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Journal of Virology, October 1998, p. 8273-8280, Vol. 72, No. 10
0022-538X/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Naïve and Memory CD4 T Cells Differ in
Their Susceptibilities to Human Immunodeficiency Virus Type 1 Infection
following CD28 Costimulation: Implications for
Transmission and Pathogenesis
James L.
Riley,1
Bruce L.
Levine,2
Nancy
Craighead,3
Tara
Francomano,2
Daniel
Kim,2
Richard G.
Carroll,2 and
Carl H.
June2,*
Division of Retrovirology, Walter Reed Army
Institute for Research, Rockville, Maryland
20850,1 and
Henry M. Jackson Foundation
for the Advancement of Military Medicine, U.S. Military HIV Research
Program,2 and
Immune Cell Biology
Program, Naval Medical Research Institute,3
Bethesda, Maryland 20889
Received 4 May 1998/Accepted 13 July 1998
 |
ABSTRACT |
In vitro evidence suggests that memory CD4+ cells are
preferentially infected by human immunodeficiency virus type 1 (HIV-1), yet studies of HIV-1-infected individuals have failed to detect preferential memory cell depletion. To explore this paradox, we stimulated CD45RA+ CD4+ (naïve) and
CD45RO+ CD4+ (memory) cells with antibodies to
CD3 and CD28 and infected them with either CCR5-dependent (R5) or
CXCR4-dependent (X4) HIV-1 isolates. Naïve CD4+
cells supported less X4 HIV replication than their memory counterparts. However, naïve cells were susceptible to R5 viral infection, while memory cells remained resistant to infection and viral
replication. As with the unseparated cells, mixing the naïve
and memory cells prior to infection resulted in cells resistant to R5
infection and highly susceptible to X4 infection. While both
naïve and memory CD4+ subsets downregulated CCR5
expression in response to CD28 costimulation, only the memory cells
produced high levels of the
-chemokines RANTES, MIP-1
, and
MIP-1
upon stimulation. Neutralization of these
-chemokines
rendered memory CD4+ cells highly sensitive to infection
with R5 HIV-1 isolates, indicating that downregulation of CCR5 is not
sufficient to mediate complete protection from CCR5 strains of HIV-1.
These results indicate that susceptibility to R5 HIV-1 isolates is
determined not only by the level of CCR5 expression but also by the
balance of CCR5 expression and
-chemokine production. Furthermore,
our results suggest a model of HIV-1 transmission and pathogenesis in
which naïve rather than memory CD4+ T cells serve
as the targets for early rounds of HIV-1 replication.
 |
INTRODUCTION |
Human immunodeficiency virus type 1 (HIV-1) infection is accompanied by depletion of CD4+ T
lymphocytes and progressive loss of immune function (26). CD4+ T lymphocytes are a heterogeneous population, and
controversy exists as to whether HIV-1 targets particular
CD4+ subtypes for elimination (18, 53). In part,
this controversy has centered on whether naïve or memory
CD4+ cell subsets are preferentially depleted by HIV-1.
Naïve CD4+ T lymphocytes have no previous antigen
exposure; exposure to the cognate antigen is followed by proliferation
and the acquisition of effector functions. A subset of the activated
cells reverts to a resting state, at which point they are termed memory
cells (61). Phenotypically, naïve cells are
CD45RA+ CD45RO
and respond to mitogenic
stimuli with a greater calcium flux and proliferative ability, while
memory cells are CD45RO+ CD45RA
and have a
much broader cytokine expression profile (7). Naïve cells are found almost exclusively in the secondary lymph organs, while
memory cells have a much wider tissue distribution. These differing
distributions are thought to be due to the higher level of adhesion
molecule expression on memory cells (41).
In vitro, memory cells are more efficiently infected by HIV-1 (31,
55, 58, 60, 67) and they are more susceptible to HIV-induced
cytopathic effects (15, 70). However, most studies of HIV-1
seroconverters either demonstrate no specific depletion of either
subtype (14, 29, 42, 50, 51, 62) or indicate specific
exhaustion of naïve cells (5, 6, 54). A major
limitation of the in vitro studies is the almost exclusive use of
CXCR4-dependent (X4) viruses. X4 viruses, also known as syncytium-inducing or T-cell-line-tropic viruses, use the
-chemokine receptor CXCR4 as a coreceptor (27). CXCR4-dependent
viruses appear late in the course of HIV infection and they are more
cytopathic than the CCR5-dependent (R5) viruses (21). R5
viruses, also known as non-syncytium-inducing or macrophage-tropic
viruses, use CCR5 for a coreceptor (3, 13, 23-25). R5
viruses are essential for transmission and predominate during the
early, asymptomatic phase of infection (45, 68). Thus, the
virus isolates critical for transmission (R5 viruses) have been rarely
used in in vitro acute infection model systems described to date.
