IL-21 and probiotic therapy improve Th17 frequencies, microbial translocation, and microbiome in ARV-treated, SIV-infected macaques

Mucosal Immunol. 2016 Mar;9(2):458-67. doi: 10.1038/mi.2015.75. Epub 2015 Aug 19.

Abstract

Increased mortality in antiretroviral (ARV)-treated, HIV-infected individuals has been attributed to persistent immune dysfunction, in part due to abnormalities at the gastrointestinal barrier. In particular, the poor reconstitution of gastrointestinal Th17 cells correlates with residual translocation of dysbiotic, immunostimulatory microflora across a compromised intestinal epithelial barrier. We have previously demonstrated that oral probiotics promote increased intestinal CD4(+) T-cell reconstitution during ARV treatment in a non-human primate model of HIV infection; however, essential mucosal T-cell subsets, such as Th17 cells, had limited recovery. Here, we sought to promote Th17 cell recovery by administering interleukin (IL)-21 to a limited number of ARV-treated, probiotic-supplemented, Simian Immunodeficiency Virus (SIV)-infected pigtailed macaques. We demonstrate that probiotic and IL-21 supplementation of ARVs are associated with enhanced polyfunctional Th17 expansion and reduced markers of microbial translocation and dysbiosis as compared with infected controls receiving ARVs alone. Importantly, treatment resulted in fewer morbidities compared with controls, and was independent of increased immune activation or loss of viral suppression. We propose that combining ARVs with therapeutics aimed at restoring intestinal stasis may significantly improve disease prognosis of ARV-treated, HIV-infected individuals.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Animals
  • Anti-Retroviral Agents / pharmacology*
  • Bacterial Translocation / drug effects
  • Cell Proliferation / drug effects
  • Combined Modality Therapy
  • Dysbiosis / immunology
  • Dysbiosis / pathology
  • Dysbiosis / therapy*
  • Dysbiosis / virology
  • Emtricitabine / pharmacology
  • Gastrointestinal Microbiome / drug effects
  • Gastrointestinal Microbiome / immunology
  • Gastrointestinal Tract / drug effects
  • Gastrointestinal Tract / immunology
  • Gastrointestinal Tract / pathology
  • Gastrointestinal Tract / virology
  • Immunity, Mucosal / drug effects
  • Interleukin-21
  • Interleukins / pharmacology*
  • Macaca nemestrina
  • Probiotics / pharmacology*
  • Simian Acquired Immunodeficiency Syndrome / immunology
  • Simian Acquired Immunodeficiency Syndrome / pathology
  • Simian Acquired Immunodeficiency Syndrome / therapy*
  • Simian Acquired Immunodeficiency Syndrome / virology
  • Simian Immunodeficiency Virus / immunology*
  • Tenofovir / pharmacology
  • Th17 Cells / drug effects
  • Th17 Cells / immunology
  • Th17 Cells / pathology
  • Th17 Cells / virology

Substances

  • Anti-Retroviral Agents
  • Interleukins
  • Tenofovir
  • Emtricitabine
  • Interleukin-21