Aminobisphosphonates reactivate the latent reservoir in people living with HIV-1

oleh: Marta Sanz, Ann Marie K. Weideman, Ann Marie K. Weideman, Adam R. Ward, Adam R. Ward, Matthew L. Clohosey, Susana Garcia-Recio, Susana Garcia-Recio, Sara R. Selitsky, Sara R. Selitsky, Brendan T. Mann, Marie Anne Iannone, Chloe P. Whitworth, Alisha Chitrakar, Carolina Garrido, Jennifer Kirchherr, Alisha R. Coffey, Yi- Hsuan Tsai, Shahryar Samir, Yinyan Xu, Dennis Copertino, Alberto Bosque, Brad R. Jones, Brad R. Jones, Joel S. Parker, Joel S. Parker, Michael G. Hudgens, Michael G. Hudgens, Nilu Goonetilleke, Natalia Soriano-Sarabia

Format: Article
Diterbitkan: Frontiers Media S.A. 2023-09-01

Deskripsi

Antiretroviral therapy (ART) is not curative due to the existence of cellular reservoirs of latent HIV-1 that persist during therapy. Current research efforts to cure HIV-1 infection include “shock and kill” strategies to disrupt latency using small molecules or latency-reversing agents (LRAs) to induce expression of HIV-1 enabling cytotoxic immune cells to eliminate infected cells. The modest success of current LRAs urges the field to identify novel drugs with increased clinical efficacy. Aminobisphosphonates (N-BPs) that include pamidronate, zoledronate, or alendronate, are the first-line treatment of bone-related diseases including osteoporosis and bone malignancies. Here, we show the use of N-BPs as a novel class of LRA: we found in ex vivo assays using primary cells from ART-suppressed people living with HIV-1 that N-BPs induce HIV-1 from latency to levels that are comparable to the T cell activator phytohemagglutinin (PHA). RNA sequencing and mechanistic data suggested that reactivation may occur through activation of the activator protein 1 signaling pathway. Stored samples from a prior clinical trial aimed at analyzing the effect of alendronate on bone mineral density, provided further evidence of alendronate-mediated latency reversal and activation of immune effector cells. Decay of the reservoir measured by IPDA was however not detected. Our results demonstrate the novel use of N-BPs to reverse HIV-1 latency while inducing immune effector functions. This preliminary evidence merits further investigation in a controlled clinical setting possibly in combination with therapeutic vaccination.