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Gag-positive reservoir cells can be identified by a new technique and can be cleared by CTL ?. Una O’ Doherty June 29, 2013. Our experimental system. HLADR-, CD69-, CD25- CD4+ T Or CD3C28 activated. Infect (X4 or R5 HIV). Culture 3-4d. Measure total & integrated HIV DNA.
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Gag-positive reservoir cells can be identified by a new technique and can be cleared by CTL ? Una O’Doherty June 29, 2013
Our experimental system HLADR-, CD69-, CD25- CD4+ T Or CD3C28 activated Infect (X4 or R5 HIV) Culture 3-4d Measure total & integrated HIV DNA Measure Gag expression O’Doherty U J. Virol. 2000 O’Doherty U J.Virol. 2002 Swiggard WJ J. Virol. 2005
Gag expression in resting cells without spreading expression Activated Resting cells produce Gag • but little Env • May explain lack of spreading infection • Activations with • CD3/28 increase both Gag & Env Pace PLoS Pathogen 2012
Can Gag expression lead to clearance of latently infected cells?
in vitro model for reservoir clearance CD4+T HIV + +/- Integrase inhibitor HIV CD8+T granules Migueles Immunity 2008
Gag expression leads to clearance of latently infected cells
Calculation of the fraction of integrated HIV DNA expressing Gag Calculation assumes all integrated HIV DNA is in resting CD4+ T cells so % expressing Gag is likely an underestimate
Is there any evidence for CTL clearance of reservoir in vivo?
CTL activity against latent cells correlates with reservoir size in vivo p < 0.05 for blue (CP) and red (EC) In vivo In vitro
Integration correlates with IUPM Menodoza Blood 2012 Eriksson PLoS Pathogen 2013
Summary of in vitro and in vivo findings Latently infected cells can express HIV proteins – continuum of latency CTL clear latently infected cells A fraction of the reservoir in rCD4T express Gag in vivo in patients on ART CTL activity against latently infected CD4+ T cells may be a determinant of integration levels
Implications for functional cure • CTL may have activity against GPR - suggests expanded targets of CTL against latent cells and potential for therapeutic vaccines • Integrated HIV DNA measurements are useful to evaluate therapies that target HIV reservoirs • Superinfected resting CD4+ T cells provide a model of latency and immune clearance
Acknowledgements Erin Graf Matt Pace Luis Agosto Jenny Yu Lindsay Lynch Laura DeMaster NIH: Michele Di Mascio Stephen Migueles Mark Connors UCSF: Steve Deeks HiroyuHatano Rick Hecht Penn: Jim Riley Carl June Don Siegel Drew Weissman Mike Betts Penn CFAR: Farida Shaheen Funding: NIH, Merck, amfAR, PKC pharmaceuticals
Sorting for Gag + resting T in vivo (except CD4) PBMCs from ART suppressed patients and stained with anti-Gag