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IFN-α blockade during ART-treated SIV infection lowers tissue vDNA, rescues immune function, and improves overall health
Louise A. Swainson, Ashish Arunkumar Sharma, Khader Ghneim, Susan Pereira Ribeiro, Peter Wilkinson, Richard M. Dunham, Rebecca G. Albright, Samson Wong, Jacob D. Estes, Michael Piatak, Steven G. Deeks, Peter W. Hunt, Rafick-Pierre Sekaly, Joseph M. McCune
Louise A. Swainson, Ashish Arunkumar Sharma, Khader Ghneim, Susan Pereira Ribeiro, Peter Wilkinson, Richard M. Dunham, Rebecca G. Albright, Samson Wong, Jacob D. Estes, Michael Piatak, Steven G. Deeks, Peter W. Hunt, Rafick-Pierre Sekaly, Joseph M. McCune
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Research Article AIDS/HIV Immunology

IFN-α blockade during ART-treated SIV infection lowers tissue vDNA, rescues immune function, and improves overall health

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Abstract

Type I IFNs (TI-IFNs) drive immune effector functions during acute viral infections and regulate cell cycling and systemic metabolism. That said, chronic TI-IFN signaling in the context of HIV infection treated with antiretroviral therapy (ART) also facilitates viral persistence, in part by promoting immunosuppressive responses and CD8+ T cell exhaustion. To determine whether inhibition of IFN-α might provide benefit in the setting of chronic, ART-treated SIV infection of rhesus macaques, we administered an anti–IFN-α antibody followed by an analytical treatment interruption (ATI). IFN-α blockade was well-tolerated and associated with lower expression of TI-IFN–inducible genes (including those that are antiviral) and reduced tissue viral DNA (vDNA). The reduction in vDNA was further accompanied by higher innate proinflammatory plasma cytokines, expression of monocyte activation genes, IL-12–induced effector CD8+ T cell genes, increased heme/metabolic activity, and lower plasma TGF-β levels. Upon ATI, SIV-infected, ART-suppressed nonhuman primates treated with anti–IFN-α displayed lower levels of weight loss and improved erythroid function relative to untreated controls. Overall, these data demonstrated that IFN-α blockade during ART-treated SIV infection was safe and associated with the induction of immune/erythroid pathways that reduced viral persistence during ART while mitigating the weight loss and anemia that typically ensue after ART interruption.

Authors

Louise A. Swainson, Ashish Arunkumar Sharma, Khader Ghneim, Susan Pereira Ribeiro, Peter Wilkinson, Richard M. Dunham, Rebecca G. Albright, Samson Wong, Jacob D. Estes, Michael Piatak, Steven G. Deeks, Peter W. Hunt, Rafick-Pierre Sekaly, Joseph M. McCune

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Figure 1

IFN-α blockade in ART-treated SIV-infected rhesus macaques causes a decline in LN vDNA, downregulation of TI-IFN signaling, and heightened proinflammatory cascades.

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IFN-α blockade in ART-treated SIV-infected rhesus macaques causes a decl...
(A) Study design showing the sampling schedule and timeline of ART, IFN-α blockade, and ATI after SIV infection. (B) Plasma SIV RNA levels measured during the study. (C) Decline in cell-associated LN vDNA (normalized to LN CD4+ T cell frequency) between weeks 20 and 29 in the anti–IFN-α-treated versus control arms (Mann-Whitney U test). (D) Plasma levels of cytokines measured and the composition of circulating cytokines defined by clustering cytokines using k-means clustering. The decline in LN vDNA was associated with increases in cytokine cluster 5 (left) and decreases in cytokine cluster 4 (right). The association with cytokines that define clusters 4 and 5 is also shown. All correlations with decline in LN vDNA were assessed using Spearman’s correlation test. (E) Principal component analysis (PCA) of whole-blood transcriptome profiles performed prior to initiating IFN-α blockade (week 20) and 9 weeks after blockade (week 29). Anti–IFN-α-treated samples observed to cluster distinctly from the control arm at week 29. (F) Heatmap showing the sample-level leading-edge scores of immune/metabolic gene sets (MSigDB’s Hallmark module; ref. 40) and cell subset signatures (44) significantly altered with anti–IFN-α treatment (vs. control arm; week 29) and/or associated with decline in LN vDNA (column annotations in purple) (Supplemental Table 3). GSEA (38) was used to determine significance with each outcome, and significant associations are shown as *P < 0.05. Sample-level scores (75) intersecting leading-edge genes (obtained after GSEA results) between virally suppressed and incompletely suppressed NHPs in both arms (3 NHPs per group per arm). Stars define significance (assessed using a 2-tailed unpaired t test) between the 2 groups with P < 0.05. No significant differences between virally suppressed and incompletely suppressed NHPs were observed in the untreated arm. Unless indicated, significant changes in NHP specimens between the 2 arms (n = 6/arm) 29 weeks after study initiation were assessed using the statistical tests indicated.

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