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J Clin Invest. 2018 Nov 1;128(11):5083-5094. doi: 10.1172/JCI120245. Epub 2018 Oct 15.

Cycling CD4+ T cells in HIV-infected immune nonresponders have mitochondrial dysfunction.

Author information

Division of Infectious Disease and.
Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA.
Institute of Ecology and Genetics of Microorganisms, Perm, Russia.
Divisions of Infectious and Rheumatic Diseases, University Hospitals Case Medical Center, The Cleveland VA Medical Center, and the Center for AIDS Research, Cleveland, Ohio, USA.
Becton Dickinson, San Diego, California, USA.
National Institute of Child Health and Human Development and.
Human Immunology Section, Vaccine Research Center, National Institutes of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA.
School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Rheumatologic and Immunologic Disease, Cleveland Clinic, Cleveland, Ohio, USA.


Immune nonresponder (INR) HIV-1-infected subjects are characterized by their inability to reconstitute the CD4+ T cell pool after antiretroviral therapy. This is linked to poor clinical outcome. Mechanisms underlying immune reconstitution failure are poorly understood, although, counterintuitively, INRs often have increased frequencies of circulating CD4+ T cells in the cell cycle. While cycling CD4+ T cells from healthy controls and HIV+ patients with restored CD4+ T cell numbers complete cell division in vitro, cycling CD4+ T cells from INRs do not. Here, we show that cells with the phenotype and transcriptional profile of Tregs were enriched among cycling cells in health and in HIV infection. Yet there were diminished frequencies and numbers of Tregs among cycling CD4+ T cells in INRs, and cycling CD4+ T cells from INR subjects displayed transcriptional profiles associated with the impaired development and maintenance of functional Tregs. Flow cytometric assessment of TGF-β activity confirmed the dysfunction of Tregs in INR subjects. Transcriptional profiling and flow cytometry revealed diminished mitochondrial fitness in Tregs among INRs, and cycling Tregs from INRs had low expression of the mitochondrial biogenesis regulators peroxisome proliferator-activated receptor γ coactivator 1-α (PGC1α) and transcription factor A for mitochondria (TFAM). In vitro exposure to IL-15 allowed cells to complete division, restored the expression of PGC1α and TFAM, and regenerated mitochondrial fitness in the cycling Tregs of INRs. Our data suggest that rescuing mitochondrial function could correct the immune dysfunction characteristic of Tregs in HIV-1-infected subjects who fail to restore CD4+ T cells during antiretroviral therapy.


AIDS/HIV; Adaptive immunity; Cellular senescence; Metabolism

[Available on 2019-02-01]
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