While coreceptor expression is required for viral entry into
CD4+ cells, productive HIV infection requires cellular
activation and entry into the G1b phase of the cell cycle
(35, 69). T-cell activation and proliferation require at
least two signals (9). Antigen presented in the context of
major histocompatibility complex class II provides the first signal by
triggering the T-cell receptor-CD3 complex. Delivery of a
costimulatory signal is accomplished through ligation of the CD28
coreceptor on the CD4+ cell surface (33).
Previously, we have shown that anti-CD3/CD28 stimulation results in
exponential, polyclonal T-cell growth (37, 38). Furthermore,
it renders the cells resistant to infection with R5 HIV isolates. This
HIV-resistant state results from the increase in expression of the
native CCR5 ligands (RANTES, MIP-1
, and MIP-1
) and the
concomitant downregulation of CCR5 expression (12, 52). In
this report, we sought to examine the HIV susceptibilities of
naïve and memory cells activated by either CD3/CD28
costimulation or by mitogenic lectins. We report that susceptibility to
R5 viruses is not governed solely by the level of CCR5 expression, but
rather by the balance between CCR5 expression and
-chemokine
expression. Together, these findings suggest a new mechanism concerning
the role of coreceptor expression in HIV transmission and pathogenesis.
 |
MATERIALS AND METHODS |
Antibodies.
The following purified and azide-free
antibodies were used for cell purification: anti-CD8 OKT8
(immunoglobulin G2a [IgG2a]), anti-CD11b OKM1 (IgG2b),
anti-CD14 63D3 (IgG1), anti-CD16 3G8 (IgG1), anti-CD20 1F5 (IgG2a), and
anti-HLA-DR 2.06 (IgG1). All of the hybridomas were obtained from the
American Type Culture Collection, Manassas, Va., except 3G8, which was
a kind gift from Stephen Shaw (National Institutes of Health, Bethesda,
Md.). CD45RA and CD45RO monoclonal antibodies were obtained from Caltag
(Burlingame, Calif.). Anti-CD3 (OKT3 [IgG2a]) (36)
and anti-CD28 (9.3 [IgG2a]) (30) were used for cell
stimulations.
-Chemokine-neutralizing antibodies (NAbs) were
purchased from R&D Systems (Minneapolis, Minn.).
Cell separation and stimulation.
Peripheral blood
lymphocytes were isolated by Percoll (Pharmacia Biotech, Uppsala,
Sweden) gradient centrifugation of leukopacks obtained by apheresis of
healthy donors. CD28+ CD4+ T cells were
purified by negative selection using magnetic beads (Dynal, Lake
Success, N.Y.) as described previously (34). Purified CD28+ CD4+ T cells, >98% CD3+,
>98% CD28+, and <3% CD8+ as judged by flow
cytometry, were separated into CD4+ CD45RO+ and
CD4+ CD45RA+ subsets by negative selection as
previously described (39). These preparations were routinely
>95% pure. Recent reports indicate that naïve cells are
further enriched by selecting for CD45RA+
CD62L+ cells (47). However, the donor cells used
in this study were routinely <3% CD45RA+
CD62L
, obviating the need for further purification. Cells
were cultured at 106/ml in complete medium RPMI 1640 (Bio
Whittaker, Walkersville, Md.) supplemented with 10% fetal bovine serum
(Hyclone, Logan, Utah)-2 mM L-glutamine (Bio
Whittaker)-20 mM HEPES (Bio Whittaker). Cells were stimulated by OKT3
and 9.3, which were covalently attached to magnetic beads
(tosyl-activated M-450; Dynal) at ~150 fg per bead (38)
and added to cells in a 1:1 ratio. Alternatively, cells were stimulated
with 5 µg of phytohemagglutinin (PHA) (Sigma Chemical Co., St. Louis,
Mo.) and 100 U of interleukin 2 (IL-2) (Boehringer Mannheim,
Indianapolis, Ind.) per ml. Cell volume was monitored on a Coulter
Counter model ZM (Coulter, Hialeah, Fla.). Cells were fed at 2- to
3-day intervals and maintained at a concentration of 106 to
2 × 106 cells/ml.
Flow cytofluorometric analysis.
Samples were stained with
anti-CD45RA-fluorescein isothiocyanate, anti-CD45RO-phycoerythrin
(PE) (Becton Dickinson, San Jose, Calif.), anti-CXCR4-PE, and
anti-CCR5-PE (Pharmingen, San Diego, Calif.) for 30 min at 4°C.
After being washed in phosphate-buffered saline-0.01% sodium
azide-0.05% bovine serum albumin (wash buffer), stained cells were
fixed at 4°C with 0.1% paraformaldehyde. Anti-CCR5- and
anti-CXCR4-stained cells were analyzed fresh without fixation. Samples
were analyzed by flow cytometry on a Coulter Epics Elite after gating
on live lymphocytes based on a standard light scatter histogram
(integral forward scatter versus log 90°).
