Interval dosing with the HDAC inhibitor vorinostat effectively reverses HIV latency
Autor: | Nancie M. Archin, Jennifer L. Kirchherr, Julia A.M. Sung, Genevieve Clutton, Katherine Sholtis, Yinyan Xu, Brigitte Allard, Erin Stuelke, Angela D. Kashuba, Joann D. Kuruc, Joseph Eron, Cynthia L. Gay, Nilu Goonetilleke, David M. Margolis |
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Rok vydání: | 2017 |
Předmět: |
Adult
CD4-Positive T-Lymphocytes Male 0301 basic medicine Time Factors genetic structures Anti-HIV Agents HIV Infections Pharmacology Hydroxamic Acids Drug Administration Schedule 03 medical and health sciences Immune system In vivo Humans Medicine Dosing Latency (engineering) Vorinostat Aged business.industry RNA General Medicine Middle Aged Virus Latency Histone Deacetylase Inhibitors Treatment Outcome 030104 developmental biology HIV-1 RNA Viral Female Virus Activation sense organs Histone deacetylase Clinical Medicine business Ex vivo medicine.drug |
Zdroj: | Journal of Clinical Investigation. 127:3126-3135 |
ISSN: | 1558-8238 0021-9738 |
Popis: | Background The histone deacetylase (HDAC) inhibitor vorinostat (VOR) can increase HIV RNA expression in vivo within resting CD4+ T cells of aviremic HIV+ individuals. However, while studies of VOR or other HDAC inhibitors have reported reversal of latency, none has demonstrated clearance of latent infection. We sought to identify the optimal dosing of VOR for effective serial reversal of HIV latency. Methods In a study of 16 HIV-infected, aviremic individuals, we measured resting CD4+ T cell-associated HIV RNA ex vivo and in vivo following a single exposure to VOR, and then in vivo after a pair of doses separated by 48 or 72 hours, and finally following a series of 10 doses given at 72-hour intervals. Results Serial VOR exposures separated by 72 hours most often resulted in an increase in cell-associated HIV RNA within circulating resting CD4+ T cells. VOR was well tolerated by all participants. However, despite serial reversal of latency over 1 month of VOR dosing, we did not observe a measurable decrease (>0.3 log10) in the frequency of latent infection within resting CD4+ T cells. Conclusions These findings outline parameters for the experimental use of VOR to clear latent infection. Latency reversal can be achieved by VOR safely and repeatedly, but effective depletion of persistent HIV infection will require additional advances. In addition to improvements in latency reversal, these advances may include the sustained induction of potent antiviral immune responses capable of recognizing and clearing the rare cells in which HIV latency has been reversed. Trial registration Clinicaltrials.gov NCT01319383. Funding NIH grants U01 AI095052, AI50410, and P30 CA016086 and National Center for Advancing Translational Sciences grant KL2 TR001109. |
Databáze: | OpenAIRE |
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