Clinical tolerance and immunologic effects after single or repeated administrations of the synthetic immunomodulator murabutide in HIV-1-infected patients

Correction of the virus-induced deficits in innate immunity of HIV-infected subjects could well contribute to enhanced immune recovery and efficacious control of viral replication. The safe synthetic immunomodulator Murabutide (ISTAC Biotechnology, Lille, France) has been found to regulate the function of antigen-presenting cells and to selectively activate CD4 lymphocytes leading to dramatic suppression of HIV replication, in vitro. Therefore, as a first step toward the evaluation of the immunotherapeutic potential of Murabutide in HIV disease, we have conducted two phase 1/2 clinical trials to address the safety and the immunologic effects of Murabutide administration into HIV-infected subjects receiving antiretroviral therapy. The first study revealed that single administration of 5, 7, or 9 mg of Murabutide, to 6 patients per dose, was well tolerated. This was accompanied by a selective induction of cytokines and chemokines detectable in the serum, and the levels appeared to plateau at the 7-mg dose. The second study then evaluated the safety and biological effects of repeated administrations of 7 mg Murabutide, on 5 consecutive days, in 12 HIV-1-infected patients. A good clinical tolerance was noted throughout the study. Moreover, changes in several immune parameters, including downregulation of coreceptor expression on lymphocytes and improved lymphoproliferative responses, were detected during or/and up to 3 weeks after Murabutide administration. These encouraging results warrant further evaluation of longer periods or cycles of immunotherapy with Murabutide in HIV-infected subjects.     

Altered sialylation of alveolar macrophages in HIV-1-infected individuals

In previous studies, we have demonstrated that O-glycans at the surface of HIV-1-infected cell lines were hyposialylated. Moreover, we and others have shown that HIV⁺ individuals produced autoantibodies that react with hyposialylated CD43, on T cell lines. Since the autoantigen responsible for this abnormal immune response was not easily found in the peripheral blood cells of corresponding patients, we searched for its possible presence in other sites. Using fluorescence staining of alveolar macrophages with various lectins, we show that the binding of the PNA lectin specific for asialo O-glycans is much more efficient on cells from HIV-1-infected individuals. Moreover, the degree of reactivity of PNA is correlated with the clinical stage of the illness.     

Poor functional immune recovery in aged HIV-1-infected patients following successfully treatment with antiretroviral therapy

Aging is now a well-recognized characteristic of the HIV-infected population and both AIDS and aging are characterized by a deficiency of the T-cell compartment. The objective of the present study was to evaluate the impact of antiretroviral (ARV) therapy in recovering functional response of T cells to both HIV-1-specific ENV peptides (ENV) and tetanus toxoid (TT), in young and aged AIDS patients who responded to ARV therapy by controlling virus replication and elevating CD4⁺ T cell counts. Here, we observed that proliferative response of T-cells to either HIV-1-specific Env peptides or tetanus toxoid (TT) was significantly lower in older antiretroviral (ARV)-treated patients. With regard to cytokine profile, lower levels of IFN-γ, IL-17 and IL-21, associated with elevated IL-10 release, were produced by Env- or TT-stimulated T-cells from older patients. The IL-10 neutralization by anti-IL-10 mAb did not elevate IFN-γ and IL-21 release in older patients. Finally, even after a booster dose of TT, reduced anti-TT IgG titers were quantified in older AIDS patients and it was related to both lower IL-21 and IFN-γ production and reduced frequency of central memory T-cells. Our results reveal that ARV therapy, despite the adequate recovery of CD4⁺ T cell counts and suppression of viremia, was less efficient in recovering adequate immune response in older AIDS patients.     

胎儿和成人皮肤相关基因的差异表达

背景：胎儿皮肤创伤后无瘢痕愈合是胎儿发育过程特定阶段的特殊现象,其机制目前尚未明确,可能与调控基因的表达有关。 目的：运用人类基因芯片技术,研究人胎儿及成人正常皮肤差异表达基因及其特征和可能的生物学意义。 方法：选择人胎儿(孕20~24周)皮肤和成人(18~48岁)皮肤各10例,提取各标本的总DNA与RNA,制成荧光标记的cDNA探针,与含10 724个人类靶基因的芯片杂交,经扫描、生物信息学分析,比较两种组织基因的差异表达。 结果与结论：基因芯片高通量地揭示了胎儿及成人正常皮肤基因信息的差异表达。与成人正常皮肤比较,胎儿皮肤基因显著差异表达83个,已明确功能基因26个,涉及多种信号传递及基因调控的改变。说明胎儿与成人正常皮肤差异表达基因的存在在一定程度上导致了胎儿创伤的无瘢痕愈合。     

