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Xie Q, Namba MD, Buck LA, Park K, Jackson JG, Barker JM. Effects of Antiretroviral Treatment on Central and Peripheral Immune Response in Mice with EcoHIV Infection. Cells 2024; 13:882. [PMID: 38786105 PMCID: PMC11120433 DOI: 10.3390/cells13100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
HIV infection is an ongoing global health issue, despite increased access to antiretroviral therapy (ART). People living with HIV (PLWH) who are virally suppressed through ART still experience negative health outcomes, including neurocognitive impairment. It is increasingly evident that ART may act independently or in combination with HIV infection to alter the immune state, though this is difficult to disentangle in the clinical population. Thus, these experiments used multiplexed chemokine/cytokine arrays to assess peripheral (plasma) and brain (nucleus accumbens; NAc) expression of immune targets in the presence and absence of ART treatment in the EcoHIV mouse model. The findings identify the effects of EcoHIV infection and of treatment with bictegravir (B), emtricitabine (F), and tenofovir alafenamide (TAF) on the expression of numerous immune targets. In the NAc, this included EcoHIV-induced increases in IL-1α and IL-13 expression and B/F/TAF-induced reductions in KC/CXCL1. In the periphery, EcoHIV suppressed IL-6 and LIF expression, while B/F/TAF reduced IL-12p40 expression. In the absence of ART, IBA-1 expression was negatively correlated with CX3CL1 expression in the NAc of EcoHIV-infected mice. These findings identify distinct effects of ART and EcoHIV infection on peripheral and central immune factors and emphasize the need to consider ART effects on neural and immune outcomes.
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Affiliation(s)
- Qiaowei Xie
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (Q.X.); (M.D.N.); (L.A.B.); (J.G.J.)
- Graduate Program in Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Mark D. Namba
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (Q.X.); (M.D.N.); (L.A.B.); (J.G.J.)
| | - Lauren A. Buck
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (Q.X.); (M.D.N.); (L.A.B.); (J.G.J.)
| | - Kyewon Park
- Center for AIDS Research, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Joshua G. Jackson
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (Q.X.); (M.D.N.); (L.A.B.); (J.G.J.)
| | - Jacqueline M. Barker
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, USA; (Q.X.); (M.D.N.); (L.A.B.); (J.G.J.)
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Pons-Fuster E, Bernal E, Guillamón CF, Gimeno L, Martínez-Sánchez MV, Ruiz-Lorente I, Campillo JA, Ceballos D, Torres A, Tomás C, Muñoz Á, Alcaraz A, Selma P, Ruiz-Nicolas C, Muro M, Minguela A. HLA-C*07 is associated with symptomatic HIV-1-associated neurocognitive disorders (HAND) and immune dysregulation. Infect Dis (Lond) 2024:1-12. [PMID: 38743055 DOI: 10.1080/23744235.2024.2351047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND HIV-1-associated neurocognitive disorders (HAND) in stable patients undergoing antiretroviral therapy (ART) may result from ongoing immune dysregulation and chronic inflammation. A contributing factor may result from the unstable HLA class I allele, HLA-C*07. OBJECTIVE To assess the genetic profile of killer-cell immunoglobulin-like receptors (KIR), human leukocyte antigens (HLA), and immune activation or senescence markers and their association with HAND in stable HIV-1 patients receiving ART. METHODS An observational cross-sectional study was carried out with 96 patients with asymptomatic or symptomatic HAND. HLA and KIR as well as immune activation/senescence biomarkers in peripheral blood cells were assessed by SSO-Luminex typing and flow cytometry, respectively. RESULTS HLA-C*07 is associated with symptomatic HAND. The frequency of two copies of HLA-C*07 was higher in patients with symptomatic than with asymptomatic HAND (12.0 vs. 2.2%, ρ < 0.001). The percentage of senescent CD8+CD28- T-cells was higher in patients with two copies of HLA-C*07 (ρ < 0.05). In patients with symptomatic HAND, the percentages of non-senescent CD8+CD28+ T cells were inversely proportional to the number of copies of the HLA-C*07 (ρ < 0.05). CONCLUSION Patients with symptomatic HAND showed a higher frequency of the homozygotic unstable HLA-C*07 allotype, which could be associated with neurocognitive complications. Two copies of HLA-C*07 were associated with immune senescent T lymphocyte profiles characterized by the loss of CD28 expression.
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Affiliation(s)
- Eduardo Pons-Fuster
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Enrique Bernal
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Concepción F Guillamón
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Lourdes Gimeno
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - María V Martínez-Sánchez
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Inmaculada Ruiz-Lorente
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - José A Campillo
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Diana Ceballos
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Ana Torres
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Cristina Tomás
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Ángeles Muñoz
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Antonia Alcaraz
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Pedro Selma
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Carlos Ruiz-Nicolas
- Infectious Disease Unit, University Hospital Reina Sofía and Murcia University and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Manuel Muro
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
| | - Alfredo Minguela
- Immunologyservice, Clinic University Hospital Virgen de la Arrixaca and Biomedical Research Institute of Murcia Pascual Parrilla (IMIB), Murcia, Spain
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Yuan NY, Medders KE, Sanchez AB, Shah R, de Rozieres CM, Ojeda-Juárez D, Maung R, Williams R, Gelman BB, Baaten BJ, Roberts AJ, Kaul M. A critical role for Macrophage-derived Cysteinyl-Leukotrienes in HIV-1 induced neuronal injury. Brain Behav Immun 2024; 118:149-166. [PMID: 38423397 DOI: 10.1016/j.bbi.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/26/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
Macrophages (MΦ) infected with human immunodeficiency virus (HIV)-1 or activated by its envelope protein gp120 exert neurotoxicity. We found previously that signaling via p38 mitogen-activated protein kinase (p38 MAPK) is essential to the neurotoxicity of HIVgp120-stimulated MΦ. However, the associated downstream pathways remained elusive. Here we show that cysteinyl-leukotrienes (CysLT) released by HIV-infected or HIVgp120 stimulated MΦ downstream of p38 MAPK critically contribute to neurotoxicity. SiRNA-mediated or pharmacological inhibition of p38 MAPK deprives MΦ of CysLT synthase (LTC4S) and, pharmacological inhibition of the cysteinyl-leukotriene receptor 1 (CYSLTR1) protects cerebrocortical neurons against toxicity of both gp120-stimulated and HIV-infected MΦ. Components of the CysLT pathway are differentially regulated in brains of HIV-infected individuals and a transgenic mouse model of NeuroHIV (HIVgp120tg). Moreover, genetic ablation of LTC4S or CysLTR1 prevents neuronal damage and impairment of spatial memory in HIVgp120tg mice. Altogether, our findings suggest a novel critical role for cysteinyl-leukotrienes in HIV-associated brain injury.
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Affiliation(s)
- Nina Y Yuan
- University of California Riverside, School of Medicine, Division of Biomedical Sciences, 900 University Ave, Riverside, CA 92521, USA.
| | - Kathryn E Medders
- Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Ana B Sanchez
- Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Rohan Shah
- University of California Riverside, School of Medicine, Division of Biomedical Sciences, 900 University Ave, Riverside, CA 92521, USA.
| | - Cyrus M de Rozieres
- Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Daniel Ojeda-Juárez
- University of California Riverside, School of Medicine, Division of Biomedical Sciences, 900 University Ave, Riverside, CA 92521, USA; Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Ricky Maung
- University of California Riverside, School of Medicine, Division of Biomedical Sciences, 900 University Ave, Riverside, CA 92521, USA; Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Roy Williams
- Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Benjamin B Gelman
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0419 USA; Department of Neurobiology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0419 USA.
| | - Bas J Baaten
- Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Amanda J Roberts
- Animal Models Core, The Scripps Research Institute, La Jolla, CA 92037, USA.
| | - Marcus Kaul
- University of California Riverside, School of Medicine, Division of Biomedical Sciences, 900 University Ave, Riverside, CA 92521, USA; Sanford Burnham Prebys Medical Discovery Institute, Infectious and Inflammatory Disease Center, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
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Xie Q, Namba MD, Buck LA, Park K, Jackson JG, Barker JM. Effects of antiretroviral treatment on central and peripheral immune response in mice with EcoHIV infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.11.589109. [PMID: 38645059 PMCID: PMC11030421 DOI: 10.1101/2024.04.11.589109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
HIV infection is an ongoing global health issue despite increased access to antiretroviral therapy (ART). People living with HIV (PLWH) who are virally suppressed through ART still experience negative health outcomes, including neurocognitive impairment. It is increasingly evident that ART may act independently or in combination with HIV infection to alter immune state, though this is difficult to disentangle in the clinical population. Thus, these experiments used multiplexed chemokine/cytokine arrays to assess peripheral (plasma) and brain (nucleus accumbens; NAc) expression of immune targets in the presence and absence of ART treatment in the EcoHIV mouse model. The findings identify effects of EcoHIV infection and of treatment with bictegravir (B), emtricitabine (F) and tenofovir alafenamide (TAF) on expression of numerous immune targets. In the NAc, this included EcoHIV-induced increases in IL-1α and IL-13 expression and B/F/TAF-induced reductions in KC/CXCL1. In the periphery, EcoHIV suppressed IL-6 and LIF expression, while B/F/TAF reduced IL-12p40 expression. In absence of ART, IBA-1 expression was negatively correlated with CX3CL1 expression in the NAc of EcoHIV-infected mice. These findings identify distinct effects of ART and EcoHIV infection on peripheral and central immune factors and emphasize the need to consider ART effects on neural and immune outcomes.
