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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, … , Rafick-Pierre Sekaly, Joseph M. McCune
Louise A. Swainson, … , Rafick-Pierre Sekaly, Joseph M. McCune
Published February 1, 2022
Citation Information: JCI Insight. 2022;7(5):e153046. https://doi.org/10.1172/jci.insight.153046.
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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 3

Heightened expression of metabolic, erythroid, and proinflammatory gene sets during ART are associated with maintenance of weight after ATI in anti–IFN-α-treated rhesus macaques.

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Heightened expression of metabolic, erythroid, and proinflammatory gene ...
(A) As monitored after ATI (week 36 to week 40), weight was found to be maintained in NHPs in the anti–IFN-α-treated arm compared with those in the control arm (Mann-Whitney U test per week; *P < 0.05). (B) Assessment of physiological outcomes (analogous to the components of VACS index; ref. 64) before and after IFN-α blockade and after ATI revealed that levels of sTNFR1 and erythroid function were differentially altered (Mann-Whitney U test; *P < 0.05, •P < 0.1 (See Supplemental Table 1 for full list of physiological markers). Only 5 control animals are represented after ATI because 1 animal from this group died during the ATI period. (C) Correlation network highlighting the association with levels of hemoglobin and hematocrit (at week 40 after infection; i.e., after ATI) with gene expression of heme metabolism and iron/oxygen pathways (29 weeks after infection; during ART). The node colors indicate log2 (fold change) between anti–IFN-α-treated and control arms (where red to blue colors reflect high to low fold change), whereas the edge colors indicate Spearman’s correlation coefficients between the nodes (where red to blue colors reflect high to low correlations). (D) Circos plot with edges representing NES values (GSEA P < 0.05; positive NES values shown in red; negative NES values shown in blue) defining associations between key gene sets (altered after anti–IFN-α treatment) and major outcomes: weight maintenance after ATI and decline in LN vDNA (Supplemental Table 8). Unless indicated, significant changes in NHP specimens between the 2 arms (n = 5 control arm and n = 6 treatment arm) at all time points after study initiation were assessed using the statistical tests indicated.

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