IntroductionRapid and profound loss of "activated" memory CD4 ϩ T cells, particularly in the intestine, is a hallmark of both HIV and simian immunodeficiency virus (SIV) infection. However, the mechanism by which CD4 ϩ T cells are eliminated in early infection remains obscure. Furthermore, infants usually have a more rapid and severe course of disease, with persistently higher viral loads than adults with HIV infection. [1][2][3][4][5] Because neonates are believed to be born with mostly "naive" T cells, why would HIV infection be more severe in infants, who have far fewer of the "activated" memory CD4 ϩ T cells required to fuel viral replication?It is well established that the intestinal tract is a major site of early HIV/SIV infection in adults 6-10 and prior studies in SIVinfected neonates showed that as in adults, intestinal CD4 ϩ T cells are also the major target for early pediatric SIV infection. 11,12 Furthermore, most intestinal CD4 ϩ T cells in the intestinal lamina propria of normal neonatal macaques already have an "activated, memory" phenotype, even on the day of birth, despite not having encountered environmental antigens outside the womb. 11 This suggests that neonates have ample target cells to support HIV infection and amplification, even prior to birth, and that these intestinal cells may be capable of mounting functional immune responses. However, absolute numbers and percentages of these target cells are far fewer in neonates than adults, so this alone cannot explain the higher viral loads in infected neonates. Because neonates are immediately exposed to a variety of new environmental antigens after birth, we hypothesized that increased activation, infection, and perhaps most importantly, a more sustained turnover of viral target cells in neonatal intestines could potentially explain why neonates have sustained viral loads and accelerated disease progression.To date, information on T-cell turnover rates is limited to peripheral blood, and few studies have examined proliferation and T-cell turnover in tissues, particularly the intestinal tract, the primary target for acute SIV and HIV infection. Furthermore, little data on mucosal immune responses to HIV or SIV infection of neonates have been published. To monitor proliferation of cell subsets in tissues, we administered bromodeoxyuridine (BrdU) to neonates 24 hours prior to tissue collection. Because BrdU is a thymidine analog incorporated only by cells synthesizing DNA, this method allows for detection of cells in the synthesis phase (S-phase) of cell division. Proliferation rates of T-cell subsets were compared in the blood, lymph nodes, spleen, and intestines of adult and pediatric macaques, as well as pediatric macaques infected with SIVmac251 and age-matched uninfected controls.
Methods
Animals, virus, and BrdU inoculationTissues from 23 infected and 20 age-matched uninfected neonatal rhesus macaques (Macaca mulatta) were obtained from the Tulane National Primate Research Center. All monkeys were housed and maintained in accordance with t...