Novel mechanisms to inhibit HIV reservoir seeding using Jak inhibitors

PLoS Pathog. 2017 Dec 21;13(12):e1006740. doi: 10.1371/journal.ppat.1006740. eCollection 2017 Dec.

Abstract

Despite advances in the treatment of HIV infection with ART, elucidating strategies to overcome HIV persistence, including blockade of viral reservoir establishment, maintenance, and expansion, remains a challenge. T cell homeostasis is a major driver of HIV persistence. Cytokines involved in regulating homeostasis of memory T cells, the major hub of the HIV reservoir, trigger the Jak-STAT pathway. We evaluated the ability of tofacitinib and ruxolitinib, two FDA-approved Jak inhibitors, to block seeding and maintenance of the HIV reservoir in vitro. We provide direct demonstration for involvement of the Jak-STAT pathway in HIV persistence in vivo, ex vivo, and in vitro; pSTAT5 strongly correlates with increased levels of integrated viral DNA in vivo, and in vitro Jak inhibitors reduce the frequency of CD4+ T cells harboring integrated HIV DNA. We show that Jak inhibitors block viral production from infected cells, inhibit γ-C receptor cytokine (IL-15)-induced viral reactivation from latent stores thereby preventing transmission of infectious particles to bystander activated T cells. These results show that dysregulation of the Jak-STAT pathway is associated with viral persistence in vivo, and that Jak inhibitors target key events downstream of γ-C cytokine (IL-2, IL-7 and IL-15) ligation to their receptors, impacting the magnitude of the HIV reservoir in all memory CD4 T cell subsets in vitro and ex vivo. Jak inhibitors represent a therapeutic modality to prevent key events of T cell activation that regulate HIV persistence and together, specific, potent blockade of these events may be integrated to future curative strategies.

Publication types

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

MeSH terms

  • Anti-HIV Agents / pharmacology*
  • CD4-Positive T-Lymphocytes / drug effects
  • CD4-Positive T-Lymphocytes / virology*
  • Cells, Cultured
  • HIV Infections / virology*
  • HIV-1 / drug effects
  • HIV-1 / physiology
  • Humans
  • Janus Kinase Inhibitors / pharmacology*
  • Nitriles
  • Piperidines / pharmacology
  • Pyrazoles / pharmacology
  • Pyrimidines / pharmacology
  • Pyrroles / pharmacology
  • Virus Latency / drug effects*
  • Virus Replication / drug effects

Substances

  • Anti-HIV Agents
  • Janus Kinase Inhibitors
  • Nitriles
  • Piperidines
  • Pyrazoles
  • Pyrimidines
  • Pyrroles
  • ruxolitinib
  • tofacitinib