Abstract
Effective prophylactic strategy against the current epidemic of sexually transmitted HIV-1 infection requires understanding of the innate gatekeeping mechanisms at the genital mucosa. Surfactant protein D (SP-D), a member of the collectin family of proteins naturally present in the vaginal tract, is a potential HIV-1 entry inhibitor at the cellular level. Human EpiVaginal tissues compartmentalized in culture inserts were apically exposed to HIV-1 and/or a recombinant fragment of human SP-D (rfhSP-D) and viral passage was assessed in the basal chamber containing mononuclear leukocytes. To map the gene signature facilitating or resisting the transepithelial viral transfer, microarray analysis of the HIV-1 challenged EpiVaginal tissues was performed in the absence or presence of rfhSP-D. Mucosal biocompatibility of rfhSP-D was assessed ex vivo and in the standard rabbit vaginal irritation model. The passage of virus through the EpiVaginal tissues toward the underlying target cells was associated with a global epithelial gene signature including differential regulation of genes primarily involved in inflammation, tight junctions and cytoskeletal framework. RfhSP-D significantly inhibited HIV-1 transfer across the vaginal tissues and was associated with a significant reversal of virus induced epithelial gene signature. Pro-inflammatory NF-κB and mTOR transcripts were significantly downregulated, while expression of the tight junctions and cytoskeletal genes was upheld. In the absence of virus, rfhSP-D directly interacted with the EpiVaginal tissues and upregulated expression of genes related to structural stability of the cell and epithelial integrity. There was no increment in the viral acquisition by the PBMCs present in basal chambers wherein, the EpiVaginal tissues in apical chambers were treated with rfhSP-D. The effective concentrations of rfhSP-D had no effect on lactobacilli, epithelial barrier integrity and were safe on repeated applications onto the rabbit vaginal mucosa. This pre-clinical safety data, coupled with its efficacy of restricting viral passage via reversal of virus-induced gene expression of the vaginal barrier, make a strong argument for clinical trials of rfhSP-D as a topical anti-HIV microbicide.
Highlights
A clear majority of the HIV-1 infections are due to heterosexual contact; more than 50% of HIV-1 infected individuals are women and most children living with HIV-1 today are infected via mother-to-child transmission [1]
For the first time, a compendium of genes that were differentially expressed in EpiVaginal tissues when challenged with HIV-1 alone [355], HIV-1 in presence of recombinant fragment of human SP-D (rfhSP-D) [518], or rfhSP-D alone [185] (Supplementary Figures S1, S2, S4)
The microarray data was validated by evaluation of transcript expression by real time RT-PCR for six randomly selected, differentially expressed genes by HIV-1 and rfhSP-D to represent the three functional categories (Figures 2B, 4D)
Summary
A clear majority of the HIV-1 infections are due to heterosexual contact; more than 50% of HIV-1 infected individuals are women and most children living with HIV-1 today are infected via mother-to-child transmission [1]. An effective vaginal microbicide for the prevention of sexual transmission of HIV1 to women will have a huge impact on limiting the HIV epidemic and its devastating consequences for both adults and children. A serious limitation is lack of an appropriate ex vivo model for the evaluation of efficacy of potential compounds on the viral passage across the vaginal barrier to the target immune cells [8,9,10,11]. For the first time, a “gatekeeping” gene signature of bioengineered human tissues induced upon HIV-1 exposure In this model, rfhSP-D showed no adverse effects on the vaginal barrier, concomitant with a significant impediment of viral movement to the activated PBMCs in the basal compartment. A range of preclinical assays confirmed safety of rfhSP-D for vaginal application at the similar concentrations it restricted viral transfer ex vivo, and establishing it as a promising anti-HIV-1 vaginal microbicide
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