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5
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Le Buanec H, Schiavon V, Merandet M, How-Kit A, Song H, Bergerat D, Fombellida-Lopez C, Bensussan A, Bouaziz JD, Burny A, Darcis G, Sajadi MM, Kottilil S, Zagury D, Gallo RC. IFNα induces CCR5 in CD4 + T cells of HIV patients causing pathogenic elevation. COMMUNICATIONS MEDICINE 2024; 4:52. [PMID: 38504093 PMCID: PMC10951336 DOI: 10.1038/s43856-024-00453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 02/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Among people living with HIV, elite controllers (ECs) maintain an undetectable viral load, even without receiving anti-HIV therapy. In non-EC patients, this therapy leads to marked improvement, including in immune parameters, but unlike ECs, non-EC patients still require ongoing treatment and experience co-morbidities. In-depth, comprehensive immune analyses comparing EC and treated non-EC patients may reveal subtle, consistent differences. This comparison could clarify whether elevated circulating interferon-alpha (IFNα) promotes widespread immune cell alterations and persists post-therapy, furthering understanding of why non-EC patients continue to need treatment. METHODS Levels of IFNα in HIV-infected EC and treated non-EC patients were compared, along with blood immune cell subset distribution and phenotype, and functional capacities in some cases. In addition, we assessed mechanisms potentially associated with IFNα overload. RESULTS Treatment of non-EC patients results in restoration of IFNα control, followed by marked improvement in distribution numbers, phenotypic profiles of blood immune cells, and functional capacity. These changes still do not lead to EC status, however, and IFNα can induce these changes in normal immune cell counterparts in vitro. Hypothesizing that persistent alterations could arise from inalterable effects of IFNα at infection onset, we verified an IFNα-related mechanism. The protein induces the HIV coreceptor CCR5, boosting HIV infection and reducing the effects of anti-HIV therapies. EC patients may avoid elevated IFNα following on infection with a lower inoculum of HIV or because of some unidentified genetic factor. CONCLUSIONS Early control of IFNα is essential for better prognosis of HIV-infected patients.
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Affiliation(s)
- Hélène Le Buanec
- Université de Paris; INSERM U976, HIPI Unit, Institut de Recherche Saint-Louis, F-75010, Paris, France
| | - Valérie Schiavon
- Université de Paris; INSERM U976, HIPI Unit, Institut de Recherche Saint-Louis, F-75010, Paris, France
| | - Marine Merandet
- Université de Paris; INSERM U976, HIPI Unit, Institut de Recherche Saint-Louis, F-75010, Paris, France
| | | | - Hongshuo Song
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA
| | - David Bergerat
- Université de Paris; INSERM U976, HIPI Unit, Institut de Recherche Saint-Louis, F-75010, Paris, France
| | - Céline Fombellida-Lopez
- Laboratory of Infectious Diseases, GIGA-I3, GIGA-Institute University of Liege, 4000, Liege, Belgium
| | - Armand Bensussan
- Université de Paris; INSERM U976, HIPI Unit, Institut de Recherche Saint-Louis, F-75010, Paris, France
| | - Jean-David Bouaziz
- Université de Paris; INSERM U976, HIPI Unit, Institut de Recherche Saint-Louis, F-75010, Paris, France
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Arsène Burny
- Laboratory of Molecular Biology, Gembloux Agrobiotech, University of Liège, Liège, Belgium
- Global Virus Network, Baltimore, MD, 21201, USA
| | - Gilles Darcis
- Laboratory of Infectious Diseases, GIGA-I3, GIGA-Institute University of Liege, 4000, Liege, Belgium
| | - Mohammad M Sajadi
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA
- Global Virus Network, Baltimore, MD, 21201, USA
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Shyamasundaran Kottilil
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA
- Global Virus Network, Baltimore, MD, 21201, USA
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA
- Program in Oncology, Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 21201, USA
| | | | - Robert C Gallo
- Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA.
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
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Siew ZY, Asudas E, Khoo CT, Cho GH, Voon K, Fang CM. Fighting nature with nature: antiviral compounds that target retroviruses. Arch Microbiol 2024; 206:130. [PMID: 38416180 DOI: 10.1007/s00203-024-03846-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/29/2024]
Abstract
The human immunodeficiency virus (HIV) is a type of lentivirus that targets the human immune system and leads to acquired immunodeficiency syndrome (AIDS) at a later stage. Up to 2021, there are millions still living with HIV and many have lost their lives. To date, many anti-HIV compounds have been discovered in living organisms, especially plants and marine sponges. However, no treatment can offer a complete cure, but only suppressing it with a life-long medication, known as combined antiretroviral therapy (cART) or highly active antiretroviral therapy (HAART) which are often associated with various adverse effects. Also, it takes many years for a discovered compound to be approved for clinical use. Thus, by employing advanced technologies such as automation, conducting systematic screening and testing protocols may boost the discovery and development of potent and curative therapeutics for HIV infection/AIDS. In this review, we aim to summarize the antiretroviral therapies/compounds and their associated drawbacks since the discovery of azidothymidine. Additionally, we aim to provide an updated analysis of the most recent discoveries of promising antiretroviral candidates, along with an exploration of the current limitations within antiretroviral research. Finally, we intend to glean insightful perspectives and propose future research directions in this crucial area of study.
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Affiliation(s)
- Zhen Yun Siew
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
| | - Elishea Asudas
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - Chia Ting Khoo
- School of Biosciences, University of Nottingham Malaysia, 43500, Semenyih, Selangor, Malaysia
| | - Gang Hyeon Cho
- School of Pharmacy, University of Nottingham Malaysia, 43500, Semenyih, Selangor, Malaysia
| | - Kenny Voon
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - Chee-Mun Fang
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
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7
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Guo Q, Zhang J, Parikh K, Brinkley A, Lin S, Zakarian C, Pernet O, Shimizu S, Khamaikawin W, Hacke K, Kasahara N, An DS. In vivo selection of anti-HIV-1 gene-modified human hematopoietic stem/progenitor cells to enhance engraftment and HIV-1 inhibition. Mol Ther 2024; 32:384-394. [PMID: 38087779 PMCID: PMC10862071 DOI: 10.1016/j.ymthe.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/17/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023] Open
Abstract
Hematopoietic stem/progenitor cell (HSPC)-based anti-HIV-1 gene therapy holds great promise to eradicate HIV-1 or to provide long-term remission through a continuous supply of anti-HIV-1 gene-modified cells without ongoing antiretroviral therapy. However, achieving sufficient engraftment levels of anti-HIV gene-modified HSPC to provide therapeutic efficacy has been a major limitation. Here, we report an in vivo selection strategy for anti-HIV-1 gene-modified HSPC by introducing 6-thioguanine (6TG) chemoresistance through knocking down hypoxanthine-guanine phosphoribosyl transferase (HPRT) expression using RNA interference (RNAi). We developed a lentiviral vector capable of co-expressing short hairpin RNA (shRNA) against HPRT alongside two anti-HIV-1 genes: shRNA targeting HIV-1 co-receptor CCR5 and a membrane-anchored HIV-1 fusion inhibitor, C46, for efficient in vivo selection of anti-HIV-1 gene-modified human HSPC. 6TG-mediated preconditioning and in vivo selection significantly enhanced engraftment of HPRT-knockdown anti-HIV-1 gene-modified cells (>2-fold, p < 0.0001) in humanized bone marrow/liver/thymus (huBLT) mice. Viral load was significantly reduced (>1 log fold, p < 0.001) in 6TG-treated HIV-1-infected huBLT mice compared to 6TG-untreated mice. We demonstrated that 6TG-mediated preconditioning and in vivo selection considerably improved engraftment of HPRT-knockdown anti-HIV-1 gene-modified HSPC and repopulation of anti-HIV-1 gene-modified hematopoietic cells in huBLT mice, allowing for efficient HIV-1 inhibition.
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Affiliation(s)
- Qi Guo
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Jian Zhang
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Keval Parikh
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Alexander Brinkley
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Samantha Lin
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Christina Zakarian
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Olivier Pernet
- Maternal, Child, and Adolescent Center for Infectious Diseases, University of Southern California, Los Angeles, CA 90089, USA
| | - Saki Shimizu
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA
| | - Wannisa Khamaikawin
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA; Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok 10520, Thailand
| | - Katrin Hacke
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Phoenix, AZ 85054, USA
| | - Noriyuki Kasahara
- UCSF, Neurological Surgery, Radiation Oncology, San Francisco, CA 94158, USA
| | - Dong Sung An
- UCLA AIDS Institute, UCLA, Los Angeles, CA 90024, USA; UCLA School of Nursing, UCLA, Los Angeles, CA 90095, USA.
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8
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Abadie RB, Brown EM, Campbell JR, Alvarez IA, Allampalli V, Ahmadzadeh S, Varrassi G, Shekoohi S, Kaye AD. Incidence and Risks of HIV Infection, Medication Options, and Adverse Effects in Accidental Needle Stick Injuries: A Narrative Review. Cureus 2024; 16:e51521. [PMID: 38304675 PMCID: PMC10831193 DOI: 10.7759/cureus.51521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
Accidental needle sticks can lead to infections, including HIV. As scientists have learned more about HIV and its replicative physiology, identification of target sites and novel medications have been developed. HIV is spread throughout the population through contact with blood, semen, and rectal or vaginal secretions of infected individuals. Therefore, it is important in general for healthcare workers to be aware of its transmission modes and ways to minimize exposure. In this regard, even with hospitals providing education, training, and safety protocols, there is a continued infection spread with HIV, especially by accidental needle sticks. There is also a wide variety of testing that can be used for HIV utilizing different methodologies, allowing for improved measurement of infection status. Any person with HIV should be tested to clarify infection status and be educated to minimize future virus spread. The current CDC recommendations for HIV infection treatment are antiretroviral therapies, such as an HIV postexposure prophylaxis regimen, which consists of a cocktail of antiretrovirals and postexposure prophylaxis immediately for occupational exposures, such as accidental needlestick exposure from an HIV infected patient. To decrease accidental HIV stick injuries, there are safety precautions in place, that if followed, would help reduce this incidence. HIV accidental needle stick injuries still happen in the hospital workplace, but with proper education and treatment, if exposed, there is hope to minimize the effects.
