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Blood, 29 October 2009, Vol. 114, No. 18, pp. 3822-3830.
Prepublished online as a Blood First Edition Paper on August 26, 2009; DOI 10.1182/blood-2009-06-226332.


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IMMUNOBIOLOGY

The decreased expression of Siglec-7 represents an early marker of dysfunctional natural killer–cell subsets associated with high levels of HIV-1 viremia

Enrico Brunetta1,2, Manuela Fogli2, Stefania Varchetta3, Luisa Bozzo1, Kelly L. Hudspeth4, Emanuela Marcenaro5, Alessandro Moretta5, and Domenico Mavilio1

1 Laboratory of Clinical and Experimental Immunology, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Clinico Humanitas, Rozzano, Milano, Italy; 2 Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; 3 Centre for Hepatology and Infectious Diseases, Policlinico San Matteo and University of Pavia, Pavia, Italy; 4 Department of Immunology and Microbiology, Rush University Medical Center, Chicago, IL; and 5 Dipartimento di Medicina Sperimentale, University of Genova, Genova, Italy

HIV-1 has developed several strategies to evade natural killer (NK)–cell antiviral functions. One of these mechanisms is the HIV-1–induced expansion of highly dysfunctional NK-cell subsets. Here, we analyze a large cohort of HIV-1–infected patients in early or chronic phases of infection, both cross-sectionally and longitudinally. We demonstrate that a striking decrease in the surface expression of sialic acid–binding immunoglobulin-like lectin 7 (Siglec-7) represents the earliest marker of the aberrant NK-cell dysregulation, which precedes the down-modulation of CD56 mostly occurring in patients with chronic HIV-1 viremia. The combined detection of Siglec-7 and CD56 allows the identification of 2 new pathologic NK-cell subsets expanded preferentially in early (Siglec-7/CD56+) or chronic (Siglec-7/CD56) stages of HIV-1 infection. Remarkably, these phenotypic abnormalities were directly associated with progressive and distinct impairments of NK-cell functions. The aforementioned NK-cell aberrancies could be observed only in the presence of high levels of viral replication and not in patients with low or undetectable HIV-1 viremia, such as long-term nonprogressors or patients having undergone antiretroviral therapy. High frequencies of Siglec-7/CD56+ and Siglec-7/CD56 pathologic NK cells reflect the immune and clinical status of HIV-1 infection and can also track the effectiveness of therapy.


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