Background The long-term immunological benefit of protease inhibitor (PI)-sparing antiretroviral ... more Background The long-term immunological benefit of protease inhibitor (PI)-sparing antiretroviral therapy (ART) using non-nucleoside reverse transcriptase inhibitors (NNRTIs) remains poorly investigated. Methods A total of 120 ART-naive, HIV-1-infected participants were included in the immunology substudy of INITIO, an international randomized trial comparing two NRTIs (didanosine + stavudine) combined with either: one NNRTI (efavirenz; EFV), one non-boosted PI (nelfinavir; NFV), or one NNRTI + one PI (EFV/NFV). CD4+ T-cell counts, HIV-1 plasma RNA load (VL), T-cell pheno-type, T-cell proliferation and IFN-γ production against opportunistic/recall and HIV-1 antigens/peptides were compared at baseline and at week (W) 96 and W156. Results Participants (37 EFV, 44 NFV, 39 EFV/NFV) had similar baseline VL; median CD4+ T-cell counts/mm3 were: 144 (64–303) EFV, 212 (42–313) NFV and 257 (86–331) EFV/NFV. At W156, the proportion of patients with VL ≤50 copies/ml was not different between the...
Background Strong virus-specific helper and cytotoxic T-cell responses correlate with non-progres... more Background Strong virus-specific helper and cytotoxic T-cell responses correlate with non-progression during HIV-1 infection. Administration of antiretroviral therapy (ART) during the chronic phases of HIV-1 infection fails to restore these responses in most patients. Design and methods We assessed the changes in immune function of 12 HIV-1-positive individuals treated with ART for over 4 years, who received 4 mg/day of recombinant human growth hormone (rhGH) for 12 weeks and were then randomized into groups receiving either placebo, twice weekly or alternate day dosing of rhGH. Peripheral blood was drawn for phenotypic analysis and functional assays at time points 0, 12 and 24 weeks. Results At week 12, we observed significant increases in naive CD4 T cells ( P<0.01) and effector CD8 T cells based on CD45RA and CCR7 expression ( P<0.02). In addition, we observed a rise in HIV-1 antigen-specific CD4 ( P<0.005) and CD8 ( P<0.05) T-cell responses. Twelve weeks post-randomi...
Progesterone (P4) is an important steroid hormone for the establishment and maintenance of pregna... more Progesterone (P4) is an important steroid hormone for the establishment and maintenance of pregnancy and its functional withdrawal in reproductive tissue is linked with the onset of parturition. However, the effects of P4 on adaptive immune responses are poorly understood. In this study, we took a novel approach by comparing the effects of P4 supplementation longitudinally, with treatment using a P4 antagonist mifepristone (RU486) in mid-trimester pregnancies. Thus, we were able to demonstrate the immune-modulatory functions of P4. We show that, in pregnancy, the immune system is increasingly activated (CD38, CCR6) with greater antigen-specific cytotoxic T cell responses (granzyme B). Simultaneously, pregnancy promotes a tolerant immune environment (IL-10 and regulatory-T cells) that gradually reverses prior to the onset of labor. P4 suppresses and RU486 enhances antigen-specific CD4 and CD8 T cell inflammatory cytokine (IFN-γ) and cytotoxic molecule release (granzyme B). P4 and RU4...
HIV-1 controllers (HIC) are extremely rare patients with the ability to control viral replication... more HIV-1 controllers (HIC) are extremely rare patients with the ability to control viral replication, maintain unchanging CD4 T-cell count, and evade disease progression for extensive periods of time, in the absence of antiretroviral therapy. In order to establish the representation of key genetic correlates of atypical disease progression within a cohort of HIV-1(+) individuals who control viral replication, we examine four-digit resolution HLA type and single-nucleotide polymorphisms (SNP) previously identified to be correlated to non-progressive infection, in strictly defined HIC. Clinical histories were examined to identify patients exhibiting HIC status. Genomic DNA was extracted, and high definition HLA typing and genome-wide SNP analysis was performed. Data were compared with frequencies of SNP in European long-term non-progressors (LTNP) and primary infection cohorts. HLA-B alleles associated with atypical disease progression were at very high frequencies in the group of five H...
