The role of IL-21 in rescuing CD8 T Cell responses in chronically infected HIV patients (105.38)

CD4 T cells are vital in regulating CD8 T cell responses during chronic viral infections. Notably, the hallmark of HIV infection is the severe loss of CD4 T cells resulting in defective CD8 T cell responses. One consequence of CD4 depletion following HIV infection is the loss of interleukin-21 (IL-21) production by the CD4 T cells, which has been demonstrated to be a critical factor in promoting viral control in murine studies. However, it is unknown whether IL-21 can rescue the exhausted CD8 T cells in chronically infected HIV+ patients. In this study we build upon novel murine studies to demonstrate a key role for IL-21 in improving CD8 T cell responses in PBMC from chronically infected HIV patients. To determine whether IL-21 can rescue exhausted CD8 T cells, PBMCs from HIV patients with viral loads > 10,000 RNA copies/mL were incubated with IL-21. Following re-stimulation with overlapping Gag-peptide, IL-21 enhanced the production of IFN-γ by CD8 T cells although no effect was observed on IL-2 or TNF-α production. In addition, an increase in the central memory (CD45RO+CD27+) population was observed with IL-21 culture along with higher MFI of Bcl-6 levels. Interestingly, IL-21 cultured CD8 T cells expressed higher MFI of PD-1 even though CD8 T cell function was enhanced. Significantly, these results provide an approach in which IL-21 can be potentially used to enhance CD8 T cell responses in chronically infected HIV patients, whose CD4 counts are low or defective.