Acute infection and PCR/liquid hybridization procedures.
Six
days poststimulation, cells were infected with either
HIV-1US-1 (43) or HIV-1NL4-3
(1) as previously described (12, 52).
Antibody-coated beads were removed immediately prior to the start of
the infection. For each infection, 5 × 106 cells were
resuspended in 400 µl of 50% conditioned medium containing 104 to 3 × 104 50% tissue culture
infective doses of HIV-1. The cells were incubated at 37°C for 2 h, washed three times in complete medium to remove excess virus, and
resuspended in 50% conditioned medium at 106/ml. Where
indicated, NAbs to the
-chemokines were preincubated with
conditioned medium for 2 h before the start of the infection. The
anti-RANTES NAb was used at 100 µg/ml, while anti-MIP-1
and anti-MIP-1
NAbs were used at a final concentration of 50 µg/ml. Goat IgG (Sigma) was used as a control antibody at a final
concentration of 200 µg/ml. Antibody concentrations were maintained
for the duration of the experiment. At designated time points,
106 cells were pelleted by centrifugation and frozen at
70°C. The cell pellets were lysed and amplified by PCR using HIV
gag-specific primers, and the amplified sequences were
detected by hybridization to a radiolabelled internal probe (64,
65). The hybridized products were resolved by electrophoresis on
10% polyacrylamide gels, exposed to a phosphorimager screen for 1 h, and developed on a PhosphorImager 445 SI (Molecular Dynamics,
Sunnyvale, Calif.). To ensure that the reactions were performed within
the linear range of the assay, log increments of HIV gag
plasmid standards were amplified at the same time (data not shown).
Human
-globin sequences were PCR amplified to demonstrate that
equivalent levels of input DNA were present in each PCR reaction
mixture (64, 65). Figures were generated with ImageQuant
software (Molecular Dynamics).
Chemokine measurements.
Levels of MIP-1
, MIP-1
, and
RANTES in cell supernatants were measured with enzyme-linked
immunosorbent assay kits from R&D Systems according to the
manufacturer's instructions.
Chemokine receptor RT-PCR assay.
Total RNA was isolated from
cells with RNA STAT-60 (Tel-Test, Friendswood, Tex.), and cDNA was
synthesized with the StrataScript reverse transcriptase PCR (RT-PCR)
kit (Stratagene, La Jolla, Calif.). cDNA products were diluted in
H2O to predetermined optimal concentrations (1:3 for CCR5,
1:300 for CXCR4) and amplified by using the following program: 95°C
for 30 s, 55°C for 30 s, and 72°C for 90 s (25 cycles). For CCR5-specific amplifications, the following primers
were used: CCR5-42 (5'-GGG TGG AAC AAG ATG GAT TAT CAA GTG TCA-3')
and CCR5-640 (5'-ATG TCT GGA AAT TCT TCC AGA ATT GAT
ACT-3'). For CXCR4-specific amplifications, the following primers
were used: CXCR4-489 (5'-CCA CCA ACA GTC AGA GGC CAA GGA AGC
TGT-3') and CXCR4-1122 (5'-TCT GTG TTA GCT GGA GTG AAA ACT TGA AGA-3'). A portion of the PCR reaction mixture was hybridized as described previously (64) with end-labeled
oligonucleotide probes specific for CCR5 (CCR5-81 [5'-GGG CTC CGA
TGT ATA ATA ATT GAT GTC ATA-3']) or CXCR4 (CXCR4-840
[5'-CCA GGA GGA TGA AGG AGT CGA TGC TGA TCC-3']). The hybridized
products were separated on 6% polyacrylamide gels, exposed to
phosphorimager screens overnight, and developed on a PhosphorImager 445 SI (Molecular Dynamics). Figures were generated with ImageQuant
software (Molecular Dynamics). To compare levels of 18S and 28S rRNA
for each RNA sample, 1 µg was electrophoresed on a 1.5% denaturing
agarose gel (56).
 |
RESULTS |
Isolation and differentiation of CD3/CD28-stimulated naïve
and memory CD4+ cells.
CD4+ cells from
healthy donors were separated into naïve and memory populations
based on CD45 isoform expression. The cells were negatively selected to
avoid any aberrant activation caused by the selection process and were
routinely >95% pure (Fig. 1). The cells
were judged to be resting based on a small mean cell volume and the
absence of HLA-DR or CD25 expression (data not shown). Following
stimulation with anti-CD3/anti-CD28-coated magnetic beads, both
naïve (CD45RA+ CD45RO
) and memory
(CD45RO+ CD45RA
) populations proliferated
equivalently for the first 14 days (data not shown), although over
longer time periods, naïve cells outgrow their memory siblings
(66). Both subsets at least tripled their cell volumes
following stimulation, but the memory cells consistently remained
slightly larger than the naïve cells (data not shown). Upon
activation, naïve cells convert from a CD45RA+
CD45RO
phenotype to a CD45RA
CD45RO+ phenotype (17, 59). Two-color
fluorescence-activated cell sorter analysis revealed that 6 days
poststimulation, 95% of the CD45RA+ CD45RO
cells had become CD45RA
CD45RO+ (Fig.