Current opinion in investigational drugs (London, England : 2000), 2002
HIV-1-specific CD8 cytotoxic and CD4 helper T-lymphocytes, which are respectively the central eff... more HIV-1-specific CD8 cytotoxic and CD4 helper T-lymphocytes, which are respectively the central effector and regulatory cells in viral infections, together with fully functional antigen-presenting cells, are essential at all stages of HIV-1 infection to control viral activity. Recent studies indicate that such protective HIV-1-specific immune responses can be preserved/induced in HIV-1-infected individuals, utilizing strategies such as treatment interruption after early HAART. Despite successful combination antiretroviral drug therapy, strong anti-HIV-1 T-cell responses are often not apparent in chronic HIV-1 infection, diminishing the probability of viral eradication. Thus, the therapeutic use of immunization and cytokines are required to induce and steer immunity towards a desirable outcome. Here, we review and discuss therapeutic immunization and immunotherapy with regard to their potential use in the treatment of chronic HIV-1 infection.
Please help us populate SUNScholar with the post print version of this article. It can be e-maile... more Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.zaGeneeskundeGeneeskundige Virologi
This randomised, open label, phase I, immunotherapeutic study investigated the effects of interle... more This randomised, open label, phase I, immunotherapeutic study investigated the effects of interleukin (IL)-2, granulocyte-macrophage colony-stimulating factor (GM-CSF), recombinant human growth hormone (rhGH), and therapeutic immunisation (a Clade B DNA vaccine) on combination antiretroviral therapy (cART)-treated HIV-1-infected individuals, with the objective to reverse residual T-cell dysfunction. Twelve HIV-1(+) patients on suppressive cART with baseline CD4 T-cell counts >400 cells/mm(3) blood were randomised into one of three groups: (1) vaccine, IL-2, GM-CSF and rhGH (n=3); (2) vaccine alone (n=4); or (3) IL-2, GM-CSF and rhGH (n=5). Samples were collected at weeks 0, 1, 2, 4, 6, 8, 12, 16, 24 and 48. Interferon (IFN)-γ, IL-2, IL-4 and perforin ELISpot assays performed at each time point quantified functional responses to Gag p17/p24, Nef, Rev, and Tat peptides; and detailed T-cell immunophenotyping was undertaken by flow cytometry. Proviral DNA was also measured. Median ba...
... Role of the Thymus in T Lymphocyte Reconstitution. Imami, Nesrina; Aspinall, Richard; Gotch, ... more ... Role of the Thymus in T Lymphocyte Reconstitution. Imami, Nesrina; Aspinall, Richard; Gotch, Frances. Article Outline. Collapse Box Author Information. Department of Immunology. ... 2. Gaulton GN, Scobie JV, Rosenzweig M. HIV-1 and the thymus. AIDS 1997; 11:403. ...
mAb MR6 has previously been shown to block both IL-4-induced T cell proliferation and IL-4-depend... more mAb MR6 has previously been shown to block both IL-4-induced T cell proliferation and IL-4-dependent IgE production, suggesting a functional association between the antigen detected by MR6 (gp200-MR6) and the human IL-4 receptor. In this study the potential modulatory effects of mAb MR6 on IL-4 function have been further analysed in alloantigen-specific assays for cytotoxic and Th cell maturation, mature cytotoxic T cell killing, helper cell proliferation, and generation of IL-2- and IL-4-producing Th cells in a mixed lymphocyte reaction (MLR). Our data show that mAb MR6 has an inhibitory effect on both clonal expansion and maturation of cytotoxic T lymphocyte precursors within the alloreactive T cell population. mAb MR6 had no effect on the maturation of Th lymphocyte precursors (assayed by IL-2 production). However, this mAb had striking differential effects on cytokine production in MLR cultures, showing total ablation of IL-4 but no alteration of IL-2 levels in the supernatant medium. The absence of IL-4 from culture supernatants could be due to the fact that mAb MR6 is blocking cytokine production, that it is speeding up IL-4 internalization and utilization or that it inhibits the expansion of the T cell subset(s) that secretes IL-4. The data demonstrate that the action of mAb MR6 is focused on the IL-4-producing population and raise the possibility that gp200-MR6 may play an important role in this aspect of IL-4 function.
