Reversing Gut Damage in HIV Infection: Using Non-Human Primate Models to Instruct Clinical Research

EBioMedicine. 2016 Jan 26:4:40-9. doi: 10.1016/j.ebiom.2016.01.028. eCollection 2016 Feb.

Abstract

Antiretroviral therapy (ART) has led to dramatic improvements in the lives of HIV-infected persons. However, residual immune activation, which persists despite ART, is associated with increased risk of non-AIDS morbidities. Accumulating evidence shows that disruption of the gut mucosal epithelium during SIV/HIV infections allows translocation of microbial products into the circulation, triggering immune activation. This disruption is due to immune, structural and microbial alterations. In this review, we highlighted the key findings of gut mucosa studies of SIV-infected macaques and HIV-infected humans that have revealed virus-induced changes of intestinal CD4, CD8 T cells, innate lymphoid cells, myeloid cells, and of the local cytokine/chemokine network in addition to epithelial injuries. We review the interplay between the host immune response and the intestinal microbiota, which also impacts disease progression. Collectively, these studies have instructed clinical research on early ART initiation, modifiers of microbiota composition, and recombinant cytokines for restoring gut barrier integrity.

Keywords: Gut barrier integrity; HIV; Interleukin-21; Interleukin-7; Microbial translocation; SIV.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / immunology
  • AIDS-Related Opportunistic Infections / metabolism
  • Animals
  • Drug Evaluation, Preclinical
  • Humans
  • Immunity, Innate
  • Intestinal Diseases / drug therapy*
  • Intestinal Diseases / immunology
  • Intestinal Diseases / metabolism
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / metabolism
  • Intestinal Mucosa / microbiology
  • Intestinal Mucosa / pathology*
  • Macaca
  • Microbiota