Differentially expressed genes in giant cell tumor of bone

Giant cells tumors of bone (GCTB) are benign in nature but cause osteolytic destruction with a number of particular characteristics. These tumors can have uncertain biological behavior often contain a significant proportion of highly multinucleated cells, and may show aggressive behavior. We have studied differential gene expression in GCTB that may give a better understanding of their physiopathology, and might be helpful in prognosis and treatment. Rapid subtractive hybridization (RaSH) was used to identify and measure novel genes that appear to be differentially expressed, including KTN1, NEB, ROCK1, and ZAK using quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry in the samples of GCTBs compared to normal bone tissue. Normal bone was used in the methodology RaSH for comparison with the GCTB in identification of differentially expressed genes. Functional annotation indicated that these genes are involved in cellular processes related to their tumor phenotype. The differential expression of KTN1, ROCK1, and ZAK was independently confirmed by qRT-PCR and immunohistochemistry. The expression of the KTN1 and ROCK1 genes were increased in samples by qRT-PCR and immunohistochemistry, and ZAK had reduced expression. Since ZAK have CpG islands in their promoter region and low expression in tumor tissue, their methylation pattern was analyzed by MSP-PCR. The genes identified KTN1, ROCK1, and ZAK may be responsible for loss of cellular homeostasis in GCTB since they are responsible for various functions related to tumorigenesis such as cell migration, cytoskeletal organization, apoptosis, and cell cycle control and thus may contribute at some stage in the process of formation and development of GCTB.     

Mechanisms underlying activity of antiretroviral drugs in HIV-1-infected macrophages: new therapeutic strategies

Monocyte-derived macrophages (M/M) are considered the second cellular target of HIV-1 and a crucial virus reservoir. M/M are widely distributed in all tissues and organs, including the CNS, where they represent the most common HIV-infected cells. Differently from activated CD4+ T lymphocytes, M/M are resistant to the cytopathic effect of HIV and survive HIV infection for a long time. Moreover, HIV-1 replication in M/M is a key pathogenetic event during the course of HIV-1 infection. Overall findings strongly support the clinical relevance of anti-HIV drugs in M/M. Nucleoside RT inhibitors (NRTIs) are more active against HIV in M/M than in CD4+ T lymphocytes. Their activity is further boosted by the presence of an additional monophosphate group (i.e., a phosphonate group, as in the case of Tenofovir), thus overcoming the bottleneck of the low phosphorylation ability of M/M. In contrast, the antiviral activity of non-NRTIs (not affecting the DNA chain elongation) in M/M is similar to that in CD4+ T lymphocytes. Protease inhibitors are the only clinically approved drugs acting at a late stage of the HIV lifecycle. They are able to interfere with HIV replication in HIV-1 chronically infected M/M, even if at concentrations greater than those observed in HIV-1 chronically infected CD4+ T lymphocytes. Finally, several new drugs have been shown to interfere efficiently with HIV replication in M/M, including entry inhibitors. A better understanding of the activity of the anti-HIV drugs in M/M may represent a key element for the design of effective anti-HIV chemotherapy.     

The potential place of chloroquine in the treatment of HIV-1-infected patients

BACKGROUND: Chloroquine has been reported to be endowed with anti-HIV-1 activity. We previously found its anti-HIV-1 activity to be additive to that of of the hydroxyurea plus didanosine combination. OBJECTIVES: Here we wish to present reported data on chloroquine's effects other than its antiretroviral activity, that may be of benefit in the therapy of HIV-1-infected individuals. RESULTS: (1) Chloroquine exerts an inhibitory effect on several AIDS-opportunistic pathogens, at least in vitro and, in some cases, in murine infections. (2) The drug exerts an inhibitory effect on the synthesis of several pro-inflammatory cytokines that may play a pathogenic role in the progression of HIV infection. (3) The drug has the potential to restrict tissular iron accumulation that may play a negative role in HIV infection. (4) The drug has practical advantages, as it is widely distributed, inexpensive and not stigmatizing. (5) We hypothesized that the drug, if given to HIV-positive breast-feeding mothers, may be of potential benefit in decreasing the rate of mother-to-child transmission of HIV-1. CONCLUSION: in view of the above-given data, combination therapy with chloroquine warrants clinical studies in HIV-1-infected patients, mainly in the setting of resource-poor countries.     

