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Blood, 15 June 2006, Vol. 107, No. 12, pp. 4825-4833. Prepublished online as a Blood First Edition Paper on March 7, 2006; DOI 10.1182/blood-2005-06-2463.
IMMUNOBIOLOGY Long-lasting CCR5 internalization by antibodies in a subset of long-term nonprogressors: a possible protective effect against disease progressionFrom the Immunobiology of HIV Unit, Infectious Diseases Clinic, San Raffaele Scientific Institute, Milan, Italy; theAIDS Immunopathogenesis Unit, Dibit, San Raffaele Scientific Institute, Milan, Italy; the Wadsworth Center, NY State Department of Health, Albany, NY; the Istituto di Biocatalisi e Riconoscimento Molecolare, Milan, Italy; the Clinic Research Office, San Raffaele Scientific Institute, Milan, Italy; the Università Vita-Salute San Raffaele, Milan, Italy; and the Laboratory for AIDS Vaccine Research and Development, Duke University Medical Center, Durham, NC.
Exposure to HIV-1 does not necessarily result in infection and progression toward disease, thus suggesting that the control of viral infection may be achieved. Antibodies to CCR5 have been detected in HIV-exposed but uninfected subjects (ESNs); thus, these antibodies could be involved in HIV protection. To assess whether anti-CCR5 antibodies may also contribute to slow HIV disease progression, we searched for anti-CCR5 antibodies in 497 subjects, including 85 long-term nonprogressors (LTNPs), 70 progressors, 135 HIV+ patients treated with highly active antiretroviral therapy (HAART), and 207 seronegative donors. We found anti-CCR5 antibodies in a fraction of the LTNPs(23.5%) but not in the other populations studied (P < .001). These antibodies recognized a conformational epitope within the first extramembrane loop of CCR5, and they induced a stable and long-lasting downregulation of CCR5 on the surface of T lymphocytes, which inhibited HIV entry. In addition, CD4+ lymphocytes from LTNPs having anti-CCR5 antibodies are resistance to R5 strains of HIV-1. Follow-up studies showed that the loss of anti-CCR5 antibodies occurred in some subjects, and this loss was significantly associated with a progression toward disease, whereas subjects who retained anti-CCR5 Abs maintained their LTNP status. Induction of anti-CCR5 Abs could be relevant to vaccine design and therapeutics.
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