Memory CD4+CCR5+ T cells are abundantly present in the gut of newborn infants to facilitate mother-to-child transmission of HIV-1

MJ Bunders, CM van der Loos… - Blood, The Journal …, 2012 - ashpublications.org
MJ Bunders, CM van der Loos, PL Klarenbeek, JL van Hamme, K Boer, JCH Wilde…
Blood, The Journal of the American Society of Hematology, 2012ashpublications.org
Despite potential clinical importance, target cells for mother-to-child transmission of HIV-1
have not yet been identified. Cord blood–derived CD4+ T cells are largely naive and do not
express CCR5, the mandatory coreceptor for transmitted HIV-1 R5 strains in infants. In the
present study, we demonstrate that in the human fetal and infant gut mucosa, there is
already a large subset of mucosal memory CD4+ CCR5+ T cells with predominantly a Th1
and Th17 phenotype. Using next-generation sequencing of the TCRβ chain, clonally …
Abstract
Despite potential clinical importance, target cells for mother-to-child transmission of HIV-1 have not yet been identified. Cord blood–derived CD4+ T cells are largely naive and do not express CCR5, the mandatory coreceptor for transmitted HIV-1 R5 strains in infants. In the present study, we demonstrate that in the human fetal and infant gut mucosa, there is already a large subset of mucosal memory CD4+CCR5+ T cells with predominantly a Th1 and Th17 phenotype. Using next-generation sequencing of the TCRβ chain, clonally expanded T cells as a hallmark for memory development predominated in the gut mucosa (30%), whereas few were found in the lymph nodes (1%) and none in cord blood (0%). The gut mucosal fetal and infant CD4+ T cells were highly susceptible to HIV-1 without any prestimulation; pol proviral DNA levels were similar to infected phytohemagglutinin-stimulated adult PBMCs. In conclusion, in the present study, we show that extensive adaptive immunity is present before birth and the gut mucosa is the preferential site for memory CD4+ T cells. These CD4+CCR5+ T cells in the infant mucosa provide a large pool of susceptible cells for ingested HIV-1 at birth and during breastfeeding, indicating a mucosal route of mother-to-child transmission that can be targeted in prevention strategies.
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