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Affiliation(s)
- Raegan B Abadie
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Elise M Brown
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - John R Campbell
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Ivan A Alvarez
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Varsha Allampalli
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | | | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
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9
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Vollmond CV, Tetens MM, Paulsen FW, Gerstoft J, Kronborg G, Johansen IS, Larsen CS, Wiese L, Dalager-Pedersen M, Leth S, Mortensen PB, Lebech AM, Obel N, Omland LH. Risk of Depression in People With Human Immunodeficiency Virus: A Nationwide Population-based Matched Cohort Study. Clin Infect Dis 2023; 77:1569-1577. [PMID: 37467149 DOI: 10.1093/cid/ciad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection is associated with depression. However, previous studies have not addressed familial factors. METHODS Nationwide, population-based, matched cohort study of people with HIV (PWH) in Denmark between 1995 and 2021 who were matched on sex and date of birth with a comparison cohort randomly selected from the Danish population. Family-related factors were examined by inclusion of siblings of those in the cohorts. We calculated hazard ratios (HRs) for depression, receipt of antidepressants, electroconvulsive therapy (ECT), and suicide, as well as the yearly proportions of study cohorts with psychiatric hospital contact due to depression and receipt of antidepressants from 10 years before to 10 years after study inclusion. RESULTS We included 5943 PWH and 59 430 comparison cohort members. Median age was 38 years, and 25% were women. We observed an increased risk of depression, receipt of antidepressants, ECT, and suicide among PWH in the 2 first years of observation (HR, 3.3; 95% confidence interval [CI]: 2.5-4.4), HR, 3.0 (95% CI: 2.7-3.4), HR, 2.8 (95% CI: .9-8.6), and HR, 10.7 (95% CI: 5.2-22.2), thereafter the risk subsided but remained increased. The proportions of PWH with psychiatric hospital contact due to depression and receipt of antidepressants were increased prior to and especially after HIV diagnosis. Risk of all outcomes was substantially lower among siblings of PWH than among PWH (HR for receipt of antidepressants, 1.1; 95% CI: 1.0-1.2). CONCLUSIONS PWH have an increased risk of depression. Family-related factors are unlikely to explain this risk.
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Affiliation(s)
- Cecilie V Vollmond
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Malte M Tetens
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Fie W Paulsen
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jan Gerstoft
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gitte Kronborg
- Department of Infectious Diseases, Copenhagen University Hospital, Amager-Hvidovre Hospital, Hvidovre, Denmark
| | - Isik S Johansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Carsten S Larsen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark
| | - Michael Dalager-Pedersen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Steffen Leth
- Department of Infectious Diseases & Internal Medicine, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Preben B Mortensen
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars H Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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10
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Yang X, Zhang J, Cheng Y, Cui M, Jiang Z, Fan C, Chen J, Qi L, Liu H, Bao D. Tenofovir disoproxil fumarate mediates neuronal injury by inducing neurotoxicity. Eur J Clin Microbiol Infect Dis 2023; 42:1195-1205. [PMID: 37604947 DOI: 10.1007/s10096-023-04654-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Highly active antiretroviral therapy (HAART) is an accepted treatment option for patients with virus infection. Mounting evidence indicated that persistent HAART treatment is implicated with increased morbidity of HIV-associated neurocognitive disorders (HAND) in patients. Tenofovir disoproxil fumarate (TDF), a novel nucleotide reverse transcriptase inhibitor (NRTI), was used in patients with HIV co-infected with HBV. And it is still a vital first-line antiretroviral compounds in HAART. However, whether persistent treatment with TDF is involved in HAND development remains to be further elucidated. In this study, we aimed to discuss the neurotoxicity of TDF. METHODS We used SH-SY5Y cells and primary neuronal cells to evaluate the neurotoxicity of TDF in vitro. The cytotoxicity of TDF on SH-SY5Y cells and primary neuronal cells was evaluated by the cell viability and LDH levels by MTT assay and LDH kit, respectively. Hoechst 33342 staining, TUNEL assay and flow cytometry were performed to evaluate the cells apoptosis. The intracellular reactive oxygen species (ROS) and malondialdehyde (MDA) production were measured by commercial kits. In addition, the activation level of caspase-3 was evaluated using spectrophotometry and western blotting. RESULTS Our results showed that TDF treatment significantly induced cell viability and induced apoptosis of SH-SY5Y cells and primary neuronal cells. Furthermore, the ROS levels and MDA productions were significantly up-regulated in nerve cells treated with TDF. CONCLUSION: Our findings indicated that TDF may induce neuronal cell apoptosis through increasing the intracellular ROS and the expression level of caspase-3, which may be related to the increasing prevalence of HAND.
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Affiliation(s)
- Xiaotian Yang
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
| | - Juanmei Zhang
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
- Ministry of Education Key Laboratory for Animal Pathogens and Biosafety, Zhengzhou, 450001, Henan, China
| | - Yanhong Cheng
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
- Shenzhen Beike Bio-Technology Co., Ltd, Shenzhen, 518000, Guangdong, China
| | - Mengmeng Cui
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
| | - Zhixiong Jiang
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
| | - Chunhui Fan
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
| | - Jiaxing Chen
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
| | - Lixia Qi
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China
| | - Hongliang Liu
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China.
- Ministry of Education Key Laboratory for Animal Pathogens and Biosafety, Zhengzhou, 450001, Henan, China.
| | - Dengke Bao
- Laboratory of Cancer Biomarkers and Liquid Biopsy, School of Pharmacy, Henan University, Kaifeng, 475004, Henan, China.
- Ministry of Education Key Laboratory for Animal Pathogens and Biosafety, Zhengzhou, 450001, Henan, China.
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11
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Thippabhotla S, Adeyemo B, Cooley SA, Roman J, Metcalf N, Boerwinkle A, Wisch J, Paul R, Ances BM. Comparison of Resting State Functional Connectivity in Persons With and Without HIV: A Cross-sectional Study. J Infect Dis 2023; 228:751-758. [PMID: 37228129 PMCID: PMC10503955 DOI: 10.1093/infdis/jiad180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study examined the effects of human immunodeficiency virus (HIV) on resting state functional connectivity (RSFC) in a large cohort of people with HIV (PWH) and healthy controls without HIV (PWoH). Within PWH analyses focused on the effects of viral suppression and cognitive impairment on RSFC. METHODS A total of 316 PWH on stable combination antiretroviral therapy and 209 demographically matched PWoH were scanned at a single institution. Effects of the virus were examined by grouping PWH by detectable (viral load > 20 copies/mL; VLD) and undetectable (VLU) viral loads and as being cognitively impaired (CI) (Global Deficit Score ≥ 0.5) or cognitively normal (CN). Regression analysis, object oriented data analysis, and spring embedded graph models were applied to RSFC measures from 298 established brain regions of interest comprising 13 brain networks to examine group differences. RESULTS No significant RSFC differences were observed between PWH and PWoH. Within PWH, there were no significant differences in RSFC between VLD and VLU subgroups and CI and CN subgroups. CONCLUSIONS There were no significant effects of HIV on RSFC in our relatively large cohort of PWH and PWoH. Future studies could increase the sample size and combine with other imaging modalities.
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Affiliation(s)
| | - Babatunde Adeyemo
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Sarah A Cooley
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - June Roman
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Nicholas Metcalf
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Anna Boerwinkle
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Julie Wisch
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Robert Paul
- University of Missouri-St Louis, St Louis, Missouri, USA
| | - Beau M Ances
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
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12
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Zondo S. The cognitive remediation of attention in HIV-associated neurocognitive disorders (HAND): A meta-analysis and systematic review. F1000Res 2023; 12:1133. [PMID: 38778812 PMCID: PMC11109681 DOI: 10.12688/f1000research.132166.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/25/2024] Open
Abstract
Background: Despite medical advances in Highly Active Antiretroviral Therapy (HAART), patients living with HIV continue to be at risk for developing HIV-associated neurocognitive disorders (HAND). The optimization of non-HAART interventions, including cognitive rehabilitation therapy (CRT), shows promise in reversing the impact of HAND. No data exist indicating the efficacy of CRT in remediating attention skills following neuroHIV. This paper presents a meta-analysis of randomised and non-randomised controlled trials (RCTs) to remediate attention skills following HIV CRT. Methods: The database search included literature from Google Scholar, ERIC, Cochrane Library, ISI Web of Knowledge, PubMed, PsycINFO, and grey literature published between 2013 and 2022. Inclusion criteria included studies with participants living with HIV who had undergone CRT intervention to remediate attention skills following neuroHIV. Exclusion criteria included case studies, non-human studies, and literature reviews. To assess study quality, including, randomisation, allocation concealment, participant and personnel blinding, the Cochrane Collaboration ratings system was applied. Results: A total of 14 studies met the inclusion criteria (n = 532). There were significant pre- to post-intervention between-group benefits due to CRT in the experimental group relative to control conditions for the remediation of attention skills following HIV acquisition (Hedges g = 0.251, 95% CI = 0.005 to 0.497; p < 0.05). No significant effects (p > 0.05) were demonstrated for subgroup analysis. Conclusions: To the author's knowledge, this is the first meta-analysis that exclusively analyses the remediation of attention skills in the era of HAART and neuroHIV, where all studies included participants diagnosed with HIV. The overall meta-analysis effect indicates the efficacy of CRT in remediating attention skills in HIV and HAND. It is recommended that future cognitive rehabilitation protocols to remediate attention skills should be context and population-specific and that they be supplemented by objective biomarkers indicating the efficacy of the CRT. Registration: Protocols.io (01/03/2023).
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Affiliation(s)
- Sizwe Zondo
- Department of Psychology, Rhodes University, Grahamstown, Eastern Cape, South Africa
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Braamfontein, Johannesburg, Gauteng, South Africa
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13
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Singh S, Thangaraj A, Chivero ET, Guo ML, Periyasamy P, Buch S. Role of Dysregulated Autophagy in HIV Tat, Cocaine, and cART Mediated NLRP3 Activation in Microglia. J Neuroimmune Pharmacol 2023; 18:327-347. [PMID: 37148425 PMCID: PMC10729649 DOI: 10.1007/s11481-023-10063-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/05/2023] [Indexed: 05/08/2023]
Abstract
Despite the ability of combination antiretroviral therapy (cART) to suppress viremia, there is persistence low levels of HIV proteins such as Transactivator of transcription (Tat) in the central nervous system (CNS), contributing to glial activation and neuroinflammation. Accumulating evidence also implicates the role of drugs of abuse in exacerbating neurological complications associated with HIV-1. The combined effects of HIV Tat, drugs of abuse, and cART can thus create a toxic milieu in the CNS. The present study investigated the combinatorial effects of HIV-Tat, cocaine, and cART on autophagy and NLRP3 inflammasome activation. We selected a combination of three commonly used cART regimens: tenofovir, emtricitabine, and dolutegravir. Our results demonstrated that exposure of mouse primary microglia (MPMs) to these agents-HIV Tat (25 ng/ml), cocaine (1 μM), and cART (1 μM each) resulted in upregulation of autophagy markers: Beclin1, LC3B-II, and SQSTM1 with impaired lysosomal functioning involving increased lysosomal pH, decreased LAMP2 and cathepsin D, ultimately leading to dysregulated autophagy. Our findings also demonstrated activation of the NLRP3 signaling in microglia exposed to these agents. We further demonstrated that gene silencing of key autophagy protein BECN1 significantly blocked NLRP3-mediated activation of microglia. Silencing of NLRP3, however, failed to block HIV Tat, cocaine, and cART-mediated dysregulation of the autophagy-lysosomal axis; these in vitro phenomena were also validated in vivo using iTat mice administered cocaine and cART. This study thus underscores the cooperative effects of HIV Tat, cocaine, and cART in exacerbating microglial activation involving dysregulated autophagy and activation of the NLRP3 inflammasome signaling.
