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Journal of Virology, March 2000, p. 2502-2509, Vol. 74, No. 6
0022-538X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Immunization with a Modified Vaccinia Virus Expressing Simian
Immunodeficiency Virus (SIV) Gag-Pol Primes for an Anamnestic
Gag-Specific Cytotoxic T-Lymphocyte Response and Is Associated with
Reduction of Viremia after SIV Challenge
Aruna
Seth,1
Ilnour
Ourmanov,2
Jorn E.
Schmitz,1
Marcelo J.
Kuroda,1
Michelle A.
Lifton,1
Christine E.
Nickerson,1
Linda
Wyatt,3
Miles
Carroll,3
Bernard
Moss,3
David
Venzon,4
Norman L.
Letvin,1 and
Vanessa
M.
Hirsch2,*
Division of Viral Pathogenesis, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, Massachusetts
021151; Laboratory of Molecular
Microbiology, National Institute of Allergy and Infectious Diseases,
National Institutes of Health, Rockville, Maryland
208522; and Laboratory of Viral
Diseases, National Institute of Allergy and Infectious
Diseases,3 and Division of Clinical
Sciences, Biostatistics and Data Management Section, National Cancer
Institute,4 National Institutes of Health,
Bethesda, Maryland 20892
Received 16 September 1999/Accepted 8 December 1999
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ABSTRACT |
The immunogenicity and protective efficacy of a modified vaccinia
virus Ankara (MVA) recombinant expressing the simian immunodeficiency virus (SIV) Gag-Pol proteins (MVA-gag-pol) was explored in
rhesus monkeys expressing the major histocompatibility complex (MHC) class I allele, MamuA*01. Macaques received four sequential
intramuscular immunizations with the MVA-gag-pol
recombinant virus or nonrecombinant MVA as a control. Gag-specific
cytotoxic T-lymphocyte (CTL) responses were detected in all
MVA-gag-pol-immunized macaques by both functional assays
and flow cytometric analyses of CD8+ T cells that bound a
specific MHC complex class I-peptide tetramer, with levels peaking
after the second immunization. Following challenge with uncloned
SIVsmE660, all macaques became infected; however, viral load set points
were lower in MVA-gag-pol-immunized macaques than in the
MVA-immunized control macaques. MVA-gag-pol-immunized macaques exhibited a rapid and substantial anamnestic CTL response specific for the p11C, C-M Gag epitope. The level at which CTL stabilized after resolution of primary viremia correlated inversely with plasma viral load set point (P = 0.03). Most
importantly, the magnitude of reduction in viremia in the vaccinees was
predicted by the magnitude of the vaccine-elicited CTL response prior
to SIV challenge.
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INTRODUCTION |
Evidence for a critical role of
cytotoxic T lymphocytes (CTLs) in the containment of human
immunodeficiency virus (HIV) infection (16, 23, 36, 39) has
led to a consensus among those attempting to develop an AIDS vaccine
that such a vaccine should generate CTL in addition to broadly
neutralizing antibodies (26). An additional hurdle for an
AIDS vaccine is the long-term maintenance of levels of CTL and antibody
that will be necessary for protection (26). Both effector
CTL and neutralizing antibodies induced by vaccination tend to be
transient. Therefore, it may not be feasible to maintain immune
responses essential for preventing infection. The importance of the
magnitude of the vaccine-elicited memory and postinfection anamnestic
immune responses thus become a critical issue in developing an AIDS vaccine.
At present, viable vaccine strategies that might effectively stimulate
CTL include viral vectors, peptides, and DNA immunization (26). Viral vectors under investigation include adenovirus
(10, 48), alphaviruses such as Semliki Forest virus (8,
35) and Venezuelan equine encephalitis virus (11),
poliovirus replicons (23), and various poxviruses (12,
21, 29, 30, 34, 43). Among these approaches, use of the
poxviruses is a particularly promising vaccine strategy to express
viral proteins. Studies with conventional New York Board of Health
vaccinia virus demonstrated that priming with a vaccinia virus
recombinant expressing simian immunodeficiency virus (SIV) envelope
and/or core proteins, followed by boosting the antibody response with
recombinant envelope protein, provided protection against a homologous
SIV challenge with a biologically cloned strain of limited
pathogenicity (SIVmne/E11S) (20). However this approach
provided only partial protection against a more pathogenic and
heterogeneous SIV challenge (SIVmne) (44) and blunting of
viremia in macaques challenged with the highly pathogenic SIVmac251
(2). Since there are side effects associated with using
conventional vaccinia viruses that become potentially life threatening
when used in immunocompromised individuals (34), the use of
attenuated poxviruses is an attractive alternative (20, 34,
43).