1). However, as indicated below, these cells remained functionally distinct from the original CD45RA
CD45RO+
population.

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FIG. 1.
Isolation and differentiation of naïve and
memory CD4+ cells after CD3/CD28 costimulation.
CD4+ T cells were isolated and fractionated by negative
selection into CD45RO+ and CD45RA+ subsets.
Two-color cytofluorometric analysis of naïve and memory cells
was performed after separation (day 0) and after stimulation with
CD3/CD28 for 6 days. Data shown are representative of at least three
experiments.
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|
CD3/CD28-stimulated naïve cells are susceptible to R5
HIV-1 infection.
The susceptibilities of naïve and
memory CD4+ T lymphocytes to HIV-1 infection were examined
by infecting cells 6 days poststimulation with either R5 or X4 HIV-1
isolates. PHA/IL-2-stimulated naïve and memory cells were
robustly infected with X4 HIV-1 (Fig.
2A). Similarly, both CD4 cell subsets
were infected with R5 virus after PHA/IL-2 stimulation (Fig. 2B). HIV
gag DNA was detected 72 h postinfection, and a
spreading infection was revealed by an analysis of later time points in
both subsets of cells. Similarly, when PHA/IL-2-stimulated
naïve and memory CD4 cells were combined immediately prior to
infection, the pooled population was also sensitive to both R5- and
X4-dependent viruses.

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FIG. 2.
Distinct R5 and X4 replication kinetics in CD4 subsets.
Purified CD4+ (CD4), CD45RO+ (RO), and
CD45RA+ (RA) cells were stimulated for 6 days with either
PHA/IL-2 or CD3/CD28 and infected with either HIVNL4-3
(CXCR4-dependent) (A) or HIVUS-1 (CCR5-dependent) (B)
strains of HIV-1 as described in Materials and Methods. Samples were
taken at 0, 2, 72, and 144 h postinfection, and cell pellets were
analyzed for gag DNA by a quantitative PCR assay using
liquid hybridization. Data shown are representative of four
experiments.
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CD3/CD28-stimulated naïve and memory cell populations, as well
as pooled naïve and memory cells, were susceptible to infection with CXCR-4-dependent viruses (Fig. 2A). However naïve
CD3/CD28-stimulated cells were much less permissive to R4-dependent
infection than memory cells, in accordance with previous reports
(15, 31, 58, 60, 67). In marked contrast,
CD3/CD28-stimulated naïve and memory cell populations infected
with R5 viruses experienced two entirely different outcomes (Fig. 2B).
Surprisingly, naïve cells supported a weak R5-dependent
virus infection, while memory cells remained completely resistant to
infection with R5-dependent isolates. As previously reported with
unfractionated CD3/CD28-stimulated CD4+ cells
(12, 52), pooling of CD3/CD28-stimulated naïve and memory cells before infection with R5-dependent HIV isolates generated a completely resistant cell population. Thus, when
CD3/ CD28-stimulated naïve CD4+ cells are
separated from memory cells, they become susceptible to low-level R5
virus infection. Furthermore, this suggested that the
previously reported absence of infection in the unfractionated CD4
cells was most likely the result of the protective effect conferred on
naïve cells by memory cells.
A quantitative analysis of HIV-1 gag DNA accumulation for
the experiment discussed above is shown in Fig.
3. After CD3/CD28 stimulation only the
naïve CD4+ cell subset was susceptible to infection
with R5 isolates of HIV. The kinetics of infection for the RA
subset were delayed compared to those for PHA/IL-2 stimulated cells,
while little or no HIV was detected in the memory subset and the
recombined CD4 cell population. The memory and recombined
CD4+ cells supported a high-level infection with X4
virus after CD3/CD28 costimulation; however, the naïve
cells produced 10- to 50-fold-less gag DNA than the other
populations. In contrast, both the X4 (NL4-3)- and R5 (US-1)-dependent
viruses produced high-level infections of CD4 cell subsets after
PHA stimulation. Together, the results shown in Fig. 2 and 3 further
indicate that infection and replication of HIV-1 in primary CD4 cell
subsets are critically dependent on the strain of HIV used as well as
the form of T-cell activation.

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FIG. 3.
Quantitative analysis of DNA HIV-1 gag
content from the experiment shown in Fig. 2. The numbers of copies per
100,000 cells were determined by using plasmid standards that contained
gag sequences, and these values were normalized to
-globin values. The top panel shows the infection data from Fig. 2B,
and the bottom panel shows the infection data from Fig. 2A.
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|
Coreceptor expression levels do not correlate with susceptibilities
of costimulated CD4+ cell subsets to R5 HIV-1
isolates.