阿尔茨海默病关于年龄因素的差异基因表达分析

目的 分析阿尔茨海默病（AD）随年龄增长表达变化的基因。方法 通过Qlucore Omics Explorer（QOE）软件分析数据库Gene Expression Omnibus（GEO）中的GSE36980和GSE53890数据集,在严格的统计学设定前提下,以两组比较和线性回归方式,选出阿尔茨海默病和年龄相关的基因,并用在线工具DAVID进行Gene Ontology (GO)功能富集分析。 结果 筛选出20个和年龄相关的阿尔茨海默病差异基因。GO功能富集分析表明,这些基因涉及的生物学过程有蛋白质代谢、细胞周期和神经代谢调控;涉及的细胞组成包括轴突,质膜,突触,细胞骨架,胞内无膜结构细胞器;涉及的分子功能为嘌呤核苷酸结合蛋白和金属离子结合蛋白。结论 PDE2A等20个基因随个体年龄增高,其基因表达降低,提示其不仅与神经系统的衰老程度相关,而且可能与阿尔茨海默病的发病机理相关。     

Identification of genes expressed in tumor-associated macrophages

Most malignant tumors contain so-called tumor-associated macrophages (TAM) as a major component of their leukocytic infiltrate. To investigate the impact of the tumor microenvironment on activation and differentiation of macrophages, we established a 3-dimensional model system by culturing human monocytes within multicellular tumor spheroids. After 7 days, monocyte-derived TAM were isolated and analyzed for phenotypic alterations as compared to macrophages cultured without tumor cell contact. We found the known macrophage differentiation marker Carboxypeptidase M to be suppressed while CD14, HLA-DR, and CD16 were up-regulated. Using Differential Display, we identified several genes that were differentially expressed between TAM and control macrophages. Prolidase, a peptidase known to influence the chemoattraction of neutrophils and macrophage activity, was down-regulated in TAM. In contrast, the Toll-like receptor family-related molecules MD-1 and RP105 were up-regulated by tumor cell contact, both at the RNA and protein level. From our data we conclude that TAM represent a distict macrophage population characterized by low expression of differentiation-associated macrophage antigens but also by a constitutive state of activation.     

Clinical tolerance and profile of cytokine induction in healthy volunteers following the simultaneous administration of ifn-alpha and the synthetic immunomodulator murabutide.

As the therapeutic use of interferon-alpha (IFN-alpha) is limited by a dose-dependent toxicity and variable efficacy, ways of improving the therapeutic index of the cytokine are being sought. Murabutide (N-acetyl muramyl-L-alanyl-D-glutamine-O-n-butyl-ester) (ISTAC Biotechnology, Lille, France) is a safe synthetic and clinically acceptable immunomodulator that enhances the biologic activities of IFN-alpha in different experimental models. We evaluated in healthy human volunteers tolerance of the coadministration of Murabutide with increasing doses of IFN-alpha. The simultaneous administration of the two drugs was well tolerated without any increased or prohibiting toxicity, and all recipients experienced side effects that were similar to those observed after the administration of IFN-alpha alone. We also profiled the serum levels of cytokines induced following coinjection of the two drugs. We mostly detected an induction of anti-inflammatory cytokines and of human immunodeficiency virus type 1 (HIV-1)-suppressive beta-chemokines, in the absence of release of key proinflammatory cytokines. Therefore, the simultaneous administration of Murabutide and IFN-alpha is well tolerated and does not lead to increased toxicity. In addition, the selectivity in the profile of cytokines and chemokines induced following the coadministration of Murabutide and IFN-alpha points to the potential use of this combination in the treatment of inflammatory diseases and chronic viral infections.     

