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Combined noncanonical NF-κB agonism and targeted BET bromodomain inhibition reverse HIV latency ex vivo.


ABSTRACT: Latency reversal strategies for HIV cure using inhibitor of apoptosis protein (IAP) antagonists (IAPi) induce unprecedented levels of latent reservoir expression without immunotoxicity during suppressive antiretroviral therapy (ART). However, full targeting of the reservoir may require combinatorial approaches. A Jurkat latency model screen for IAPi combination partners demonstrated synergistic latency reversal with bromodomain (BD) and extraterminal domain protein inhibitors (BETi). Mechanistic investigations using CRISPR-CAS9 and single-cell RNA-Seq informed comprehensive ex vivo evaluations of IAPi plus pan-BET, bD-selective BET, or selective BET isoform targeting in CD4+ T cells from ART-suppressed donors. IAPi+BETi treatment resulted in striking induction of cell-associated HIV gag RNA, but lesser induction of fully elongated and tat-rev RNA compared with T cell activation-positive controls. IAPi+BETi resulted in HIV protein induction in bulk cultures of CD4+ T cells using an ultrasensitive p24 assay, but did not result in enhanced viral outgrowth frequency using a standard quantitative viral outgrowth assay. This study defines HIV transcriptional elongation and splicing as important barriers to latent HIV protein expression following latency reversal, delineates the roles of BET proteins and their BDs in HIV latency, and provides a rationale for exploration of IAPi+BETi in animal models of HIV latency.

SUBMITTER: Falcinelli SD 

PROVIDER: S-EPMC9012286 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Combined noncanonical NF-κB agonism and targeted BET bromodomain inhibition reverse HIV latency ex vivo.

Falcinelli Shane D SD   Peterson Jackson J JJ   Turner Anne-Marie W AW   Irlbeck David D   Read Jenna J   Raines Samuel Lm SL   James Katherine S KS   Sutton Cameron C   Sanchez Anthony A   Emery Ann A   Sampey Gavin G   Ferris Robert R   Allard Brigitte B   Ghofrani Simon S   Kirchherr Jennifer L JL   Baker Caroline C   Kuruc JoAnn D JD   Gay Cynthia L CL   James Lindsey I LI   Wu Guoxin G   Zuck Paul P   Rioja Inmaculada I   Furze Rebecca C RC   Prinjha Rab K RK   Howell Bonnie J BJ   Swanstrom Ronald R   Browne Edward P EP   Strahl Brian D BD   Dunham Richard M RM   Archin Nancie M NM   Margolis David M DM  

The Journal of clinical investigation 20220401 8


Latency reversal strategies for HIV cure using inhibitor of apoptosis protein (IAP) antagonists (IAPi) induce unprecedented levels of latent reservoir expression without immunotoxicity during suppressive antiretroviral therapy (ART). However, full targeting of the reservoir may require combinatorial approaches. A Jurkat latency model screen for IAPi combination partners demonstrated synergistic latency reversal with bromodomain (BD) and extraterminal domain protein inhibitors (BETi). Mechanistic  ...[more]

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