The differential susceptibilities of CD3/CD28-stimulated
naïve CD4+ cells to R5 and X4 HIV-1 isolates
suggested that in these cells, CXCR4 expression was decreased and
CCR5 expression was enhanced compared to the memory cell
population. Previously, we showed that CD3/CD28 costimulation inhibited
CCR5 mRNA accumulation but not CXCR4 mRNA expression in unfractionated
CD4+ cell populations (12). To examine in
more detail the steady-state CXCR4 and CCR5 transcript levels in
naïve and memory cell populations, a semiquantitative chemokine
receptor RT-PCR assay was developed as described in Materials and
Methods. Memory and naïve cells were activated with PHA/IL-2 or
CD3/CD28 for 6 days, the sixth day having been chosen to coincide with
the day of infection for the above experiments, and coreceptor
expression was examined by RT-PCR. Twofold dilutions of the RT product
were tested to ensure that the PCR was in the linear range. CXCR4 mRNA
was readily detectable in both PHA/IL-2- and CD3/CD28-stimulated cells
(Fig. 4). Marked differences in CXCR4
mRNA were not observed in the resting and activated CD4 cell subsets,
consistent with the previously reported constitutive expression of this
coreceptor (4, 8, 28). However, after activation, transcript
levels were lower in the CD3/CD28-stimulated naïve population
(by approximately fourfold) than in CD3/CD28-stimulated memory
cells, consistent with the infection and viral replication data (Fig. 2
and 3).

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FIG. 4.
Chemokine receptor expression in CD4 cells, and in
CD45RA+ (RA) and CD45RO+ (RO) subpopulations.
Total RNA was isolated from purified CD4+,
CD45RO+, and CD45RA+ cells that were either
resting (day 0), or were stimulated with PHA/IL-2 or with CD3/CD28
immunobeads for 6 days. (A) cDNA was synthesized and diluted to the
optimal level (1:3 for CCR5 and 1:300 for CXCR4), and either 2.5, 5, or
10 µl of the RT product was used in the subsequent PCR and liquid
hybridization reaction. NoRT indicates a control lane where 10 µl of
an RT product was run with reverse transcriptase omitted. Data shown
are representative of three experiments. (B) One microgram of total RNA
for each sample was electrophoresed on a 1.5% denaturing agarose
gel.
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In contrast to those of CXCR4, CCR5 mRNA levels varied widely between
CD4 cell subsets and as a consequence of the method of cellular
activation (Fig. 4). Low levels of CCR5 mRNA were detected in resting
CD4+ cells, and these transcripts were largely confined to
the memory cell population. PHA/IL-2 stimulation resulted in a large
increase in steady-state CCR5 transcript levels in both memory and
naïve cell populations, as predicted by the infection data.
Following stimulation with CD3/CD28 for 6 days, the levels of CCR5 mRNA decreased to below that of resting cells. Trace levels of CCR5 mRNA
were detected in memory cell populations, but, surprisingly, CCR5 mRNA
levels were below the limit of detection in naïve cells, despite their sensitivity to R5 viruses. Thus, CCR5 mRNA levels in
naïve and memory cells did not correlate with sensitivity to
infection.
The discrepancy between CCR5 mRNA levels and susceptibility to R5 HIV-1
isolates was further explored by examining CCR5 and CXCR4 surface
expression in naïve and memory cell populations (Table
1). CXCR4 expression was much more
prominent on resting cells, and preferential expression on
naïve cells was observed, consistent with previous reports
(8, 28). PHA/IL-2 stimulation resulted in an upregulation
of CXCR4 expression levels as judged by the mean fluorescent
intensities of all subsets (data not shown), although the fraction of
cells expressing CXCR4 changed only modestly. CD3/CD28
stimulation resulted in much less surface CXCR4 expression of all CD4+ cells, and this was most pronounced in
naïve cells. In the four donors examined after CD3/CD28
costimulation, 38% (standard error of the mean [SEM] = 2%) of the
memory cells were expressing CXCR4 whereas only 21% (SEM = 4%)
of the naïve cells were expressing CXCR4. This suggests a
possible explanation for why naïve cells are less
susceptible to infection by X4 viruses.
Resting CD4+ cells expressed low surface levels of CCR5,
and this expression was confined to the memory subset, in
agreement with recent observations by Bleul et al. (8).
As predicted by the infection and RNA data, CCR5 expression
increased in both memory and naïve-cell subsets after PHA/IL-2
stimulation. In contrast, CD3/CD28 costimulation resulted in the
reduction of CCR5 expression to background levels in both memory
and naïve-CD4 cell subsets, consistent with the mRNA
data. In concurrence with the mRNA expression data,
CD3/CD28-stimulated naïve cells, though susceptible to R5
viruses, were negative for CCR5 expression. Thus, the levels of CCR5
coreceptor expression cannot account for the differential
susceptibilities of CD3/CD28-stimulated naïve and memory cells
to R5 HIV-1 isolates.