Background The long-term immunological benefit of protease inhibitor (PI)-sparing antiretroviral ... more Background The long-term immunological benefit of protease inhibitor (PI)-sparing antiretroviral therapy (ART) using non-nucleoside reverse transcriptase inhibitors (NNRTIs) remains poorly investigated. Methods A total of 120 ART-naive, HIV-1-infected participants were included in the immunology substudy of INITIO, an international randomized trial comparing two NRTIs (didanosine + stavudine) combined with either: one NNRTI (efavirenz; EFV), one non-boosted PI (nelfinavir; NFV), or one NNRTI + one PI (EFV/NFV). CD4+ T-cell counts, HIV-1 plasma RNA load (VL), T-cell pheno-type, T-cell proliferation and IFN-γ production against opportunistic/recall and HIV-1 antigens/peptides were compared at baseline and at week (W) 96 and W156. Results Participants (37 EFV, 44 NFV, 39 EFV/NFV) had similar baseline VL; median CD4+ T-cell counts/mm3 were: 144 (64–303) EFV, 212 (42–313) NFV and 257 (86–331) EFV/NFV. At W156, the proportion of patients with VL ≤50 copies/ml was not different between the...
Background Strong virus-specific helper and cytotoxic T-cell responses correlate with non-progres... more Background Strong virus-specific helper and cytotoxic T-cell responses correlate with non-progression during HIV-1 infection. Administration of antiretroviral therapy (ART) during the chronic phases of HIV-1 infection fails to restore these responses in most patients. Design and methods We assessed the changes in immune function of 12 HIV-1-positive individuals treated with ART for over 4 years, who received 4 mg/day of recombinant human growth hormone (rhGH) for 12 weeks and were then randomized into groups receiving either placebo, twice weekly or alternate day dosing of rhGH. Peripheral blood was drawn for phenotypic analysis and functional assays at time points 0, 12 and 24 weeks. Results At week 12, we observed significant increases in naive CD4 T cells ( P<0.01) and effector CD8 T cells based on CD45RA and CCR7 expression ( P<0.02). In addition, we observed a rise in HIV-1 antigen-specific CD4 ( P<0.005) and CD8 ( P<0.05) T-cell responses. Twelve weeks post-randomi...
Progesterone (P4) is an important steroid hormone for the establishment and maintenance of pregna... more Progesterone (P4) is an important steroid hormone for the establishment and maintenance of pregnancy and its functional withdrawal in reproductive tissue is linked with the onset of parturition. However, the effects of P4 on adaptive immune responses are poorly understood. In this study, we took a novel approach by comparing the effects of P4 supplementation longitudinally, with treatment using a P4 antagonist mifepristone (RU486) in mid-trimester pregnancies. Thus, we were able to demonstrate the immune-modulatory functions of P4. We show that, in pregnancy, the immune system is increasingly activated (CD38, CCR6) with greater antigen-specific cytotoxic T cell responses (granzyme B). Simultaneously, pregnancy promotes a tolerant immune environment (IL-10 and regulatory-T cells) that gradually reverses prior to the onset of labor. P4 suppresses and RU486 enhances antigen-specific CD4 and CD8 T cell inflammatory cytokine (IFN-γ) and cytotoxic molecule release (granzyme B). P4 and RU4...
HIV-1 controllers (HIC) are extremely rare patients with the ability to control viral replication... more HIV-1 controllers (HIC) are extremely rare patients with the ability to control viral replication, maintain unchanging CD4 T-cell count, and evade disease progression for extensive periods of time, in the absence of antiretroviral therapy. In order to establish the representation of key genetic correlates of atypical disease progression within a cohort of HIV-1(+) individuals who control viral replication, we examine four-digit resolution HLA type and single-nucleotide polymorphisms (SNP) previously identified to be correlated to non-progressive infection, in strictly defined HIC. Clinical histories were examined to identify patients exhibiting HIC status. Genomic DNA was extracted, and high definition HLA typing and genome-wide SNP analysis was performed. Data were compared with frequencies of SNP in European long-term non-progressors (LTNP) and primary infection cohorts. HLA-B alleles associated with atypical disease progression were at very high frequencies in the group of five H...
