The CD8 ؉ cell noncytotoxic anti-HIV response (CNAR) is associated with a longterm healthy clinical state in HIV-infected individuals. Over time CNAR is reduced concomitant with progression to disease. In studies to evaluate whether the interaction between CD8 ؉ cells and dendritic cells (DCs) could increase CNAR, CD8 ؉ cells from individuals who showed a decrease in this antiviral activity were cocultured with monocyte-derived dendritic cells matured with CD40 ligand. After coculture with these mature DCs, the CD8 ؉ cells showed an increase in CNAR greater than that observed with CD8 ؉ cells costimulated with CD3/CD28 antibodies. This antiviral response appeared to be mediated primarily by production of interleukin-15 (IL-15) by the mature DCs. Purified IL-15 also enhanced CNAR, whereas IL-12 showed no substantial effect. These studies provide another potential approach by which the immune system in HIV infection could be restored by cytokine therapy, particularly IL-15 administration. (
IntroductionCD8 ϩ cells from healthy HIV-infected individuals demonstrate a unique ability to suppress HIV replication without killing the infected cell. 1 The extent of this CD8 ϩ cell noncytotoxic antiviral response (CNAR) is reduced in infected individuals who progress to disease. [2][3][4][5] The cause for this loss in CNAR is not yet understood. One reason could be the decrease in a T helper 1 (TH-1) cell cytokine profile observed over time in HIV-infected individuals with a change toward the TH-2 type of immune response, that is, production of interleukin-4 (IL-4), IL-5, and IL-10. 6 TH-1 cell cytokines, particularly IL-2, help maintain CNAR; TH-2 cytokines inhibit its activity. 7,8 Since IL-2 production by lymphocytes results from their interaction with dendritic cells (DCs), 9 a compromise in DC function may be responsible for the loss of CNAR over time. In this regard, previous studies have shown that HIV-infected individuals exhibit a decrease in DC function and numbers circulating in the blood. 10,11 Another reason for reduced CD8 ϩ cell activity can be low CD4 ϩ cell counts, which also correlate with the loss of CNAR. 2,3,5 Therefore, CD40 ligand (CD40L), a surface protein expressed on CD4 ϩ cells following activation, may not be present at sufficient levels to mature DCs via CD40 to stimulate CD8 ϩ cell immune responses, specifically, CNAR. Upon activation by CD40L, dendritic cells mature and secrete IL-15 and IL-12. 12-16 IL-15 can regulate expansion and differentiation of CD8 ϩ cells, particularly the memory subsets of CD8 ϩ cells. 17-21 IL-12 induces the differentiation of T cells into TH-1 type cells that secrete large amounts of interferon-␥, which can also increase CD8 ϩ cell immune responses and CNAR. 7 Therefore, improving DC/T-cell interactions might restore or enhance CNAR in HIV-infected individuals. In evaluating this possibility, we studied whether dendritic cells, matured by CD40L, could enhance CNAR in CD8 ϩ cells from HIV-infected individuals.
Patients, materials, and methods
SubjectsHIV-infected s...