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Affiliation(s)
- Seema Singh
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Annadurai Thangaraj
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
- Centre for Excellence in Nanobio Translational Research, Department of Pharmaceutical Technology, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Ernest T Chivero
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
- Department of Psychology, University of Nebraska Omaha, Omaha, NE, 68182-0001, USA
| | - Ming-Lei Guo
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, 23507, USA.
| | - Palsamy Periyasamy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
| | - Shilpa Buch
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
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14
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Kaur H, Minchella P, Alvarez-Carbonell D, Purandare N, Nagampalli VK, Blankenberg D, Hulgan T, Gerschenson M, Karn J, Aras S, Kallianpur AR. Contemporary Antiretroviral Therapy Dysregulates Iron Transport and Augments Mitochondrial Dysfunction in HIV-Infected Human Microglia and Neural-Lineage Cells. Int J Mol Sci 2023; 24:12242. [PMID: 37569616 PMCID: PMC10419149 DOI: 10.3390/ijms241512242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
HIV-associated cognitive dysfunction during combination antiretroviral therapy (cART) involves mitochondrial dysfunction, but the impact of contemporary cART on chronic metabolic changes in the brain and in latent HIV infection is unclear. We interrogated mitochondrial function in a human microglia (hμglia) cell line harboring inducible HIV provirus and in SH-SY5Y cells after exposure to individual antiretroviral drugs or cART, using the MitoStress assay. cART-induced changes in protein expression, reactive oxygen species (ROS) production, mitochondrial DNA copy number, and cellular iron were also explored. Finally, we evaluated the ability of ROS scavengers or plasmid-mediated overexpression of the antioxidant iron-binding protein, Fth1, to reverse mitochondrial defects. Contemporary antiretroviral drugs, particularly bictegravir, depressed multiple facets of mitochondrial function by 20-30%, with the most pronounced effects in latently infected HIV+ hμglia and SH-SY5Y cells. Latently HIV-infected hμglia exhibited upregulated glycolysis. Increases in total and/or mitochondrial ROS, mitochondrial DNA copy number, and cellular iron accompanied mitochondrial defects in hμglia and SH-SY5Y cells. In SH-SY5Y cells, cART reduced mitochondrial iron-sulfur-cluster-containing supercomplex and subunit expression and increased Nox2 expression. Fth1 overexpression or pre-treatment with N-acetylcysteine prevented cART-induced mitochondrial dysfunction. Contemporary cART impairs mitochondrial bioenergetics in hμglia and SH-SY5Y cells, partly through cellular iron accumulation; some effects differ by HIV latency.
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Affiliation(s)
- Harpreet Kaur
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Paige Minchella
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48202, USA
| | - David Alvarez-Carbonell
- Department of Microbiology and Molecular Biology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Neeraja Purandare
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48202, USA
| | - Vijay K. Nagampalli
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Daniel Blankenberg
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Todd Hulgan
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mariana Gerschenson
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96844, USA
| | - Jonathan Karn
- Department of Microbiology and Molecular Biology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Siddhesh Aras
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48202, USA
| | - Asha R. Kallianpur
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA
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15
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Chou CH, Chiou JS, Ho MW, Tien N, Li TM, Chiu ML, Tsai FJ, Wu YC, Chou IC, Lu HF, Lin TH, Liao CC, Huang SM, Liang WM, Lin YJ. Association of combination antiretroviral therapy with risk of neurological diseases in patients with HIV/AIDS in Taiwan: a nested case-control study. Front Pharmacol 2023; 14:1110605. [PMID: 37361207 PMCID: PMC10285306 DOI: 10.3389/fphar.2023.1110605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/09/2023] [Indexed: 06/28/2023] Open
Abstract
Heterogeneous neurocognitive impairment remains an important issue, even in the era of combination antiretroviral therapy (cART), with an incidence ranging from 15% to 65%. Although ART drugs with higher penetration scores to the central nervous system (CNS) show better HIV replication control in the CNS, the association between CNS penetration effectiveness (CPE) scores and neurocognitive impairment remains inconclusive. To explore whether ART exposure is associated with the risk of neurological diseases among patients with HIV/AIDS, this study in Taiwan involved 2,571 patients with neurological diseases and 10,284 matched, randomly selected patients without neurological diseases between 2010 and 2017. A conditional logistic regression model was used in this study. The parameters for ART exposure included ART usage, timing of exposure, cumulative defined daily dose (DDD), adherence, and cumulative CPE score. Incident cases of neurological diseases, including CNS infections, cognitive disorders, vasculopathy, and peripheral neuropathy, were obtained from the National Health Insurance Research Database in Taiwan. Odds ratios (ORs) for the risk of neurological diseases were conducted using a multivariate conditional logistic regression model. Patients with a history of past exposure (OR: 1.68, 95% confidence interval [CI]:1.22-2.32), low cumulative DDDs (< 2,500) (OR: 1.28, 95% CI: 1.15-1.42), low adherence (0 < adherence (ADH) ≤ 0.8) (OR: 1.46, 95% CI: 1.30-1.64), or high cumulative CPE scores (>14) (OR: 1.34, 95% CI: 1.14-1.57) had a high risk of neurological diseases. When stratified by classes of ART drugs, patients with low cumulative DDDs or low adherence had a high risk of neurological diseases, including NRTIs, PIs, NNRTIs, INSTIs, and multi-drug tablets. Subgroup analyses also suggested that patients with low cumulative DDDs or low adherence had a high risk of neurological diseases when they had high cumulative CPE scores. Patients with high cumulative DDDs or medication adherence were protected against neurological diseases only when they had low cumulative CPE scores (≤ 14). Patients may be at risk for neurological diseases when they have low cumulative DDDs, low adherence, or usage with high cumulative CPE scores. Continuous usage and low cumulative CPE scores of ART drugs may benefit neurocognitive health in patients with HIV/AIDS.
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Affiliation(s)
- Chen-Hsing Chou
- PhD Program for Health Science and Industry, College of Health Care, China Medical University, Taichung, Taiwan
| | - Jian-Shiun Chiou
- PhD Program for Health Science and Industry, College of Health Care, China Medical University, Taichung, Taiwan
| | - Mao-Wang Ho
- Section of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Internal Medicine, School of Medicine, China Medical University, Taichung, Taiwan
| | - Ni Tien
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Te-Mao Li
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Mu-Lin Chiu
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
- Department of Pediatrics, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Yang-Chang Wu
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - I-Ching Chou
- Department of Pediatrics, China Medical University Children’s Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Hsing-Fang Lu
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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16
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Cornea A, Lata I, Simu M, Rosca EC. Assessment and Diagnosis of HIV-Associated Dementia. Viruses 2023; 15:v15020378. [PMID: 36851592 PMCID: PMC9966987 DOI: 10.3390/v15020378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/11/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
The modern combined antiretroviral treatment (cART) for human immunodeficiency virus (HIV) infection has substantially lowered the incidence of HIV-associated dementia (HAD). The dominant clinical features include deficits in cognitive processing speed, concentration, attention, and memory. As people living with HIV become older, with high rates of comorbidities and concomitant treatments, the prevalence and complexity of cognitive impairment are expected to increase. Currently, the management of HAD and milder forms of HAND is grounded on the best clinical practice, as there is no specific, evidence-based, proven intervention for managing cognitive impairment. The present article acknowledges the multifactorial nature of the cognitive impairments found in HIV patients, outlining the current concepts in the field of HAD. Major areas of interest include neuropsychological testing and neuroimaging to evaluate CNS status, focusing on greater reliability in the exclusion of associated diseases and allowing for earlier diagnosis. Additionally, we considered the evidence for neurological involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the impact of the coronavirus (COVID-19) pandemic, with wider consequences to population health than can be attributed to the virus itself. The indirect effects of COVID-19, including the increased adoption of telehealth, decreased access to community resources, and social isolation, represent a significant health burden, disproportionately affecting older adults with dementia who have limited social networks and increased functional dependence on the community and health system. This synopsis reviews these aspects in greater detail, identifying key gaps and opportunities for researchers and clinicians; we provide an overview of the current concepts in the field of HAD, with suggestions for diagnosing and managing this important neurological complication, which is intended to be applicable across diverse populations, in line with clinical observations, and closely representative of HIV brain pathology.
