Abstract

The major obstacle to human immunodeficiency type 1 virus (HIV-1) eradication is a reservoir of latently infected cells that persists despite long-term antiretroviral therapy (ART) and is maintained through cellular proliferation. Long-lived memory CD4+ T cells with high self-renewal capacity, such as central memory (CM) T cells and stem cell memory (SCM) T cells, are major contributors to the viral reservoir in HIV-infected individuals on ART. The Wnt/β-catenin signaling pathway regulates the balance between self-renewal and differentiation of SCM and CM T cells, and pharmacological manipulation of this pathway offers an opportunity to interfere with the proliferation of latently infected cells. Here, we evaluated in vivo a novel approach to inhibit self-renewal of SCM and CM CD4+ T cells in the rhesus macaque (RM) model of simian immunodeficiency (SIV) infection. We used an inhibitor of the Wnt/β-catenin pathway, PRI-724, that blocks the interaction between the coactivator CREB-binding protein (CBP) and β-catenin, resulting in the cell fate decision to differentiate rather than proliferate. Our study shows that PRI-724 treatment of ART-suppressed SIVmac251-infected RMs resulted in decreased proliferation of SCM and CM T cells and modified the SCM and CM CD4+ T cell transcriptome toward a profile of more differentiated memory T cells. However, short-term treatment with PRI-724 alone did not significantly reduce the size of the viral reservoir. This work demonstrates for the first time that stemness pathways of long-lived memory CD4+ T cells can be pharmacologically modulated in vivo, thus establishing a novel strategy to target HIV persistence.IMPORTANCE Long-lasting CD4+ T cell subsets, such as central memory and stem cell memory CD4+ T cells, represent critical reservoirs for human immunodeficiency virus (HIV) persistence despite suppressive antiretroviral therapy. These cells possess stem cell-like properties of enhanced self-renewal/proliferation, and proliferation of latently infected memory CD4+ T cells plays a key role in maintaining the reservoir over time. Here, we evaluated an innovative strategy targeting the proliferation of long-lived memory CD4+ T cells to reduce viral reservoir stability. Using the rhesus macaque model, we tested a pharmacological inhibitor of the Wnt/β-catenin signaling pathway that regulates T cell proliferation. Our study shows that administration of the inhibitor PRI-724 decreased the proliferation of SCM and CM CD4+ T cells and promoted a transcriptome enriched in differentiation genes. Although the viral reservoir size was not significantly reduced by PRI-724 treatment alone, we demonstrate the potential to pharmacologically modulate the proliferation of memory CD4+ T cells as a strategy to limit HIV persistence.

Highlights

  • The major obstacle to human immunodeficiency type 1 virus (HIV-1) eradication is a reservoir of latently infected cells that persists despite long-term antiretroviral therapy (ART) and is maintained through cellular proliferation

  • The key obstacle to cure human immunodeficiency virus (HIV) infection is a reservoir of latently infected memory CD4ϩ T cells that persists despite long-term antiretroviral therapy (ART) and causes a rebound of viremia if therapy is interrupted

  • After 13 to 14 weeks on ART and a plasma viral load suppression of Ͻ80 copies/ml for at least 4 weeks, 8 rhesus macaque (RM) received the CREB-binding protein (CBP)/␤-catenin inhibitor PRI-724, while the 4 remaining RMs were maintained on ART only and served as controls (Fig. 1)

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Summary

Introduction

The major obstacle to human immunodeficiency type 1 virus (HIV-1) eradication is a reservoir of latently infected cells that persists despite long-term antiretroviral therapy (ART) and is maintained through cellular proliferation. IMPORTANCE Long-lasting CD4ϩ T cell subsets, such as central memory and stem cell memory CD4ϩ T cells, represent critical reservoirs for human immunodeficiency virus (HIV) persistence despite suppressive antiretroviral therapy These cells possess stem cell-like properties of enhanced self-renewal/proliferation, and proliferation of latently infected memory CD4ϩ T cells plays a key role in maintaining the reservoir over time. A lower frequency of latently infected SCM and/or CM CD4ϩ T cells has been found in adult [4, 5] and pediatric nonprogressors [6], as well as in a cohort of patients treated soon after infection who exhibited controlled viremia after ART discontinuation (termed “post᎑treatment HIV controllers” [7, 8]) Due to their stem cell-like properties of enhanced self-renewal/proliferation, SCM and CM CD4ϩ T cells may provide a more stable reservoir for HIV than effector memory (EM) T cells, which are more susceptible to programmed cell death [2, 9]. Control of the two distinct fates of SCM and CM T cells, i.e., self-renewal versus differentiation, is regulated by molecular stem cell-like pathways, which include the Wnt/␤-catenin signaling pathway [29, 30, 32, 33]

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