News (Updated November 21, 2010)

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How HIV thwarts the body's natural defense

2010-11-20

Researchers at Rush University Medical Center have apparently found why natural killer cells are powerless against HIV.

The study has marked the "beginning of a fascinating story that will shed new light on an important but still poorly understood aspect of the interaction of HIV with natural killer cells," according to an editorial in the journal.

Edward Barker, lead author of the study said, "With this information, we now have a major new target for drug therapies that could potentially stop HIV and allow the body's natural killer cells to do what they are designed to do - protect the body from this lethal virus."

HIV, like any virus, infects a cell, replicates itself over and over, and spreads throughout the body by using its "accessory" proteins to both take over the machinery of the cells it inhabits and thwart the arsenal of immunological cells that might destroy it.

Oddly, some of these proteins work at cross-purposes. One, the Vpr protein, initiates what is called DNA damage repair, stopping the host cell in its tracks so that the virus can take over.

But that action also sends a message to the cell surface that something is amiss. A ligand, called ULBP, is sent to the surface of the cell, which the prowling natural killer cells recognize and latch onto - the initial steps just before moving in for a kill.

Meanwhile, another protein produced by HIV prevents the cytotoxic T cells of the immune system from homing in on the HIV-infected cell and obliterating it. But this same protein also provokes the natural killer cells into action by shutting down an inhibitory mechanism that would hold the killer cells back.

If all worked as it should to protect the body from HIV, the natural killer cells would start firing their lethal pellets. But they don't, and that is what has puzzled scientists for so long.

"The barrel of the shotgun is loaded, but the trigger still has to be pulled," said Barker.

Barker and his colleagues now know why the trigger is not pulled: ecause yet another protein, called NTB-A (for Natural killer T-cell and B-cell Antigen), has virtually disappeared from the surface of the infected cell. Without NTB-A in place, the natural killer cells don't start firing the guns.

The culprit, the researchers found, is a protein made by HIV called Vpu, which holds NTB-A inside the cell and prevents it from reaching the cell surface.

When the researchers altered the Vpu protein, allowing NTB-A to migrate to the cell membrane, the natural killer cells blasted the HIV-infected cells - proof that both the ULBP ligand and NTB-A are needed before the natural killer cells will start shooting.

The findings were reported online in the journal Cell Host and icrobe. (ANI)

 

Why so many antibodies turn out to be ineffective in blocking HIV infection

2010-11-21

Duke University scientists have found why some of the earliest and most abundant antibodies available fail to protect against HIV infection.

The scientists based their conclusion on the results of a series of crystallography and biochemical experiments that revealed the specific molecular structures different types of antibodies need to have in place in order for them to mount an effective defence.

Previous research had shown that two of the most robust antibodies against HIV -antibodies called 2F5 and 4E10 - target a specific part of the outer coating of the virus called the MPER region of gp41.

The antibodies, which operate in a lock and key relationship, are able to latch on to the virus as it reveals this vulnerable part of its structure, referred to as an 'Achilles heel' of the AIDS virus.

"What our studies revealed, however, is that the virus actually creates two versions of this 'Achilles heel,' said Barton Haynes of the Duke Human Vaccine Institute (DHVI).

"One version is for these rarer, broadly-neutralizing antibodies, and the other is for the more abundant, first-responding antibodies that won't be able to do much good because the Achilles heel isn't detectable to them until the virus has already gained entry," said Haynes.

Nathan Nicely, the lead author of the study and a member of the DHVI, designed and conducted most of the crystallography studies.

"This structure has been difficult to obtain, but now that we have it, it has been instrumental in our understanding why this non-neutralizing antibody interacts with the HIV-1 outer coat," said Nicely.

Haynes said the findings are important because they distinguish what parts of the virus an antibody needs to recognize from those parts that are decoys.

"We are homing in on a better understanding of what the immune system needs to do in order to mount an effective defense against HIV," he added.

The study has been published in the Journal Nature. (ANI)

 

Study explains why HIV so tough to beat

Nov 16, 2010

Scientists have solved one of the great mysteries of the HIV/AIDS virus: why it is so successful at breaking down the body's resistance.

A paper in the journal Nature, published today, lays out the reasons why humans do not produce antibodies against the virus.

This lack of a natural defence allows the virus to enter cells without being attacked.

The findings offer new hope for vaccines which could target HIV/AIDS more effectively.

The key is a potential weak link, a protein on the surface of HIV called gp41, which helps the virus invade cells.

Professor Stephen Kent, an immunologist at the University of Melbourne , says gp41 has been of great interest to HIV vaccinologists.

"The GP41 component is the component that essentially punches a hole in the membrane or the surface of the cell and allows the virus to get in," he said.

"It's a very critical component of the entry mechanism of the virus.

"If we can prevent the HIV from getting into cells, then we'd have a great vaccine."

It has been known for many years that about one in 1,000 people can naturally control the HIV virus, by making an antibody against gp41.

The work published in Nature shows that while most people do develop an antibody against gp41, they do this after the virus has already entered their cells.

"They're making a response against this gp41 after the horse has already bolted," Professor Kent said.