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Affiliation(s)
- Amalia Cornea
- Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Irina Lata
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Mihaela Simu
- Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
| | - Elena Cecilia Rosca
- Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
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17
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Chiou JS, Chou CH, Ho MW, Tien N, Liang WM, Chiu ML, Tsai FJ, Wu YC, Chou IC, Lu HF, Lin TH, Liao CC, Huang SM, Li TM, Lin YJ. Effect of Chinese herbal medicine therapy on risks of all-cause mortality, infections, parasites, and circulatory-related mortality in HIV/AIDS patients with neurological diseases. Front Pharmacol 2023; 14:1097862. [PMID: 36937878 PMCID: PMC10020503 DOI: 10.3389/fphar.2023.1097862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction: Long-term living with human immunodeficiency virus (HIV) and/or antiretroviral therapy (ART) is associated with various adverse effects, including neurocognitive impairment. Heterogeneous neurocognitive impairment remains an important issue, affecting between 15-65% of human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) patients and resulting in work performance, safety, and health-related outcomes that have a heavy economic burden. Methods: We identified 1,209 HIV/AIDS patients with neurological diseases during 2010-2017. The Kaplan-Meier method, log-rank test, and Cox proportional hazards model were used to analyze 308 CHM users and 901 non-CHM users within this population. Major CHM clusters were determined using association rule mining and network analysis. Results and Discussion: Results showed that CHM users had a 70% lower risk of all-cause mortality (adjusted hazard ratio (aHR) = 0.30, 95% confidence interval (CI):0.16-0.58, p < 0.001) (p = 0.0007, log-rank test). Furthermore, CHM users had an 86% lower risk of infections, parasites, and circulatory-related mortality (aHR = 0.14, 95% confidence interval (CI):0.04-0.46, p = 0.001) (p = 0.0010, log-rank test). Association rule mining and network analysis showed that two CHM clusters were important for patients with neurological diseases. In the first CHM cluster, Huang Qin (HQ; root of Scutellaria baicalensis Georgi), Gan Cao (GC; root of Glycyrrhiza uralensis Fisch.), Huang Lian (HL; root of Coptis chinensis Franch.), Jie Geng (JG; root of Platycodon grandiflorus (Jacq.) A.DC.), and Huang Bai (HB; bark of Phellodendron amurense Rupr.) were identified as important CHMs. Among them, the strongest connection strength was identified between the HL and HQ. In the second CHM cluster, Suan-Zao-Ren-Tang (SZRT) and Ye Jiao Teng (YJT; stem of Polygonum multiflorum Thunb.) were identified as important CHMs with the strongest connection strength. CHMs may thus be effective in treating HIV/AIDS patients with neurological diseases, and future clinical trials are essential for the prevention of neurological dysfunction in the population.
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Affiliation(s)
- Jian-Shiun Chiou
- PhD Program for Health Science and Industry, College of Healthcare, China Medical University, Taichung, Taiwan
| | - Chen-Hsing Chou
- PhD Program for Health Science and Industry, College of Healthcare, China Medical University, Taichung, Taiwan
| | - Mao-Wang Ho
- Section of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Internal Medicine, School of Medicine, China Medical University, Taichung, Taiwan
| | - Ni Tien
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Mu-Lin Chiu
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
- Department of Pediatrics, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Yang-Chang Wu
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - I-Ching Chou
- Department of Pediatrics, China Medical University Children’s Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Hsing-Fang Lu
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Te-Mao Li
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Te-Mao Li, ; Ying-Ju Lin,
| | - Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- *Correspondence: Te-Mao Li, ; Ying-Ju Lin,
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18
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Riggs PK, Chaillon A, Jiang G, Letendre SL, Tang Y, Taylor J, Kaytes A, Smith DM, Dubé K, Gianella S. Lessons for Understanding Central Nervous System HIV Reservoirs from the Last Gift Program. Curr HIV/AIDS Rep 2022; 19:566-579. [PMID: 36260191 PMCID: PMC9580451 DOI: 10.1007/s11904-022-00628-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW Deep tissue HIV reservoirs, especially within the central nervous system (CNS), are understudied due to the challenges of sampling brain, spinal cord, and other tissues. Understanding the cellular characteristics and viral dynamics in CNS reservoirs is critical so that HIV cure trials can address them and monitor the direct and indirect effects of interventions. The Last Gift program was developed to address these needs by enrolling altruistic people with HIV (PWH) at the end of life who agree to rapid research autopsy. RECENT FINDINGS Recent findings from the Last Gift emphasize significant heterogeneity across CNS reservoirs, CNS compartmentalization including differential sensitivity to broadly neutralizing antibodies, and bidirectional migration of HIV across the blood-brain barrier. Our findings add support for the potential of CNS reservoirs to be a source of rebounding viruses and reseeding of systemic sites if they are not targeted by cure strategies. This review highlights important scientific, practical, and ethical lessons learned from the Last Gift program in the context of recent advances in understanding the CNS reservoirs and key knowledge gaps in current research.
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Affiliation(s)
| | | | - Guochun Jiang
- Department of Biochemistry and Biophysics, Institute of Global Health and Infectious Diseases, UNC HIV Cure Center, Chapel Hill, NC, USA
| | | | - Yuyang Tang
- Department of Biochemistry and Biophysics, Institute of Global Health and Infectious Diseases, UNC HIV Cure Center, Chapel Hill, NC, USA
| | - Jeff Taylor
- AntiViral Research Center (AVRC) Community Advisory Board, University of California San Diego, San Diego, CA, USA
- HIV + Aging Research Project - Palm Springs (HARP-PS), Palm Springs, CA, USA
| | - Andrew Kaytes
- AntiViral Research Center (AVRC) Community Advisory Board, University of California San Diego, San Diego, CA, USA
| | | | - Karine Dubé
- Department of Medicine, UCSD, San Diego, CA, USA
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19
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Gao L, Zhou J, Ye L. Role of CXCR5 + CD8 + T cells in human immunodeficiency virus-1 infection. Front Microbiol 2022; 13:998058. [PMID: 36452930 PMCID: PMC9701836 DOI: 10.3389/fmicb.2022.998058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/24/2022] [Indexed: 07/30/2023] Open
Abstract
Human immunodeficiency virus (HIV) infection can be effectively suppressed by life-long administration of combination antiretroviral therapy (cART). However, the viral rebound can occur upon cART cessation due to the long-term presence of HIV reservoirs, posing a considerable barrier to drug-free viral remission. Memory CD4+ T cell subsets, especially T follicular helper (T FH ) cells that reside in B-cell follicles within lymphoid tissues, are regarded as the predominant cellular compartment of the HIV reservoir. Substantial evidence indicates that HIV-specific CD8+ T cell-mediated cellular immunity can sustain long-term disease-free and transmission-free HIV control in elite controllers. However, most HIV cure strategies that rely on expanded HIV-specific CD8+ T cells for virus control are likely to fail due to cellular exhaustion and T FH reservoir-specialized anatomical structures that isolate HIV-specific CD8+ T cell entry into B-cell follicles. Loss of stem-like memory properties is a key feature of exhaustion. Recent studies have found that CXC chemokine receptor type 5 (CXCR5)-expressing HIV-specific CD8+ T cells are memory-like CD8+ T cells that can migrate into B-cell follicles to execute inhibition of viral replication. Furthermore, these unique CD8+ T cells can respond to immune checkpoint blockade (ICB) therapy. In this review, we discuss the functions of these CD8+ T cells as well as the translation of findings into viable HIV treatment and cure strategies.
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Affiliation(s)
- Leiqiong Gao
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Zhou
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Lilin Ye
- Institute of Immunology, Third Military Medical University, Chongqing, China
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20
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Ahmed-Leitao F, Du Plessis S, Konkiewitz EC, Spies G, Seedat S. Altered white matter integrity in the corpus callosum in adults with HIV: a systematic review of diffusion tensor imaging studies. Psychiatry Res Neuroimaging 2022; 326:111543. [PMID: 36126346 DOI: 10.1016/j.pscychresns.2022.111543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/17/2022] [Accepted: 09/01/2022] [Indexed: 11/28/2022]
Abstract
We systematically reviewed studies comparing differences in the integrity of the corpus callosum in adults with HIV compared to healthy controls, using Diffusion Tensor Imaging (DTI), using search engines Science Direct, Web of Science and PubMed. The search terms used were "HIV", "corpus callosum", and a variation of either "DTI" or "Diffusion Tensor Imaging" with or without the term "adults". We specifically examined the corpus callosum as it is the largest white matter tract in the brain, plays a primary role in cognition, and has been shown to be morphologically altered in people living with HIV. Lower fractional anisotropy (FA) was consistently found in the corpus callosum in people with HIV compared to controls. As most studies used only FA as a measure of diffusion, it would be informative for future research if other DTI metrics, such as mean diffusivity (MD), were also investigated as these metrics may be more sensitive markers of HIV-related neuropathology.
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Affiliation(s)
- Fatima Ahmed-Leitao
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Stellenbosch University, South Africa.
| | - Stefan Du Plessis
- Department of Psychiatry, Stellenbosch University, South Africa; SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
| | | | - Georgina Spies
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Stellenbosch University, South Africa; SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
| | - Soraya Seedat
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Stellenbosch University, South Africa; SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
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21
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Mulherkar TH, Gómez DJ, Sandel G, Jain P. Co-Infection and Cancer: Host–Pathogen Interaction between Dendritic Cells and HIV-1, HTLV-1, and Other Oncogenic Viruses. Viruses 2022; 14:v14092037. [PMID: 36146843 PMCID: PMC9503663 DOI: 10.3390/v14092037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Dendritic cells (DCs) function as a link between innate and adaptive immune responses. Retroviruses HIV-1 and HTLV-1 modulate DCs to their advantage and utilize them to propagate infection. Coinfection of HTLV-1 and HIV-1 has implications for cancer malignancies. Both viruses initially infect DCs and propagate the infection to CD4+ T cells through cell-to-cell transmission using mechanisms including the formation of virologic synapses, viral biofilms, and conduits. These retroviruses are both neurotrophic with neurovirulence determinants. The neuropathogenesis of HIV-1 and HTLV-1 results in neurodegenerative diseases such as HIV-associated neurocognitive disorders (HAND) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Infected DCs are known to traffic to the brain (CNS) and periphery (PNS, lymphatics) to induce neurodegeneration in HAND and HAM/TSP patients. Elevated levels of neuroinflammation have been correlated with cognitive decline and impairment of motor control performance. Current vaccinations and therapeutics for HIV-1 and HTLV-1 are assessed and can be applied to patients with HIV-1-associated cancers and adult T cell leukemia/lymphoma (ATL). These diseases caused by co-infections can result in both neurodegeneration and cancer. There are associations with cancer malignancies and HIV-1 and HTLV-1 as well as other human oncogenic viruses (EBV, HBV, HCV, HDV, and HPV). This review contains current knowledge on DC sensing of HIV-1 and HTLV-1 including DC-SIGN, Tat, Tax, and current viral therapies. An overview of DC interaction with oncogenic viruses including EBV, Hepatitis viruses, and HPV is also provided. Vaccines and therapeutics targeting host–pathogen interactions can provide a solution to co-infections, neurodegeneration, and cancer.
