Role of T-cell reconstitution in HIV-1 antiretroviral therapy-induced bone loss

Nat Commun. 2015 Sep 22:6:8282. doi: 10.1038/ncomms9282.

Abstract

HIV infection causes bone loss. We previously reported that immunosuppression-mediated B-cell production of receptor activator of NF-κB ligand (RANKL) coupled with decline in osteoprotegerin correlate with decreased bone mineral density (BMD) in untreated HIV infection. Paradoxically, antiretroviral therapy (ART) worsens bone loss although existing data suggest that such loss is largely independent of specific antiretroviral regimen. This led us to hypothesize that skeletal deterioration following HIV disease reversal with ART may be related to T-cell repopulation and/or immune reconstitution. Here we transplant T cells into immunocompromised mice to mimic ART-induced T-cell expansion. T-cell reconstitution elicits RANKL and TNFα production by B cells and/or T cells, accompanied by enhanced bone resorption and BMD loss. Reconstitution of TNFα- or RANKL-null T-cells and pharmacological TNFα antagonist all protect cortical, but not trabecular bone, revealing complex effects of T-cell reconstitution on bone turnover. These findings suggest T-cell repopulation and/or immune reconstitution as putative mechanisms for bone loss following ART initiation.

Publication types

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

MeSH terms

  • Adoptive Transfer
  • Animals
  • Anti-HIV Agents / adverse effects*
  • Bone Density / drug effects
  • Bone Density / immunology
  • Bone Resorption
  • CD4 Lymphocyte Count
  • Female
  • Genes, T-Cell Receptor beta
  • HIV-1*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Osteoporosis / chemically induced*
  • Spleen
  • T-Lymphocytes / physiology*
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Anti-HIV Agents
  • Tumor Necrosis Factor-alpha