Background
This study investigated whether a selective serotonin reuptake inhibitor (SSRI), citalopram, downregulates the expression of HIV receptor (CD4) and coreceptors (CCR5 and CXCR4) on peripheral blood mononuclear cells (PBMC) and macrophages ex vivo as a potential mechanism of reducing susceptibility to HIV infection.
Methods
The sample included 150 participants ages 18–58 (59% women, 65% African American, 61% depressed). Monocyte depleted PBMC were treated with phytohemagglutinin (PHA) for 72-hours and then cultured in the presence of IL-2 with vehicle control or SSRI (10−6 M) for 2-hours. To generate monocyte derived macrophages (MDM), monocytes were cultured for 7-days, after which either vehicle control or SSRI (10−6 M) was added for 2-hours. RNA was then collected from both cell types, and CD4, CCR5 and CXCR4 mRNA expression was measured by real-time PCR.
Results
In PBMC, SSRI treatment decreased expression of CD4 (p=.009), CCR5 (p=.008), and CXCR4 (p<.0001). In MDM, SSRI decreased expression of CD4 (p<.0001) and CXCR4 (p=.0003), but not CCR5 (p=.71). The suppressive effects of SSRI on receptor expression did not differ as a function of depression diagnosis or depressive symptom severity.
Conclusions
SSRI treatment at a physiologic dose decreased CD4, CCR5 and CXCR4 expression on PBMC and macrophages ex vivo. These findings suggest that SSRI treatment, independent of depression status, downregulates HIV receptor and coreceptor expression and thus may reduce susceptibility of immune cells to HIV infection and decrease inflammation. If clinical trials confirm the present findings, ultimately there may be a role for using SSRI treatment adjunctively in HIV/AIDS.