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Affiliation(s)
- Tania H. Mulherkar
- Department of Microbiology and Immunology, Drexel University, College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
| | - Daniel Joseph Gómez
- Department of Microbiology and Immunology, Drexel University, College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
- Department of Biological Sciences, California State University, 25800 Carlos Bee Blvd, Hayward, CA 94542, USA
| | - Grace Sandel
- Department of Microbiology and Immunology, Drexel University, College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
| | - Pooja Jain
- Department of Microbiology and Immunology, Drexel University, College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
- Correspondence:
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22
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Sreeram S, Ye F, Garcia-Mesa Y, Nguyen K, El Sayed A, Leskov K, Karn J. The potential role of HIV-1 latency in promoting neuroinflammation and HIV-1-associated neurocognitive disorder. Trends Immunol 2022; 43:630-639. [PMID: 35840529 PMCID: PMC9339484 DOI: 10.1016/j.it.2022.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
Despite potent suppression of HIV-1 viral replication in the central nervous system (CNS) by antiretroviral therapy (ART), between 15% and 60% of HIV-1-infected patients receiving ART exhibit neuroinflammation and symptoms of HIV-1-associated neurocognitive disorder (HAND) - a significant unmet challenge. We propose that the emergence of HIV-1 from latency in microglia underlies both neuroinflammation in the CNS and the progression of HAND. Recent molecular studies of cellular silencing mechanisms of HIV-1 in microglia show that HIV-1 latency can be reversed both by proinflammatory cytokines and by signals from damaged neurons, potentially creating intermittent cycles of HIV-1 reactivation and silencing in the brain. We posit that anti-inflammatory agents that also block HIV-1 reactivation, such as nuclear receptor agonists, might provide new putative therapeutic avenues for the treatment of HAND.
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Affiliation(s)
- Sheetal Sreeram
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA
| | - Fengchun Ye
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA
| | - Yoelvis Garcia-Mesa
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA
| | - Kien Nguyen
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA
| | - Ahmed El Sayed
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA
| | - Konstantin Leskov
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA
| | - Jonathan Karn
- Department of Molecular Biology and Microbiology. Case Western Reserve University, Cleveland, OH, USA.
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23
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Ipser JC, Joska J, Sevenoaks T, Gouse H, Freeman C, Kaufmann T, Andreassen OA, Shoptaw S, Stein DJ. Limited evidence for a moderating effect of HIV status on brain age in heavy episodic drinkers. J Neurovirol 2022; 28:383-391. [PMID: 35355213 DOI: 10.1007/s13365-022-01072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/01/2022]
Abstract
We set out to test the hypothesis that greater brain ageing will be observed in people with HIV (PWH) and those who engage in heavy episodic drinking (HED), with their combined effects being especially detrimental in cognitive control brain networks. We correlated measures of "brain age gap" (BAG) and neurocognitive impairment in participants with and without HIV and HED. Sixty-nine participants were recruited from a community health centre in Cape Town: HIV - /HED - (N = 17), HIV + /HED - (N = 14), HIV - /HED + (N = 21), and HIV + /HED + (N = 17). Brain age was modelled using structural MRI features from the whole brain or one of six brain regions. Linear regression models were employed to identify differences in BAG between patient groups and controls. Associations between BAG and clinical data were tested using bivariate statistical methods. Compared to controls, greater global BAG was observed in heavy drinkers, both with (Cohen's d = 1.52) and without (d = 1.61) HIV. Differences in BAG between HED participants and controls were observed for the cingulate and parietal cortex, as well as subcortically. A larger BAG was associated with higher total drinking scores but not nadir CD4 count or current HIV viral load. The association between heavy episodic drinking and BAG, independent of HIV status, points to the importance of screening for alcohol use disorders in primary care. The relatively large contribution of cognitive control brain regions to BAG highlights the utility of assessing the contribution of different brain regions to brain age.
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Affiliation(s)
- Jonathan C Ipser
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa. .,Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - John Joska
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Tatum Sevenoaks
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa
| | - Hetta Gouse
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa
| | - Carla Freeman
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa
| | - Tobias Kaufmann
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT Oslo University Hospital & University of Oslo, Tübingen, Germany.,Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT Oslo University Hospital & University of Oslo, Tübingen, Germany
| | - Steve Shoptaw
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa.,Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa.,MRC Unit On Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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24
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Basova LV, Lukkes SE, Milner R, Ellis RJ, Cherner M, Iudicello J, Marcondes MCG. Polygenic networks in peripheral leukocytes indicate patterns associated with HIV infection and context-dependent effects of cannabis use. Brain Behav Immun Health 2022; 20:100414. [PMID: 35128491 PMCID: PMC8808072 DOI: 10.1016/j.bbih.2022.100414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 11/26/2022] Open
Abstract
In spite of suppressive antiretroviral therapies (ART), Human Immunodeficiency Virus (HIV)-infected subjects still experience the consequences of viral persistence and chronic inflammation. In the brain, where most HIV-1 targets are of innate immune origin, neurological and cognitive impairments are detectable and enhanced by highly prevalent substance use disorders. Cannabis is one of the most prevalent substances among HIV+ subjects, compared to non-infected populations, either prescribed for improving various symptoms or used recreationally, as well as a component of polysubstance use. The mechanisms by which addictive substances and HIV interact are multifactorial and poorly understood. Importantly, the HIV brain target cells, macrophages and microglia, express receptors to neurotransmitters elevated by such drugs, and express receptors to cannabinoids, particularly CB2R. We have tested a panel of 784 transcripts associated with neurological disorders, digitally multiplexed and detectable in peripheral blood cells from a small cohort (n = 102) of HIV-positive (HIV+) and HIV-negative (HIV-) specimens, stratified based on criteria of lifetime (LT) dependence of cannabis (CAN+) or not (CAN-). Demographic homogeneity and low incidence of co-morbidities helped increase power and allowed the identification of key differences consistent with HIV infection, cannabis exposure, or their interactions. A small percentage of these subjects used cannabis as well as other drugs. The data was analyzed using robust systems and visualization strategies to detect orchestrated patterns in gene networks connected based on molecular interfaces with higher power than in single genes. We found that the effects of cannabis differed drastically between HIV- and HIV+ groups, particularly in gene networks playing a role in inflammation, neurodegeneration, apoptosis and leukocyte adhesion and transmigration. At the level of individual genes, we identified detrimental effects that were associated with polysubstance use as a covariate, particularly methamphetamine. Transcription factor usage predictions suggest that the effects of cannabis are associated with transcriptional co-regulation at the gene promoters by multiple factors that vary by context. Overall, we have found that the effects of cannabis may be context-dependent, with potential benefits in the context of HIV reflected by improvements in cognition, but in the absence of the polysubstance use component.
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Affiliation(s)
- Liana V. Basova
- San Diego Biomedical Research Institute, San Diego, CA, 92121, USA
| | | | - Richard Milner
- San Diego Biomedical Research Institute, San Diego, CA, 92121, USA
| | - Ronald J. Ellis
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
| | - Jennifer Iudicello
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92093, USA
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25
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Sari H, Galbusera R, Bonnier G, Lin Y, Alshelh Z, Torrado-Carvajal A, Mukerji SS, Ratai EM, Gandhi RT, Chu JT, Akeju O, Orhurhu V, Salvatore AN, Sherman J, Kwon DS, Walker B, Rosen B, Price JC, Pollak LE, Loggia M, Granziera C. Multimodal Investigation of Neuroinflammation in Aviremic Patients With HIV on Antiretroviral Therapy and HIV Elite Controllers. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/2/e1144. [PMID: 35140142 PMCID: PMC8860468 DOI: 10.1212/nxi.0000000000001144] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES The presence of HIV in the CNS has been related to chronic immune activation and cognitive dysfunction. The aim of this work was to investigate (1) the presence of neuroinflammation in aviremic people with HIV (PWH) on therapy and in nontreated aviremic PWH (elite controllers [ECs]) using a translocator protein 18 kDa radioligand; (2) the relationship between neuroinflammation and cognitive function in aviremic PWH; and (3) the relationship between [11C]-PBR28 signal and quantitative MRI (qMRI) measures of brain tissue integrity such as T1 and T2 relaxation times (rts). METHODS [11C]-PBR28 (standard uptake value ratio, SUVR) images were generated in 36 participants (14 PWH, 6 ECs, and 16 healthy controls) using a statistically defined pseudoreference region. Group comparisons of [11C]-PBR28 SUVR were performed using region of interest-based and voxelwise analyses. The relationship between inflammation, qMRI measures, and cognitive function was studied. RESULTS In region of interest analyses, ECs exhibited significantly lower [11C]-PBR28 signal in the thalamus, putamen, superior temporal gyrus, prefrontal cortex, and cerebellum compared with the PWH. In voxelwise analyses, differences were observed in the thalamus, precuneus cortex, inferior temporal gyrus, occipital cortex, cerebellum, and white matter (WM). [11C]-PBR28 signal in the WM and superior temporal gyrus was related to processing speed and selective attention in PWH. In a subset of PWH (n = 12), [11C]-PBR28 signal in the thalamus and WM regions was related to a decrease in T2 rt and to an increase in T1 rt suggesting a colocalization of increased glial metabolism, decrease in microstructural integrity, and iron accumulation. DISCUSSION This study casts a new light onto the role of neuroinflammation and related microstructural alterations of HIV infection in the CNS and shows that ECs suppress neuroinflammation more effectively than PWH on therapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Cristina Granziera
- From the MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging (H.S., Y.L., Z.A., A.T.-C., E.M.R., A.N.S., B.R., J.C.P., M.L.), Massachusetts General Hospital, Harvard Medical School, Charlestown; Neurologic Clinic and Policlinic (R.G., G.B., C.G.), Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland; Translational Imaging in Neurology (ThINk) Basel (R.G., G.B., C.G.), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland; Medical Image Analysis and Biometry Lab (A.T.-C.), Universidad Rey Juan Carlos, Madrid, Spain; Department of Neurology (S.S.M., R.T.G.), Infectious Diseases (J.T.C.), Department of Anesthesia (O.A., V.O.), and Department of Psychiatry (J.S., L.E.P.), Massachusetts General Hospital, Boston; and Ragon Institute of MGH (D.S.K., B.W.), MIT and Harvard, Cambridge, MA.
