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. 2023 Dec;56(6):1129-1138.
doi: 10.1016/j.jmii.2023.08.011. Epub 2023 Sep 2.

Caecum OX40+CD4 T-cell subset associates with mucosal damage and key markers of disease in treated HIV-infection

Isaac Rosado-Sánchez  1 , Inés Herrero-Fernández  2 , Salvador Sobrino  3 , Ana E Carvajal  4 , Miguel Genebat  5 , Laura Tarancón-Díez  6 , María Carmen Garcia-Guerrero  7 , María Carmen Puertas  8 , Rocío M de Pablos  9 , Rocío Ruiz  10 , Javier Martinez-Picado  11 , Manuel Leal  12 , Yolanda M Pacheco  13
Affiliations
Free article

Caecum OX40+CD4 T-cell subset associates with mucosal damage and key markers of disease in treated HIV-infection

Isaac Rosado-Sánchez et al. J Microbiol Immunol Infect. 2023 Dec.
Free article

Abstract

Background: Blood OX40-expressing CD4 T-cells from antiretroviral (ART)-treated people living with HIV (PWH) were found to be enriched for clonally-expanded HIV sequences, hence contributing to the HIV reservoir. OX40-OX40L is also a checkpoint regulator of inflammation in multiple diseases. We explored gut mucosal OX40+CD4+ T-cells and their potential significance in HIV disease.

Methods: Biopsies of caecum and terminal-ileum of ART-treated PWH (n = 32) were obtained and mucosal damage and HIV reservoir were assessed. Mucosal OX40+ and Ki67+ CD4 T-cell subsets, as well as several tissue T-cell subsets modulating mucosal integrity and homeostasis (Th17, Th22, Treg, Tc17, Tc22, IL17+TCRγδ, IL22+TCRγδ) were quantified. Inflammatory-related markers, T-cell activation and thymic output were also determined in blood samples. Correlations were explored using Spearman rank test and corrected for multiple comparisons by Benjamini-Hochberg.

Results: Compared to healthy controls, a high frequency of mucosal, mainly caecum, CD4 T-cells were OX40+ in PWH. Such frequency strongly correlated with nadir CD4 (r = -0.836; p < 0.0001), CD4/CD8 ratio (r = -0.630; p = 0.002), caecum mucosal damage (r = 0.606; p = 0.008), caecum Th22 (r = -0.635; p = 0.002), caecum Th17 (r = 0.474; p = 0.03) and thymic output (r = -0.686; p < 0.001). It also correlated with Neutrophil-to-Lymphocyte Ratio and blood CD4 T-cell activation and tended to with mucosal HIV reservoir.

Conclusion: High frequencies of caecum OX40+CD4 T-cells are found in people with HIV (PWH) and successful viral control. Interestingly, this cellular subset reflects key markers of disease and peripheral T-cell activation, as well as HIV-driven mucosal damage. OX40+CD4 T-cells deserve further investigation since they could expand because of T-cell homeostatic proliferation and relate to the Th22/Th17 gut mucosal ratio.

Keywords: Caecum; GALT; HIV; OX40; Thymus.

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