The Journal of Clinical Investigation (May 2022)

Rapamycin limits CD4+ T cell proliferation in simian immunodeficiency virus–infected rhesus macaques on antiretroviral therapy

  • Benjamin D. Varco-Merth,
  • William Brantley,
  • Alejandra Marenco,
  • Derick D. Duell,
  • Devin N. Fachko,
  • Brian Richardson,
  • Kathleen Busman-Sahay,
  • Danica Shao,
  • Walter Flores,
  • Kathleen Engelman,
  • Yoshinori Fukazawa,
  • Scott W. Wong,
  • Rebecca L. Skalsky,
  • Jeremy Smedley,
  • Michael K. Axthelm,
  • Jeffrey D. Lifson,
  • Jacob D. Estes,
  • Paul T. Edlefsen,
  • Louis J. Picker,
  • Cheryl M.A. Cameron,
  • Timothy J. Henrich,
  • Afam A. Okoye

Journal volume & issue
Vol. 132, no. 10

Abstract

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Proliferation of latently infected CD4+ T cells with replication-competent proviruses is an important mechanism contributing to HIV persistence during antiretroviral therapy (ART). One approach to targeting this latent cell expansion is to inhibit mTOR, a regulatory kinase involved with cell growth, metabolism, and proliferation. Here, we determined the effects of chronic mTOR inhibition with rapamycin with or without T cell activation in SIV-infected rhesus macaques (RMs) on ART. Rapamycin perturbed the expression of multiple genes and signaling pathways important for cellular proliferation and substantially decreased the frequency of proliferating CD4+ memory T cells (TM cells) in blood and tissues. However, levels of cell-associated SIV DNA and SIV RNA were not markedly different between rapamycin-treated RMs and controls during ART. T cell activation with an anti-CD3LALA antibody induced increases in SIV RNA in plasma of RMs on rapamycin, consistent with SIV production. However, upon ART cessation, both rapamycin and CD3LALA–treated and control-treated RMs rebounded in less than 12 days, with no difference in the time to viral rebound or post-ART viral load set points. These results indicate that, while rapamycin can decrease the proliferation of CD4+ TM cells, chronic mTOR inhibition alone or in combination with T cell activation was not sufficient to disrupt the stability of the SIV reservoir.

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