CD3/CD28 costimulation does not trigger equivalent
-chemokine production in memory and naïve
CD4+ cells.
The
-chemokines MIP-1
,
MIP-1
, and RANTES, the native ligands for CCR5 (57),
block infection of susceptible cells by R5 HIV-1 isolates
(19). In human lymphocytes, CD28 stimulation upregulates
RANTES promoter activity (46), and in mouse cells, CD28
stimulation is essential for MIP-1
but not RANTES secretion (32). Additionally, we have demonstrated that unfractionated CD4+ cells generally produce 50- to 100-fold more of these
CCR5 ligands in response to CD3/CD28 costimulation than after PHA/IL-2
stimulation (52). The discordance between CCR5 expression
and HIV susceptibility in CD3/CD28-stimulated naïve and memory
cells prompted us to examine
-chemokine production in these cell
subsets 6 days post-CD3/CD28 stimulation (Table
2). Although the absolute levels of
MIP-1
, MIP-1
, and RANTES varied between donors, in every
instance, the accumulation of
-chemokines in the supernatants
after costimulation was substantially higher in
memory cells than in naïve cells. As yet we do not know whether
the differences in the magnitude of secretion between samples reflects
donor-to-donor variation or differential contamination of
naïve-cell populations with memory cells. Previously, it was
noted that naïve CD4+ and CD8+ cells
stimulated by anti-CD3 and phorbol ester plus ionomycin produce
significantly less
-chemokines than similarly stimulated memory
cells (20). Thus, in subsets of CD3/CD28-stimulated cells, resistance to infection by R5 HIV-1 isolates correlates not with CCR5
expression but rather with CCR5 ligand (
-chemokine) production.
Neutralization of
-chemokine function renders
CD3/CD28-stimulated memory cells susceptible to R5 virus
infection.
The analysis of CCR5 surface expression and
-chemokine production in CD3/CD28-stimulated cells suggested that
memory cells, despite their higher levels of CCR5 expression, remain
resistant to R5 viruses because their high level of
-chemokine
production restricts the ability of infecting viruses to use CCR5 as a
coreceptor. Therefore, we hypothesized that neutralization of
-chemokine binding to CCR5 should render memory cells readily
susceptible to infection by R5 viruses. This hypothesis was tested by
incubating CD3/CD28-stimulated cells with neutralizing antibodies to
RANTES, MIP-1
, and MIP-1
prior to infection with R5 HIV-1
isolates (Fig. 5). Preincubation with
-chemokine-neutralizing antibodies resulted in a modest increase in
HIV susceptibility in CD3/CD28-stimulated naïve cells
compared to the same cells treated with control IgG (data not shown).
In contrast, when previously resistant CD3/CD28-stimulated memory
cells were pretreated with
-chemokine-neutralizing antibodies, a vigorous infection ensued, as indicated by HIV-1 gag DNA
accumulation. The neutralization of
-chemokines to
CD3/CD28-costimulated memory cells resulted in a nearly 300-fold
enhancement of p24 production in culture supernatants (data not shown).
This observation demonstrates that the resistance of
CD3/CD28-stimulated memory cells to R5 viruses is due to their ability,
through
-chemokine production, to prevent coreceptor utilization by
R5 viruses. Furthermore, this observation suggests that the resistance
of unfractionated CD3/CD28-stimulated CD4+ cells to R5 HIV
isolates arises from memory cell-driven
-chemokine production
sufficient to block coreceptors on both memory and naïve cells.

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FIG. 5.
Costimulated memory cells treated with neutralizing
antibodies to -chemokines are rendered susceptible to R5 HIV-1
infection. Purified CD45RA+ (RA) and CD45RO+
(RO) cells were stimulated with CD3/CD28 for 6 days and infected with
HIVUS-1 (R5 virus strain) in the presence or absence of
NAbs to the -chemokines. Samples were taken at 0, 2, 72, and
144 h postinfection, and cell pellets were analyzed for HIV-1
gag DNA by a quantitative PCR liquid hybridization assay.
Data shown are representative of two experiments.
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 |
DISCUSSION |
The identification of
- and
-chemokine receptors as
coreceptors for X4 (27) and R5 HIV-1 isolates (3, 13,
23-25), respectively, has spurred rapid advances in the
understanding of HIV-1 infection and pathogenesis. In this report, we
demonstrate that R5 viruses, the isolates critical for transmission
(22, 45, 68), infect CD3/CD28-stimulated naïve
CD4+ cells. In contrast, R5 isolates were
unable to infect either CD3/CD28-stimulated memory cells or
unfractionated CD4+ T cells. Given that naïve
cells express lower levels of CCR5 than memory cells, this
susceptibility was surprising. However, after costimulation
memory cells were found to secrete significantly higher
levels of the native CCR5 ligands RANTES, MIP-1
, and MIP-1
than
naïve cells. Neutralization of these
-chemokines rendered memory cells highly susceptible to infection with R5 isolates. These
observations suggest, therefore, that susceptibility to R5
isolates at the cellular level is governed not by the absolute level of
CCR5 expression but rather by the level of unoccupied CCR5. This
assertion is supported by our previous observation that CD3/CD28
costimulation renders unfractionated CD4+ cells resistant
to R5 HIV-1 isolates through upregulation of
-chemokine expression
(52) and inhibition of CCR5 upregulation (12).