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26
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High-content analysis and Kinetic Image Cytometry identify toxicity and epigenetic effects of HIV antiretrovirals on human iPSC-neurons and primary neural precursor cells. J Pharmacol Toxicol Methods 2022; 114:107157. [PMID: 35143957 PMCID: PMC9103414 DOI: 10.1016/j.vascn.2022.107157] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Despite viral suppression due to combination antiretroviral therapy (cART), HIV-associated neurocognitive disorders (HAND) continue to affect half of people with HIV, suggesting that certain antiretrovirals (ARVs) may contribute to HAND. METHODS We examined the effects of nucleoside/nucleotide reverse transcriptase inhibitors tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) and the integrase inhibitors dolutegravir (DTG) and elvitegravir (EVG) on viability, structure, and function of glutamatergic neurons (a subtype of CNS neuron involved in cognition) derived from human induced pluripotent stem cells (hiPSC-neurons), and primary human neural precursor cells (hNPCs), which are responsible for neurogenesis. RESULTS Using automated digital microscopy and image analysis (high content analysis, HCA), we found that DTG, EVG, and TDF decreased hiPSC-neuron viability, neurites, and synapses after 7 days of treatment. Analysis of hiPSC-neuron calcium activity using Kinetic Image Cytometry (KIC) demonstrated that DTG and EVG also decreased the frequency and magnitude of intracellular calcium transients. Longer ARV exposures and simultaneous exposure to multiple ARVs increased the magnitude of these neurotoxic effects. Using the Microscopic Imaging of Epigenetic Landscapes (MIEL) assay, we found that TDF decreased hNPC viability and changed the distribution of histone modifications that regulate chromatin packing, suggesting that TDF may reduce neuroprogenitor pools important for CNS development and maintenance of cognition in adults. CONCLUSION This study establishes human preclinical assays that can screen potential ARVs for CNS toxicity to develop safer cART regimens and HAND therapeutics.
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Spies G, Ahmed-Leitao F, Hoddinott G, Seedat S. Effects of unhealthy alcohol use on brain morphometry and neurocognitive function among people with HIV. J Neurovirol 2021; 28:35-45. [PMID: 34882280 DOI: 10.1007/s13365-021-01027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/13/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
Individual impacts of alcohol misuse and HIV on brain structure and function have been well demonstrated; however, the potential compounded effect of these conditions is seldom considered, despite the high prevalence of alcohol use in HIV infection. We aimed to determine the effects of unhealthy alcohol use on brain morphometry and cognitive function amongst people with HIV (PWH). In 27 (50.9%) HIV-positive users of alcohol and 26 (49.1%) HIV-positive abstainers from alcohol, results revealed significant differences for left and right amygdala (p < 0.01), left and right hippocampus (p = 0.05), left and right posterior cingulate (p < 0.01), left and right precuneus (p < 0.01), left insula (p < 0.01), left and right caudate (p < 0.01), right thalamus (p < 0.01), and corpus callosum (p < 0.05). Mean volume of these regions was significantly smaller in HIV-positive alcohol users compared to HIV-positive abstainers. Homogeneity of slopes ANCOVA revealed significant associations between anterior cingulate cortex, precuneus, amygdala, hippocampus, and insula volumes and cognitive function in the domains of learning and delayed recall, motor function, speed of information processing, executive function, attention/working memory, and language. Among PWH, unhealthy alcohol use is associated with negative effects on brain structure and cognitive function.
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Affiliation(s)
- Georgina Spies
- DSI/NRF South African Research Chairs Initiative in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa. .,Department of Psychiatry, South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, P.O. Box 241, Cape Town, 8000, South Africa.
| | - Fatima Ahmed-Leitao
- DSI/NRF South African Research Chairs Initiative in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Soraya Seedat
- DSI/NRF South African Research Chairs Initiative in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Department of Psychiatry, South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, P.O. Box 241, Cape Town, 8000, South Africa
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Ojeda-Juárez D, Kaul M. Transcriptomic and Genetic Profiling of HIV-Associated Neurocognitive Disorders. Front Mol Biosci 2021; 8:721954. [PMID: 34778371 PMCID: PMC8586712 DOI: 10.3389/fmolb.2021.721954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/24/2021] [Indexed: 12/20/2022] Open
Abstract
Early in the HIV pandemic, it became evident that people living with HIV (PLWH) develop a wide range of neurological and neurocognitive complications. Even after the introduction of combination antiretroviral therapy (cART), which dramatically improved survival of PLWH, the overall number of people living with some form of HIV-associated neurocognitive disorders (HAND) seemed to remain unchanged, although the incidence of dementia declined and questions about the incidence and diagnosis of the mildest form of HAND arose. To better understand this complex disease, several transcriptomic analyses have been conducted in autopsy samples, as well as in non-human primates and small animal rodent models. However, genetic studies in the HIV field have mostly focused on the genetic makeup of the immune system. Much less is known about the genetic underpinnings of HAND. Here, we provide a summary of reported transcriptomic and epigenetic changes in HAND, as well as some of the potential genetic underpinnings that have been linked to HAND, and discuss future directions with hurdles to overcome and angles that remain to be explored.
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Affiliation(s)
- Daniel Ojeda-Juárez
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Marcus Kaul
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
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Gaskill PJ, Fields JA, Langford DT, Stauch KL, Williams DW. Editorial: Advances in Understanding NeuroHIV Associated Changes in Neuroimmune Communication in the Combined Anti-retroviral Therapy (cART) Era. Front Neurol 2021; 12:763448. [PMID: 34675877 PMCID: PMC8523985 DOI: 10.3389/fneur.2021.763448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/08/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
- Peter J Gaskill
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Jerel Adam Fields
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Dianne T Langford
- Department of Neuroscience, Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Kelly L Stauch
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Dionna W Williams
- Department of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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30
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Guzman VA, Cham H, Gutierrez J, Byrd D, Morris EP, Tureson K, Morgello S, Mindt MR. The Longitudinal Effects of Blood Pressure and Hypertension on Neurocognitive Performance in People Living With HIV. J Acquir Immune Defic Syndr 2021; 88:197-205. [PMID: 34081663 PMCID: PMC8434985 DOI: 10.1097/qai.0000000000002740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hypertension (HTN) and HIV are salient risk factors for cerebral small vessel disease and neurocognitive (NC) impairment, yet the effects of HTN on NC performance in persons living with HIV remain poorly understood. This is the first study to examine the longitudinal associations between blood pressure (BP), HTN, and pulse pressure (PP) with NC performance in persons living with HIV. SETTING New York City. METHODS Analysis of medical, NC, and virologic data from 485 HIV+ participants was collected by the Manhattan HIV Brain Bank, a prospective, observational, longitudinal study of neuroHIV. A series of multilevel linear growth curve models with random intercepts and slopes were estimated for BP, HTN status, and PP to predict the change in NC performance. RESULTS The baseline prevalence of HTN was 23%. Longitudinal changes in diastolic and systolic pressure were associated with a 10.5-second and 4-second increase in the Grooved Pegboard Test nondominant hand performance, respectively. A longitudinal change in diastolic BP was also associated with a 0.3-point decline in correct categories and 3-point increase in perseverative responses and total errors on the Wisconsin Card Sorting Test. Increasing odds of prevalent and/or incident HTN were associated with a 0.1-point decrease in correct categories and a 0.8-point increase in total errors on the Wisconsin Card Sorting Test. There was no association between PP and NC performance. CONCLUSIONS The results indicate linear longitudinal relations for BP and HTN with poorer NC test performance, particularly in psychomotor and executive functions in persons with HIV.
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Affiliation(s)
- Vanessa A. Guzman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Fordham University, New York, NY, USA
| | - Heining Cham
- Department of Psychology, Fordham University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Desiree Byrd
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Queens College and The Graduate Center, CUNY, Queens, New York, USA
| | - Emily P. Morris
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kayla Tureson
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Psychology, University of Southern California, Los Angeles, USA
| | - Susan Morgello
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Departments of Pathology and Neuroscience, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Monica Rivera Mindt
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Fordham University, New York, NY, USA
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Jordan-Sciutto KL. Effects of Antiretroviral Therapy in the Central Nervous System: Beyond Viral Suppression. J Neuroimmune Pharmacol 2021; 16:71-73. [PMID: 33649998 DOI: 10.1007/s11481-021-09987-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/15/2022]
Abstract
Persistence of cognitive, behavioral and, to a lesser extent, motor dysfunction in People living with HIV (PLWH) despite viral suppression has raised the question about the potential contribution of antiretroviral (ARV) compounds themselves. Converging clinical and experimental evidence support a contribution of ARV compounds. In this issue we explore the existing clinical evidence on the impact of antiretroviral therapy (ART) on the CNS across the age continuum and in women. We further examine cell type specific effects of ARV drugs as well as the class specific effects. Finally, underlying mechanisms for the observed clinical and experimental ARV-induced effects are discussed. To improve the quality of life for PLWH who are dependent on life-long ART for viral suppression, it is critical to minimize ARV-induced cellular and tissue dysfunction in the CNS.
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Affiliation(s)
- Kelly L Jordan-Sciutto
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, 240 S. 40th St, Rm 312 Levy Bldg, Philadelphia, PA, 19104-6030, USA.
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Sullivan MN, Brill SA, Mangus LM, Jeong YJ, Solis CV, Knight AC, Colantuoni C, Keceli G, Paolocci N, Queen SE, Mankowski JL. Upregulation of Superoxide Dismutase 2 by Astrocytes in the SIV/Macaque Model of HIV-Associated Neurologic Disease. J Neuropathol Exp Neurol 2021; 79:986-997. [PMID: 32783052 DOI: 10.1093/jnen/nlaa084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/11/2020] [Accepted: 07/03/2020] [Indexed: 12/13/2022] Open
Abstract
HIV-associated neurocognitive disorders (HAND) remain prevalent despite implementation of antiretroviral therapy (ART). Development of HAND is linked to mitochondrial dysfunction and oxidative stress in the brain; therefore, upregulation of antioxidant defenses is critical to curtail neuronal damage. Superoxide dismutase 2 (SOD2) is a mitochondrial antioxidant enzyme essential for maintaining cellular viability. We hypothesized that SOD2 was upregulated during retroviral infection. Using a simian immunodeficiency virus (SIV)-infected macaque model of HIV, quantitative PCR showed elevated SOD2 mRNA in cortical gray ([GM], 7.6-fold for SIV vs uninfected) and white matter ([WM], 77-fold for SIV vs uninfected) during SIV infection. Further, SOD2 immunostaining was enhanced in GM and WM from SIV-infected animals. Double immunofluorescence labeling illustrated that SOD2 primarily colocalized with astrocyte marker glial fibrillary acidic protein (GFAP) in SIV-infected animals. Interestingly, in ART-treated SIV-infected animals, brain SOD2 RNA levels were similar to uninfected animals. Additionally, using principal component analysis in a transcriptomic approach, SOD2 and GFAP expression separated SIV-infected from uninfected brain tissue. Projection of these data into a HIV dataset revealed similar expression changes, thereby validating the clinical relevance. Together, our findings suggest that novel SOD2-enhancing therapies may reduce neuroinflammation in ART-treated HIV-infected patients.
