苯丙氨酸代谢为PCS的蛋白水解细菌属。我们提出,肠道细菌菌群产生的有毒溶质可能会损害ART期间CD4+ T细胞的恢复,并可能导致INR特有的CD4+ T细胞淋巴细胞减少。
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