"And so the virus gets in, it infects, it destroys these CD4 cells, and only then is the antibody made.

"It's disappointing, but at the same time it's also a clue. As we understand this better we can now try and direct our efforts against the specific parts of gp41 that we can attack before the virus can get into the cell.

"It's perhaps a couple of steps back and one step forward for HIV vaccine research."

Kidney transplants found safe in HIV patients

Nov 18 2010

By Gene Emery

BOSTON (Reuters) - People infected with HIV can safely receive a kidney transplant, researchers reported on Wednesday.

The finding, published in Thursday's New England Journal of Medicine, is good news for people with the virus, who are more prone to kidney disease, in part because of the drugs they must take to stay healthy.

Before drug cocktails turned HIV from a death sentence to a chronic condition, patients were not eligible to receive a kidney.

But now they can. "Patient and graft survival are really pretty good and it approximates the general population," Dr. Peter Stock of the University of California San Francisco , who led the study, said in a telephone interview.

But the news was not uniformly good. Rejection rates were two to three times higher than normal, which surprised Stock.

"It's not that dramatic and we've been able to reverse them," said Stock. "But we know that each rejection episode takes a little bit of life out of a kidney. So instead of lasting 20 years, it might last 15 years. That's why it's very important to figure that out."

His team studied 150 patients treated at 19 U.S. medical centers.

The patients, who were followed for up to three years after their transplants, had a 95 percent survival rate at one year and an 88 percent rate by the three-year mark. Ninety percent of the kidneys were still functioning after one year; 74 percent by the third year.

Those success rates are between what would be expected for all recipients and those age 65 and older.

Eleven of the 150 died. The deaths were caused by heart problems, cancer in the old kidney, bacterial and lung infections.

Stock said there was no evidence that the transplant process caused a resurgence of the HIV, even though the number of protective white blood cells did initially decline.

"HIV simply doesn't progress," said Stock, adding that the same phenomenon has been seen among liver transplant recipients.

In the past, doctors had been concerned that the drugs needed to prevent rejection of the kidney might interfere with the drugs that keep the virus under control.

In a commentary, Dr. Lynda Anne Szczech of Duke University Medical Center in Durham , North Carolina , said the next step is to develop effective treatments for all HIV-related kidney diseases before they progress to near-complete kidney failure.

SOURCE: New England Journal of Medicine, November 18, 2010.

 

Lab detectives use science to nab HIV criminals: study

By Jean-Louis Santini (AFP) – 5 days ago

WASHINGTON US lab sleuths have helped nab a pair of criminals who infected their sexual partners with HIV after tracing the virus from the perpetrators to the victims, according to a study published Monday.

In both cases, one in the western state of Washington and one in Texas , the men were found guilty of infecting multiple women with the virus that causes AIDS after science confirmed the link.

The findings published in the Proceedings of the National Academy of Sciences describe how scientists were able to narrow down the exact type of HIV that matched both the accused criminals and the women they infected.

The research marks a breakthrough in scientists' ability to say definitively which person was the source of the infection.

"This is the first case study to establish the direction of transmission," said Michael Metzker, associate professor in the Baylor College of Medicine Human Genome Sequencing Center in Texas .

Scientists were "blinded" in the studies, meaning they were unaware which samples came from the accused and which came from the women.

The process was complicated because of the way HIV presents itself in an infected person, said Metzker.

"Within a given person, there is not just one strain but a population of strains because HIV mutates all the time when it makes new virions (viral particles)," said Metzker.

"During transmission, however, there is a genetic bottleneck in which only one or two viruses get transmitted to the recipient."

By narrowing down the single "ancestor" of HIV and comparing two distinct gene regions of the virus across different subjects, scientists were able to reconstruct the history of the virus -- in a process known as phylogenetic analysis.

But more importantly, the scientists were able to decipher which sample was the source of the infection.

"We can identify the source in a cluster of infections because some isolates of HIV from the source will be related to HIV isolates in each of the recipients," said study coauthor David Hillis of the University of Texas at Austin .

After the analysis was done, scientists handed over their results, showing which sample they believed was the source of the HIV infection and which samples were the recipients.

Prosecutors then linked the samples to the suspects, in each case making a perfect match to the person they suspected of being responsible for the women's HIV infections.

As a result, Philippe Padieu was sentenced by a Texas jury in 2009 to 45 years in prison for aggravated assault with a deadly weapon, after having sex with multiple women and not telling them of his HIV positive status.

And in Washington , Anthony Eugene Whitfield was convicted and sentenced in 2004 to 178 years in prison for infecting his wife and four others with the virus, for which there is no cure.

A prior study was able to link patients with the same viral sequences in the southern state of Louisiana .

In that situation, a doctor was accused in 1998 of having taken blood samples from patients infected with HIV and hepatitis C and injecting them into his ex-girlfriend, who later developed HIV.

However scientists knew to whom the samples belonged, so their study was not entirely objective, said Metzker.