Increased Mycobacterium tuberculosis growth in HIV-1-infected human macrophages: role of tumour necrosis factor-alpha

Synergism between Mycobacterium tuberculosis (M. tuberculosis) and HIV-1 infections was demonstrated in several in vitro models and clinical studies. Here, we investigated their reciprocal effects on growth in chronically HIV-1-infected promonocytic U1 cells and in acutely infected monocyte-derived macrophages (MDM). Phagocytosis of M. tuberculosis induced HIV-1 expression in U1 cells, together with increased TNF-alpha production. M. tuberculosis growth, evaluated by competitive PCR, was greater in HIV-1-infected MDM compared to uninfected cells. M. tuberculosis phagocytosis induced greater TNF-alpha and IL-10 production in HIV-1-infected MDM than in uninfected cells. In uninfected MDM, addition of TNF-alpha and IFN-gamma decreased, whereas IL-10 increased M. tuberculosis growth. On the contrary, in HIV-1-infected MDM, addition of TNF-alpha and IFN-gamma increased, whereas IL-10 has no effect on M. tuberculosis growth. TNF-alpha seems to play a pivotal role in the enhanced M. tuberculosis growth observed in HIV-1-infected MDM, being unable to exert its physiological antimycobacterial activity. Here, for the first time we demonstrated an enhanced M. tuberculosis growth in HIV-1-infected MDM, in line with the observed clinical synergism between the two infections.     

Changes in circulating levels of soluble cell adhesion molecules following highly active antiretroviral treatment of HIV-1-infected patients

Increased levels of soluble cell adhesion molecules (sCAM) have been reported in HIV-1 infection and may possibly contribute to altering the adhesion mechanisms of phagocytic cells. We evaluated the effect of highly active antiretroviral therapy (HAART) on plasma levels of sL-selectin, sE-selectin, intercellular cell adhesion molecule-1 (sICAM-1), sICAM-3, and vascular cell adhesion molecule-1 (sVCAM-1). Study participants included 22 HIV-1-infected patients with a CD4+ T-cell count/microl below 500 who were started on a HAART regimen and followed up for 9 months. After the initiation of therapy, plasma sL-selectin concentrations progressively decreased to normal ranges in the majority of our patients (P < 0.001), while no changes in sE-selectin were found. In all patients sICAM-1 remained relatively constant at significantly elevated concentrations during the 9 months of therapy. A significant reduction in plasma concentrations of both sICAM-3 and sVCAM-1 was found; however, the levels of these sCAM were not normalized by HAART and remained significantly elevated throughout the study (P < 0.001). The reduced release of sL-selectin could improve the ability of phagocitic cells to migrate in response to chemotactic stimuli after starting HAART. On the other hand, the persistent elevation of sICAM-1, sICAM-3, and sVCAM-1 could reflect continuous HIV-1-mediated immune activation, despite adequate control of plasma HIV-1 replication by therapy.     

Stimulation of bystander T-cell proliferation by tumor necrosis factor produced by HIV-1-infected macrophages

OBJECTIVE: Cocultivation of the CD4+CD95+ T-cell line (MT4) with monocyte-derived macrophages (MDMs) infected with the HIV-1 resulted in costimulation of proliferation and apoptosis after 20 hours of contact. This study sought to determine whether tumor necrosis factor (TNF) produced by HIV-1-infected MDMs was involved in the costimulation of cell proliferation, the apoptotic pathway, or both. STUDY DESIGN/METHODS: MT4 cells were cocultivated with infected or noninfected MDMs in the presence or absence of soluble TNF receptors (sTNFRs) or antagonistic anti-Fas antibody (ZB4). Cell proliferation was assessed by measuring thymidine incorporation. Apoptosis was monitored by using flow cytometry and enzyme-linked immunosorbent assay (ELISA). RESULTS: Thymidine incorporation was higher in cells cocultivated with HIV-infected or noninfected MDMs than it was in controls grown in culture medium. It also was higher in cells cocultivated with HIV-infected MDMs than it was in cells cocultivated with noninfected MDMs. sTNFRs blocked the increase of thymidine incorporation specifically induced by HIV-infected MDMs. They did not inhibit apoptosis at 20 hours. Cells recovered from cocultures involving HIV-infected or noninfected MDMs exhibited decreased sensitivity to apoptosis induced through the Fas receptor. CONCLUSION: TNF produced by HIV-infected MDMs acts as an accessory T-cell growth factor that synergizes with an as yet unidentified growth-inducing signal or signals produced by HIV-infected and noninfected MDMs. Stimulation of cell proliferation by MDMs induces transient resistance to Fas-induced apoptosis.