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      Foreskin T cell subsets differ substantially from blood with respect to HIV co-receptor expression, inflammatory profile and memory status

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          Abstract

          The foreskin is the main site of heterosexual HIV acquisition in uncircumcised men, but functional data regarding T cells subsets present at this site are lacking. Foreskin tissue and blood were obtained from Ugandan men undergoing elective adult circumcision. Tissue was treated by mechanical and enzymatic digestion followed by T cell subset identification and assessment of cytokine production using flow cytometery. Foreskin CD4 + T cells were predominantly an effector memory phenotype, and compared to blood they displayed a higher frequency of CCR5 expression (42.0% vs. 9.9%) and IL-17 production. There was no difference in T regulatory cell frequency, but IFNγ and TNFα production were increased in foreskin CD8 + T cells. These novel techniques demonstrate that the foreskin represents a pro-inflammatory milieu that is enriched for HIV-susceptible T cell subsets. Further characterization of foreskin T cell subsets may help to define the correlates of HIV susceptibility in the foreskin.

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          Most cited references41

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          Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies.

          To estimate the sex-specific effect of herpes simplex virus type 2 (HSV-2) on the acquisition of HIV infection. The increased number of longitudinal studies available since the last meta-analysis was published allows for the calculation of age- and sexual behaviour-adjusted relative risks (RR) separately for men and women. Systematic review and meta-analysis of longitudinal studies. PubMed, Embase and relevant conference abstracts were systematically searched to identify longitudinal studies in which the relative timing of HSV-2 infection and HIV infection could be established. Where necessary, authors were contacted for separate estimates in men and women, adjusted for age and a measure of sexual behaviour. Summary adjusted RR were calculated using random-effects meta-analyses where appropriate. Studies on recent HSV-2 incidence as a risk factor for HIV acquisition were also collated. Of 19 eligible studies identified, 18 adjusted for age and at least one measure of sexual behaviour after author contact. Among these, HSV-2 seropositivity was a statistically significant risk factor for HIV acquisition in general population studies of men [summary adjusted RR, 2.7; 95% confidence interval (CI), 1.9-3.9] and women (RR, 3.1; 95% CI, 1.7-5.6), and among men who have sex with men (RR, 1.7; 95% CI, 1.2-2.4). The effect in high-risk women showed significant heterogeneity, with no overall evidence of an association. Prevalent HSV-2 infection is associated with a three-fold increased risk of HIV acquisition among both men and women in the general population, suggesting that, in areas of high HSV-2 prevalence, a high proportion of HIV is attributable to HSV-2.
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            Glycerol monolaurate prevents mucosal SIV transmission

            While there has been great progress in treating HIV-1 infection1, preventing transmission has thus far proven an elusive goal. Indeed, recent trials of a candidate vaccine and microbicide have been disappointing, both for want of efficacy and concerns about increased rates of transmission2–4. Nonetheless, studies of vaginal transmission in the SIV-rhesus macaque model point to opportunities in the earliest stages of infection where a vaccine or microbicide might be protective, by limiting the expansion of infected founder populations at the portal of entry5, 6. Here we show in this SIV-macaque model, that an outside-in endocervical mucosal signalling system, involving MIP-3α, plasmacytoid dendritic cells and CCR5+cell-attracting chemokines produced by these cells, in combination with the innate immune and inflammatory responses to infection in both cervix and vagina, recruit CD4+T cells to fuel this obligate expansion. We then show that glycerol monolaurate, a widely used antimicrobial compound 7 with inhibitory activity against production of MIP-3α and other proinflammatory cytokines8, can inhibit mucosal signalling and the innate and inflammatory response to HIV-1 and SIV in vitro, and in vivo can protect rhesus macaques from acute infection despite repeated intra-vaginal exposure to high doses of SIV. This novel approach, plausibly linked to interfering with innate host responses that recruit the target cells necessary to establish systemic infection, opens a promising new avenue for development of effective interventions to block HIV-1 mucosal transmission.
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              Sexual transmission and propagation of SIV and HIV in resting and activated CD4+ T cells.

              In sexual transmission of simian immunodeficiency virus, and early and later stages of human immunodeficiency virus-type 1 (HIV-1) infection, both viruses were found to replicate predominantly in CD4(+) T cells at the portal of entry and in lymphoid tissues. Infection was propagated not only in activated and proliferating T cells but also, surprisingly, in resting T cells. The infected proliferating cells correspond to the short-lived population that produces the bulk of HIV-1. Most of the HIV-1-infected resting T cells persisted after antiretroviral therapy. Latently and chronically infected cells that may be derived from this population pose challenges to eradicating infection and developing an effective vaccine.
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                Author and article information

                Journal
                101299742
                35518
                Mucosal Immunol
                Mucosal Immunol
                Mucosal immunology
                1933-0219
                1935-3456
                17 November 2011
                16 November 2011
                March 2012
                01 September 2012
                : 5
                : 2
                : 121-128
                Affiliations
                [1 ]Clinical Science Division, Department of Medicine, University of Toronto, Toronto, Canada
                [2 ]Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
                [3 ]Rakai Health Sciences Program, Kalisizo, Uganda
                [4 ]Department of Medicine, Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
                [5 ]Department of Surgery, University of Toronto, Toronto, Canada
                [6 ]College of Health Sciences, Makerere University, Kampala, Uganda
                [7 ]Institute of Public Health, Makerere University, Kampala, Uganda
                Author notes
                Corresponding author: Dr. Rupert Kaul, University of Toronto, Medical Sciences Building #6356, 1 King’s College Circle, Toronto, Ontario, Canada, M5S 1A8, Tel: (1-416) 978-8607; Fax: (1-416) 978-8765, rupert.kaul@ 123456utoronto.ca
                Article
                nihpa337059
                10.1038/mi.2011.56
                3288185
                22089029
                aa9c6018-2d7e-42c1-9747-ed075f937af7
                History
                Funding
                Funded by: National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID
                Award ID: R01 AI087409-02 || AI
                Categories
                Article

                Immunology
                Immunology

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