In contrast to the distinct susceptibilities of costimulated CD4 cell
subsets to infection with R5 strains, we found that both subsets were
susceptible to infection with CXCR4-dependent strains. However, viral
replication was at least 10-fold less efficient in costimulated
naïve cells than in memory cells. These results confirm
those of other studies indicating that the ability of CXCR4-dependent
strains to replicate in naïve cells is impaired relative to
their ability to replicate in memory cells (55, 60, 67).
Indeed, it is likely that our studies have underestimated the magnitude
of this effect as our naïve-cell populations were contaminated
with approximately 3% memory cells since we did not exclude
CD62L
cells from our populations (55). Spina
and coworkers have found that viral replication in naïve cells
is inefficient and particularly dependent on nef function
(60).
The use of CD3/CD28 costimulation reveals distinct facets of HIV-1
coreceptor regulation of CD4 cells. R5 isolates were unable to infect
either CD3/CD28-stimulated memory cells or unfractionated CD4+ T cells. This form of natural immunity appears to act
by both a paracrine mechanism mediated by enhanced
-chemokine
secretion and an autocrine mechanism involving costimulation-mediated
downregulation of CCR5 expression. In fact, CD3/CD28 costimulation
exerts a generally repressive effect on all
-chemokine receptor
transcripts examined to date: CCR1, CCR2b (40), CCR3, and
Bonzo/Strl33 (52a). The susceptibility of
CD3/CD28-stimulated naïve cells to R5 virus despite the lack of
detectable CCR5 expression is surprising considering the essential role
that CCR5 plays in virus entry (3). However, Platt and
colleagues recently reported that in the presence of optimal CD4 levels
only minute levels of CCR5 are needed for viral entry, suggesting that
undetectable levels of CCR5 on the surfaces of naïve cells may
be sufficient for entry (48). While it is possible that
R5 isolates infect naïve cells through an alternate coreceptor,
the global
-chemokine receptor downregulation caused by CD3/CD28
costimulation makes this an unlikely possibility as the addition of
exogenous recombinant RANTES and MIP-1
to naïve cells
blocked infection (data not shown).
In contrast to that of CCR5, CXCR4 expression was less variable between
donors and after cellular activation. However, we did note discordance
between CD28-mediated upregulation of CXCR4 mRNA and the decrease
in surface CXCR4 levels for both memory and naïve cells (Table
1). Forster and coworkers have provided a potential explanation for
these observations by demonstrating that there is a large intracellular
store of CXCR4 (28). They found that cell signaling by
phorbol ester treatment could lead to rapid downregulation of CXCR4
surface expression by internalization. Even though CD3/CD28 stimulation
appears to lead to a downregulation of CXCR4 surface expression, our
previous studies of unfractionated CD4 cells have shown that
substantial amounts of functional CXCR4 remain on the cells, as
indicated by the ability of the cells to mediate fusion with cells
expressing X4 envelopes (12).
We found that CD3/CD28-stimulated naïve cells rapidly acquire
the "memory" marker of CD45RO expression. The kinetics of the CD45RA-to-CD45RO transition were similar to those previously reported for cord blood naïve cells (47). However, the
naïve cells still retain their naïve characteristics in
their impaired ability to sustain HIV-1 replication, and in our
previous studies, we found that they remain unable to secrete gamma
interferon after CD3/CD28 stimulation (39). Thus, the
conversion of naïve cells to memory cells is a complex,
multistep process, and the conversion from CD45RA to CD45RO probably
represents one of the earliest changes.
The implications from our present studies may suggest modifications to
current models of HIV transmission and pathogenesis. While there is
general agreement that dendritic cells and/or macrophages (dendriphages) are the initial targets of incoming virus
(10, 11), the mechanism by which HIV-1 is subsequently
introduced into the CD4+ T-cell population is unclear.
Based on the demonstration of Bleul et al. (8) showing the
predominant memory distribution of CCR5 expression, Unutmaz and Littman
proposed that memory T cells are the first targets of infected
dendriphages (63). In this model, dendritic cells and
macrophages are the first cells infected by the transmitting
virus. Although dendriphages can transmit X4 viruses to
circulating T cells, this occurs at a very low frequency, and R5
viruses are predominantly passed to the new host (10, 11,
49). Based on the higher CCR5 surface levels of memory cells and
on the propensity of resting memory cells to migrate to sites of
inflammation (41), it was proposed that R5 would become
established first in the memory CD4+ cell population.
