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Expansion of GARP-Expressing CD4+CD25FoxP3+ T Cells and SATB1 Association with Activation and Coagulation in Immune Compromised HIV-1-Infected Individuals in South Africa

  • RESEARCH ARTICLE
  • Published:
Virologica Sinica

Abstract

Although antiretroviral treatment lowers the burden of human immunodeficiency virus (HIV)-related disease, it does not always result in immunological recovery. This manifests as persistent chronic inflammation, immune activation or exhaustion that can promote the onset of co-morbidities. As the exact function of regulatory T (Treg) cells in HIV remains unclear, this cross-sectional study investigated three expression markers (Forkhead box protein P3 [FOXP3], glycoprotein A repetitions predominant [GARP], special AT-rich sequence binding protein 1 [SATB1]) and compared their expansion between CD4+CD25 and CD4+CD25++ T cells. Age-matched study subjects were recruited (Western Cape, South Africa) and sub-divided: HIV-negative subjects (n = 12), HIV-positive naïve treated (n = 22), HIV-positive treated based on CD4 count cells/µL (CD4 > 500 and CD4 < 500) (n = 34) and HIV-treated based on viral load (VL) copies/mL (VL < 1000 and VL > 1000) (n = 34). Markers of immune activation (CD38) and coagulation (CD142) on T cells (CD8) were assessed by flow cytometry together with FOXP3, GARP and SATB1 expression on CD4+CD25 and CD4+CD25++ T cells. Plasma levels of interleukin-10 (IL-10; anti-inflammatory marker), IL-6 (inflammatory marker) and D-dimer (coagulation marker) were assessed. This study revealed three major findings in immuno-compromised patients with virological failure (CD4 < 500; VL > 1000): (1) the expansion of the unconventional Treg cell subset (CD4+CD25FOXP3+) is linked with disease progression markers; (2) increased GARP expression in the CD4+CD25 and CD4+CD25++ subsets; and (3) the identification of a strong link between CD4+CD25SATB1+ cells and markers of immune activation (CD8+CD38+) and coagulation (CD8+CD142+ and D-dimer).

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Acknowledgments

This work was supported by South African Medical Research Council and Stellenbosch University (to M. F. Essop). We acknowledge Nazma Mansoor and Rozanne Adam for excellent assistance with flow cytometry.

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Authors

Contributions

ET, RHG, and MFE conceived and designed research. ET, DEJ and LD performed experiments. ET, DEJ, LD, RHG, and MFE analyzed data. ET, DEJ, LD, RHG, and MFE interpreted results of experiments. ET and DEJ prepared figures. ET, DEJ, RHG, and MFE drafted manuscript. ET, DEJ, RHG, and MFE edited and revised manuscript. All authors read and approved the final manuscript.

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Correspondence to M. Faadiel Essop.

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Animal and Human Rights Statement

Ethical clearance was obtained from the Human Research Ethics Committee of Stellenbosch University (N12/12/086) and the Department of Health in the Western Cape, South Africa (reference number: RP090/2013). Prior to the study, we informed participants (attending the Worcester Community Day Center) about the various study procedures and subsequently obtained written consent.

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Teer, E., Joseph, D.E., Dominick, L. et al. Expansion of GARP-Expressing CD4+CD25FoxP3+ T Cells and SATB1 Association with Activation and Coagulation in Immune Compromised HIV-1-Infected Individuals in South Africa. Virol. Sin. 36, 1133–1143 (2021). https://doi.org/10.1007/s12250-021-00386-8

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  • DOI: https://doi.org/10.1007/s12250-021-00386-8

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