Statins and natural regulatory T cells in HIV infection

Abstract

Drs McGoldrick and Leen [1] assessed the currently available evidence concerning the management of dyslipidaemias in HIV-infected individuals treated with antiretroviral therapy. We wish to shed further light on the potential detrimental effect of statins in this context, focusing on their recognized immunomodulatory properties. One aspect of immune homeostasis and self-tolerance is actively maintained by regulatory T cells (Tregs). Tregs, however, also have a detrimental effect in their suppression of appropriate antigen-specific immune responses. Mounting evidence [2] indicates that immunity to HIV infection may be controlled by natural Tregs. HIV infection is associated with loss of CD4 T cells and progressive immune dysfunction. Removal of Tregs from peripheral blood mononuclear cell populations has been shown to result in increased anti-HIV CD4 T-cell responses [3]. Furthermore, a recent study [4] found that Tregs had the ability to suppress HIV-specific responses, particularly cell-mediated cytolytic function, throughout the course of HIV disease. However, a relevant pleiotropic effect of statins is their immunomodulatory effect, which can be mediated via a significant increase in the number of Tregs in vivo [5]. Therefore, we suggest that the statin-related action on Tregs might be detrimental in HIV-infected patients and also impair the effects of antiretroviral therapy. References