Copyright © 2010 AFP

 

Nov. 17, 2010

HIV DNA Vaccine Achieves Strong T-Cell Immune Responses in Phase I Human Trial

Significant T-cell responses demonstrate potential of PENNVAX(TM)-B HIV DNA vaccine delivered using electroporation

BLUE BELL, Pa., Nov 17, 2010 (BUSINESS WIRE) -- Inovio Pharmaceuticals, Inc. /quotes/comstock/14*!ino/quotes/nls/ino, a leader in the development of therapeutic and preventive vaccines against cancers and infectious diseases, announced today that it has achieved high vaccine-induced response rates and strong magnitude of immune responses in its Phase I clinical study of PENNVAX(TM)-B, a DNA vaccine for the prevention of HIV infection. Similar to recently reported results from a Phase I clinical study of Inovio's therapeutic DNA vaccine for cervical cancer, the response rates and magnitude of responses achieved in this study are significantly higher than those seen previously with other DNA vaccine trials. Dr. Spyros Kalams, principal investigator for the study and Immunology Director of the Vanderbilt Center for AIDS Research at Vanderbilt University Medical Center , presented the interim immune response and safety data at the Annual HIV Vaccine Trials Network (HVTN) Conference being held November 15-17 in Seattle , WA .

Inovio previously reported data from non-human primates demonstrating up to a 100-fold enhancement in immune responses resulting from the vaccine when delivered via in vivo electroporation compared to syringe injection without electroporation. This study, designated HVTN-080, involved vaccination of 48 healthy, HIV-negative volunteers to assess safety and levels of immune responses generated by Inovio's PENNVAX-B vaccine delivered with its CELLECTRA(R) electroporation device. PENNVAX-B is a SynCon(TM) DNA vaccine that targets HIV gag, pol, and env proteins. This randomized, double-blind, multi-center study is being sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), an agency of the National Institutes of Health, and conducted by the NIAID-funded HVTN, at several clinical sites.

Of the 48 total volunteers, eight subjects received a placebo, 10 subjects received a 1 mg dose of PENNVAX(TM)-B vaccine, and 30 subjects received a 1 mg dose of PENNVAX-B along with IL-12 DNA. The IL-12 for this study (Genevax-IL-12), manufactured under a contract with DAIDS, was provided by Profectus Biosciences. All volunteers received vaccine or placebo administered with electroporation at months 0, 1, and 3. The T-cell immune responses were detected using a validated flow cytometry-based intracellular cytokine staining (ICS) assay at the HVTN core immunology laboratory at the Fred Hutchinson Cancer Research Center ( Seattle , WA ).

Preliminary data from the trial reported at the meeting included safety data from all trial participants (48) and immunogenicity data from 38 out of 40 samples from vaccine recipients post-second-dose and from 31 out of 40 samples from vaccine recipients post-third-dose. The data indicate that antigen-specific T-cell responses were generated by the vaccine in a majority of subjects. Either CD4+ or CD8+ or both T-cell responses were observed against at least one of the vaccine antigens in 61% (23 out of 38) of evaluated subjects after two vaccinations. After three vaccinations, 84% (26 out of 31) of evaluated subjects had positive T-cell responses.

Notably, after three vaccinations:

67% (6 out of 9) of evaluated subjects receiving PENNVAX-B and 91% (20 of 22) of evaluated subjects receiving PENNVAX-B + IL-12 were observed to have generated antigen-specific T-cell responses (either CD4+ or CD8+). Antigen-specific CD4+ T-cell responses were generated by the vaccine in 70% of evaluated vaccine recipients (21 out of 30). Significantly strong antigen-specific, CD8+ T-cell responses were also generated by the vaccine in 55% of evaluated vaccine recipients (17 out of 31). Samples from eight placebo recipients and pre-vaccine samples from vaccine recipients were also tested and were negative for both CD4+ T-cell responses and CD8+ T-cell responses. PENNVAX-B delivered using the CELLECTRA(R) intramuscular electroporation delivery device with or without IL-12 was generally safe and well tolerated. There were no vaccine-related serious adverse events. Reported adverse events and injection site reactions were mild to moderate and required no treatment.

Dr. Kalams stated, "The preliminary immune response data from this novel DNA-based vaccine are indeed very encouraging. We look forward to our continuing work with Inovio to develop the potential of this promising vaccine candidate."

Dr. J. Joseph Kim, Inovio's President and CEO, said: "After recently announcing best-in-class immunogenicity data from our clinical trial for our cervical cancer DNA vaccine using the same technology platform, we are pleased to again see very strong T-cell immune responses from this vaccine platform for a different disease, and particularly a disease with unmet needs like HIV. They are amongst the highest immune responses seen in other HIV vaccine trials either with DNA or other vaccine platforms including proteins and viral vectors. However, unlike viral vectors, DNA vaccines do not induce unwanted immune responses against the carrier. Taken together these results further support the prospect that Inovio's DNA vaccine and delivery platform could play an important role in developing new vaccines and therapies for major diseases like cancer and HIV."

In addition to the interim ICS results presented at the meeting, the complete immunogenicity data including data from the few remaining unanalyzed samples and additional antibody and T-cell results based on ELISpot assays as well as the end-of-study safety data are expected in 2Q 2011.


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