Current opinion in investigational drugs (London, England : 2000), 2002
HIV-1-specific CD8 cytotoxic and CD4 helper T-lymphocytes, which are respectively the central eff... more HIV-1-specific CD8 cytotoxic and CD4 helper T-lymphocytes, which are respectively the central effector and regulatory cells in viral infections, together with fully functional antigen-presenting cells, are essential at all stages of HIV-1 infection to control viral activity. Recent studies indicate that such protective HIV-1-specific immune responses can be preserved/induced in HIV-1-infected individuals, utilizing strategies such as treatment interruption after early HAART. Despite successful combination antiretroviral drug therapy, strong anti-HIV-1 T-cell responses are often not apparent in chronic HIV-1 infection, diminishing the probability of viral eradication. Thus, the therapeutic use of immunization and cytokines are required to induce and steer immunity towards a desirable outcome. Here, we review and discuss therapeutic immunization and immunotherapy with regard to their potential use in the treatment of chronic HIV-1 infection.
Please help us populate SUNScholar with the post print version of this article. It can be e-maile... more Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.zaGeneeskundeGeneeskundige Virologi
This randomised, open label, phase I, immunotherapeutic study investigated the effects of interle... more This randomised, open label, phase I, immunotherapeutic study investigated the effects of interleukin (IL)-2, granulocyte-macrophage colony-stimulating factor (GM-CSF), recombinant human growth hormone (rhGH), and therapeutic immunisation (a Clade B DNA vaccine) on combination antiretroviral therapy (cART)-treated HIV-1-infected individuals, with the objective to reverse residual T-cell dysfunction. Twelve HIV-1(+) patients on suppressive cART with baseline CD4 T-cell counts >400 cells/mm(3) blood were randomised into one of three groups: (1) vaccine, IL-2, GM-CSF and rhGH (n=3); (2) vaccine alone (n=4); or (3) IL-2, GM-CSF and rhGH (n=5). Samples were collected at weeks 0, 1, 2, 4, 6, 8, 12, 16, 24 and 48. Interferon (IFN)-γ, IL-2, IL-4 and perforin ELISpot assays performed at each time point quantified functional responses to Gag p17/p24, Nef, Rev, and Tat peptides; and detailed T-cell immunophenotyping was undertaken by flow cytometry. Proviral DNA was also measured. Median ba...
... Role of the Thymus in T Lymphocyte Reconstitution. Imami, Nesrina; Aspinall, Richard; Gotch, ... more ... Role of the Thymus in T Lymphocyte Reconstitution. Imami, Nesrina; Aspinall, Richard; Gotch, Frances. Article Outline. Collapse Box Author Information. Department of Immunology. ... 2. Gaulton GN, Scobie JV, Rosenzweig M. HIV-1 and the thymus. AIDS 1997; 11:403. ...
mAb MR6 has previously been shown to block both IL-4-induced T cell proliferation and IL-4-depend... more mAb MR6 has previously been shown to block both IL-4-induced T cell proliferation and IL-4-dependent IgE production, suggesting a functional association between the antigen detected by MR6 (gp200-MR6) and the human IL-4 receptor. In this study the potential modulatory effects of mAb MR6 on IL-4 function have been further analysed in alloantigen-specific assays for cytotoxic and Th cell maturation, mature cytotoxic T cell killing, helper cell proliferation, and generation of IL-2- and IL-4-producing Th cells in a mixed lymphocyte reaction (MLR). Our data show that mAb MR6 has an inhibitory effect on both clonal expansion and maturation of cytotoxic T lymphocyte precursors within the alloreactive T cell population. mAb MR6 had no effect on the maturation of Th lymphocyte precursors (assayed by IL-2 production). However, this mAb had striking differential effects on cytokine production in MLR cultures, showing total ablation of IL-4 but no alteration of IL-2 levels in the supernatant medium. The absence of IL-4 from culture supernatants could be due to the fact that mAb MR6 is blocking cytokine production, that it is speeding up IL-4 internalization and utilization or that it inhibits the expansion of the T cell subset(s) that secretes IL-4. The data demonstrate that the action of mAb MR6 is focused on the IL-4-producing population and raise the possibility that gp200-MR6 may play an important role in this aspect of IL-4 function.
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