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Affiliation(s)
- Michelle N Sullivan
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Samuel A Brill
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa M Mangus
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yea Ji Jeong
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Clarisse V Solis
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Audrey C Knight
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Carlo Colantuoni
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gizem Keceli
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nazareno Paolocci
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Suzanne E Queen
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joseph L Mankowski
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract
Even after more than 30 years since its discovery, there is no cure for HIV-1 infection. Combination antiretroviral therapy (cART) is currently the only HIV-1 infection management option in clinics. Despite its success in suppressing viral replication and converting HIV-1 from a lethal infection to a chronic and manageable disease, cART treatment is life long and long-term use can result in major drawbacks such as high cost, multiple side effects, and an increase in the development of multidrug-resistant escape mutants. Recently, antibody-based anti-HIV-1 treatment has emerged as a potential alternative therapeutic modality for HIV-1 treatment and cure strategies. These antibody-based anti-HIV-1 treatments comprising either receptor-targeting antibodies or broad neutralizing antibodies (bNAbs) are currently being developed and evaluated in clinical trials. These antibodies have demonstrated potent antiviral effects against multiple strains of HIV-1, and shown promise for prevention, maintenance, and prolonged remission of HIV-1 infection. This review gives an update on the current status of these antibody-based treatments for HIV-1, discusses their mechanism of action and the challenges in developing them, providing insight for their development as novel clinical therapies against HIV-1 infection.
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Affiliation(s)
- Wanwisa Promsote
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Megan E DeMouth
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Cassandra G Almasri
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Amarendra Pegu
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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34
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Chattopadhyay S, Hu CMJ. Nanomedicinal delivery of stimulator of interferon genes agonists: recent advances in virus vaccination. Nanomedicine (Lond) 2020; 15:2883-2894. [PMID: 33252301 DOI: 10.2217/nnm-2020-0269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The discovery of stimulator of interferon genes (STING) and their agonists as primary components that link antiviral innate and adaptive immunity has motivated growing research on STING agonist-mediated immunotherapy and vaccine development. To overcome the delivery challenge in shuttling highly polar STING agonists, typically in the form of cyclic dinucleotides, to target cells and to STING proteins in cellular cytosol, numerous nanoformulation strategies have been implemented for effective STING activation. While many STING-activating nanoparticles are developed to enhance anticancer immunotherapy, their adoption as vaccine adjuvant has vastly propelled antiviral vaccination efforts against challenging public health threats, including HIV, influenza and coronaviruses. In light of the COVID-19 pandemic that has thrusted vaccine development into the public spotlight, this review highlights advances in nanomedicinal STING agonist delivery with an emphasis on their applications in antiviral vaccination.
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Affiliation(s)
- Saborni Chattopadhyay
- Taiwan International Graduate Program in Molecular Medicine, National Yang-Ming University & Academic Sinica, Taipei 11529, Taiwan.,Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan
| | - Che-Ming Jack Hu
- Taiwan International Graduate Program in Molecular Medicine, National Yang-Ming University & Academic Sinica, Taipei 11529, Taiwan.,Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan.,Center of Applied Nanomedicine, National Cheng Kung University, Tainan 701, Taiwan
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35
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Spies G, Mall S, Wieler H, Masilela L, Castelon Konkiewitz E, Seedat S. The relationship between potentially traumatic or stressful events, HIV infection and neurocognitive impairment (NCI): a systematic review of observational epidemiological studies. Eur J Psychotraumatol 2020; 11:1781432. [PMID: 33029322 PMCID: PMC7473036 DOI: 10.1080/20008198.2020.1781432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND HIV/AIDS and potentially traumatic events (PTEs) or stressful life events (SLEs) and/or PTSD are independently associated with neurocognitive impairment (NCI). Literature suggests that HIV and PTE/SLE exposure independently and consistently affect various domains of cognition including language ability, working memory and psychomotor speed. There are limited data on the interaction between HIV infection and PTEs and their combined effect on NCI. OBJECTIVE In this systematic review, we synthesise evidence for the combined effect of HIV infection and PTEs and SLEs and/or post-traumatic stress disorder (PTSD) on NCI of people living with HIV/AIDS (PLWHA) from high-, middle- and low- income countries. METHOD Our inclusion criteria were observational epidemiological studies (case-control, cohort and cross-sectional designs) that investigated the interaction of HIV infection, PTEs and SLEs and/or PTSD and specifically their combined effect on NCI in adults. We searched a number of electronic databases including Pubmed/Medline, PsycINFO, Scopus and Global Health using the search terms: cognition, HIV/AIDS, observational studies, trauma and permutations thereof. RESULTS Fifteen studies were included in the review, of which the majority were conducted in high-income countries. Ten of the fifteen studies were conducted in the United States of America (USA) and five in South Africa. Seven of these focused on early life stress/childhood trauma. The remaining studies assessed adult-onset PTEs and SLEs only. Eight studies included women only. Overall, the studies suggest that PTE and SLE exposure and/or PTSD are a significant risk factor for NCI in adults living with HIV, with impairments in memory and executive functions being the most likely consequence of PTE and SLE exposure. CONCLUSION These findings highlight the need for trauma screening and for the integration of trauma-focused interventions in HIV care to improve outcomes.
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Affiliation(s)
- G. Spies
- DST/NRF South African Research Chair in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - S. Mall
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - H. Wieler
- DST/NRF South African Research Chair in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - L. Masilela
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - E. Castelon Konkiewitz
- Faculdade de Ciências Médicas e da Saúde, Universidade Federal da Grande Dourados, Dourados, Brasil
| | - S. Seedat
- DST/NRF South African Research Chair in PTSD, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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36
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Ghura S, Gross R, Jordan-Sciutto K, Dubroff J, Schnoll R, Collman RG, Ashare RL. Bidirectional Associations among Nicotine and Tobacco Smoke, NeuroHIV, and Antiretroviral Therapy. J Neuroimmune Pharmacol 2019; 15:694-714. [PMID: 31834620 DOI: 10.1007/s11481-019-09897-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/01/2019] [Indexed: 12/12/2022]
Abstract
People living with HIV (PLWH) in the antiretroviral therapy (ART) era may lose more life-years to tobacco use than to HIV. Yet, smoking rates are more than twice as high among PLWH than the general population, contributing not just to mortality but to other adverse health outcomes, including neurocognitive deficits (neuroHIV). There is growing evidence that synergy with chronic inflammation and immune dysregulation that persists despite ART may be one mechanism by which tobacco smoking contributes to neuroHIV. This review will summarize the differential effects of nicotine vs tobacco smoking on inflammation in addition to the effects of tobacco smoke components on HIV disease progression. We will also discuss biomarkers of inflammation via neuroimaging as well as biomarkers of nicotine dependence (e.g., nicotine metabolite ratio). Tobacco smoking and nicotine may impact ART drug metabolism and conversely, certain ARTs may impact nicotine metabolism. Thus, we will review these bidirectional relationships and how they may contribute to neuroHIV and other adverse outcomes. We will also discuss the effects of tobacco use on the interaction between peripheral organs (lungs, heart, kidney) and subsequent CNS function in the context of HIV. Lastly, given the dramatic rise in the use of electronic nicotine delivery systems, we will discuss the implications of vaping on these processes. Despite the growing recognition of the importance of addressing tobacco use among PLWH, more research is necessary at both the preclinical and clinical level to disentangle the potentially synergistic effects of tobacco use, nicotine, HIV, cognition and immune dysregulation, as well as identify optimal approaches to reduce tobacco use. Graphical Abstract Proposed model of the relationships among HIV, ART, smoking, inflammation, and neurocognition. Solid lines represent relationships supported by evidence. Dashed lines represent relationships for which there is not enough evidence to make a conclusion. (a) HIV infection produces elevated levels of inflammation even among virally suppressed individuals. (b) HIV is associated with deficits in cognition function. (c) Smoking rates are higher among PLWH, compared to the general population. (d) The nicotine metabolite ratio (NMR) is associated with smoking behavior. (e) HIV and tobacco use are both associated with higher rates of psychiatric comorbidities, such as depression, and elevated levels of chronic stress. These factors may represent other mechanisms linking HIV and tobacco use. (f) The relationship between nicotine, tobacco smoking, and inflammation is complex, but it is well-established that smoking induces inflammation; the evidence for nicotine as anti-inflammatory is supported in some studies, but not others. (g) The relationship between tobacco use and neurocognition may differ for the effects of nicotine (acute nicotine use may have beneficial effects) vs. tobacco smoking (chronic use may impair cognition). (h) Elevated levels of inflammation may be associated with deficits in cognition. (i) PLWH may metabolize nicotine faster than those without HIV; the mechanism is not yet known and the finding needs validation in larger samples. We also hypothesize that if HIV-infection increases nicotine metabolism, then we should observe an attenuation effect once ART is initiated. (j) It is possible that the increase in NMR is due to ART effects on CYP2A6. (k) We hypothesize that faster nicotine metabolism may result in higher levels of inflammation since nicotine has anti-inflammatory properties.
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Affiliation(s)
- Shivesh Ghura
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Gross
- Division of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, USA.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - Kelly Jordan-Sciutto
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacob Dubroff
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Schnoll
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA
| | - Ronald G Collman
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca L Ashare
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite, Philadelphia, PA, 4100, USA.
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