Additional evidence for this model came from in vitro studies showing
that memory cells serve as better targets for HIV-1, although only X4
viruses were used (31, 55, 58, 60, 67). Here, we show that
the generalization of data generated with X4 viruses to all strains of
HIV-1 was oversimplified and that R5 and X4 viruses have different
tropisms in regard to naïve and memory cells. We have also
found that the level of total CCR5 expression is not correlated with
the susceptibility of costimulated lymphocytes to infection with
R5 isolates of HIV-1. Thus, several aspects of the Unutmaz and
Littman model are not supported by our results derived from
costimulated cells which have been activated in a presumably more
physiologic manner than that associated with stimulation by PHA/IL-2.
It is important to note that our results are not likely to pertain to
resting lymphocytes, as CCR5 is not expressed in detectable amounts at
the RNA level (Fig. 4) or on the surfaces (8) of resting
naïve cells and
-chemokine secretion is not detected in
resting memory cells (data not shown).
Our assertion that the level of coreceptor unbound by native ligand
governs HIV susceptibility leads us to propose an altered model of
viral transmission. In this model, shown in Fig.
6, dendriphages are the initial targets
of HIV infection and naïve T cells are the targets of initial
rounds of viral replication. Furthermore, we propose that successful
early transmission events occur not in the periphery but in the
regional secondary lymph organs. Dendritic cells have been reported to
migrate to lymph nodes (16) and preferentially interact with
naïve T cells via DC-CK1, a recently described chemokine that
attracts naïve cells to dendritic cells (2). In this
setting of antigen presentation and cell activation without a
concomitant increase in
-chemokine production, activated naïve cells serve as ideal targets for HIV-1 infection. Memory cells, by virtue of their wider tissue distribution, are not
concentrated in the lymph nodes and hence may be underrepresented
during the initial transmission events. More importantly, despite their
higher level of CCR5 expression, memory cells are resistant to
infection by R5 viruses due to their high-level
-chemokine
production. Furthermore, due to this high level of
-chemokine
production, memory cells may be able to offer protection from an R5
virus to nearby naïve cells. In a physiologic situation it is
difficult to estimate the concentration of
-chemokines available to
bind CCR5; however, CD3/CD28 stimulation results in optimal chemokine secretion, which is probably not duplicated by natural ligand interactions (B7 family). Nonetheless, the relative differences of
chemokine production between naïve and memory cells are
maintained upon B7-1 costimulation (52a). As the infection
matures and X4 viruses emerge, memory cells become susceptible to
infection while naïve cells remain susceptible to infection.

View larger version (51K):
[in this window]
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|
FIG. 6.
Model of HIV-1 transmission. In this model, R5 viruses
preferentially infect dendritic cells (DC) in the periphery and the DC
transport the virus to the lymph nodes, where there is a high
concentration of activated naïve CD4 T cells and low levels of
-chemokines. Naïve cells are preferentially depleted but
occasionally can be protected from R5 virus by nearby activated memory
cells.
|
|
One implication of this model is that naïve cells must die more
rapidly after infection than memory cells, in order to account for the
observation first made by Schnittman and coworkers that circulating
memory cells preferentially harbor HIV-1 (58). Another prediction of the model is that while naïve cells could serve as targets for CCR5-dependent virus, memory cells would be expected to
serve as the primary producers of the viral load because naïve cells presumably die quicker and cannot produce as much progeny virus
as memory cells (31, 55, 58, 60, 67). Finally, this model,
if correct, could serve to explain the previously reported rapid
depletion of naïve cells in adults with HIV-1 infection
(14, 44, 54, 70). Thus, the distinction between total CCR5
expression and levels of unoccupied CCR5 revealed by examination of
costimulated naïve and memory CD4 lymphocytes has important
implications for viral transmission and pathogenesis.
 |
ACKNOWLEDGMENTS |
We acknowledge F. C. Music, S. E. Allen, and Julio Cotte at the
National Naval Medical Center Blood Bank for assistance with the
apheresis. Additionally, we thank Dave Ritchey, Doug Smoot, and Steve
Perfetto for excellent technical assistance and Patrick Blair for
critical reading of the manuscript. We also appreciate the
encouragement and support received from D. Birx.
This study was supported by Army contract DAMD17-93-V-3004 and by the
Henry M. Jackson Foundation.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Mail Stop 061, Naval Medical Research Institute, 8901 Wisconsin Ave., Bethesda, MD 20889-5607. Phone: (301) 295-1847. Fax: (301) 295-0376. E-mail: junec{at}nmripo.nmri.nnmc.navy.mil.
 |
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Journal of Virology, October 1998, p. 8273-8280, Vol. 72, No. 10
0022-538X/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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