Interleukin-21 combined with ART reduces inflammation and viral reservoir in SIV-infected macaques

J Clin Invest. 2015 Dec;125(12):4497-513. doi: 10.1172/JCI81400. Epub 2015 Nov 9.

Abstract

Despite successful control of viremia, many HIV-infected individuals given antiretroviral therapy (ART) exhibit residual inflammation, which is associated with non-AIDS-related morbidity and mortality and may contribute to virus persistence during ART. Here, we investigated the effects of IL-21 administration on both inflammation and virus persistence in ART-treated, SIV-infected rhesus macaques (RMs). Compared with SIV-infected animals only given ART, SIV-infected RMs given both ART and IL-21 showed improved restoration of intestinal Th17 and Th22 cells and a more effective reduction of immune activation in blood and intestinal mucosa, with the latter maintained through 8 months after ART interruption. Additionally, IL-21, in combination with ART, was associated with reduced levels of SIV RNA in plasma and decreased CD4(+) T cell levels harboring replication-competent virus during ART. At the latest experimental time points, which were up to 8 months after ART interruption, plasma viremia and cell-associated SIV DNA levels remained substantially lower than those before ART initiation in IL-21-treated animals but not in controls. Together, these data suggest that IL-21 supplementation of ART reduces residual inflammation and virus persistence in a relevant model of lentiviral disease and warrants further investigation as a potential intervention for HIV infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Retroviral Agents / pharmacology*
  • DNA, Viral / blood
  • DNA, Viral / immunology
  • Inflammation / blood
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / pathology
  • Inflammation / virology
  • Interleukins / pharmacology*
  • Intestinal Mucosa / metabolism
  • Intestines / immunology*
  • Intestines / pathology
  • Intestines / virology
  • Macaca mulatta
  • RNA, Viral / blood
  • RNA, Viral / immunology
  • Simian Acquired Immunodeficiency Syndrome / blood
  • Simian Acquired Immunodeficiency Syndrome / drug therapy*
  • Simian Acquired Immunodeficiency Syndrome / immunology
  • Simian Acquired Immunodeficiency Syndrome / pathology
  • Simian Immunodeficiency Virus / immunology*
  • Simian Immunodeficiency Virus / metabolism
  • Th17 Cells / immunology*
  • Th17 Cells / metabolism
  • Th17 Cells / pathology
  • Time Factors

Substances

  • Anti-Retroviral Agents
  • DNA, Viral
  • Interleukins
  • RNA, Viral
  • interleukin-21