A number of attenuated poxvirus strains have been developed as vaccine
vectors: the avipoxviruses (43), canarypox virus, fowlpox
virus, and the attenuated vaccinia virus derivatives, NYVAC
(43), and modified vaccinia virus Ankara (MVA) (13, 32,
34, 43). The attenuated poxviruses appear to be safe in
immunosuppressed animals (30), although their bases for
attenuation differ. Thus, the avipoxviruses are genetically quite
distinct from vaccinia viruses and do not complete an entire
replication cycle in mammalian cells. NYVAC is a genetically engineered
derivative of the Copenhagen strain with deletion of host range genes
(43). MVA is a spontaneously derived attenuated variant of
the Ankara strain that has multiple deletions in host range genes and
genes involved in suppressing vaccinia virus-elicited immune responses (29, 30, 34). Perhaps due to these latter deletions, MVA appears to be as immunogenic as wild-type vaccinia virus strains, despite limited replication in mammalian cells (5, 9, 13, 32). In addition, MVA has an excellent safety record in humans, having been used without incident as a smallpox vaccine in
approximately 100,000 individuals (30). Each of these
attenuated poxvirus vectors has been evaluated in primate models and
has shown some degree of efficacy (1, 4, 7, 14, 19, 22, 24, 37,
49, 50, 54).
In previous studies, we explored the use of MVA as a viral vector to
express SIV antigens and have evaluated its efficacy in the
SIVsm-macaque model (19). The SIV-macaque model is a highly
relevant system in which to evaluate the efficacy of partially protective vaccines since it provides valid disease endpoints. In
addition, the level at which plasma viremia stabilizes after primary
infection (or viral set point) is a highly significant prognostic
surrogate for the rate of disease progression in both HIV infection
(31) and SIV infection (19, 52, 55). While the
SIV-HIV (SHIV) chimeras provide a system to evaluate the role of
envelope-specific immune response in vaccine protection, there is no
particular advantage to the use of SHIV in evaluating Gag-Pol-specific immunity. Indeed, the pathogenesis of SIV infection of macaques more
closely models the pathogenesis of human AIDS (18) than the
rapid CD4+ T-cell depletion observed with the pathogenic
SHIVs (21, 28, 51).
Prior immunization with MVA expressing the SIVsmH4 Gag-Pol and Env
followed by boosting with whole inactivated SIV particles, administered
without adjuvant, resulted in significant modulation of viremia and
disease progression in macaques subsequently challenged with pathogenic
SIVsmE660 (19). Two of these MVA-SIV vaccinees have
maintained low viremia and normal CD4+ T-lymphocyte numbers
throughout the 4 years since challenge, analogous to HIV type
1-infected clinical long-term nonprogressor humans (12, 42).
The recent development of technology for measuring effector CTL by flow
cytometric analyses of CD8+ T lymphocytes that bind
specific peptide epitope-major histocompatibility complex (MHC) class I
tetrameric complexes (3) has revolutionized the ability to
quantitate CTL responses in SIV-infected macaques (24, 25).
This technology is particularly useful for evaluation of CTL responses
in recombinant vaccinia virus-immunized macaques since the background
cytolysis that is seen in functional CTL assays with the use of
vaccinia virus expression of viral proteins in target cells can be
avoided. In a previous study we used tetramer technology to evaluate
the ability of an MVA recombinant expressing SIV Gag-Pol to elicit CTL
(50). In the present study, we evaluated immunogenicity of
this recombinant through two subsequent boosts and evaluated the
efficacy following intravenous challenge with pathogenic, uncloned, SIVsmE660.
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MATERIALS AND METHODS |
Selection of Mamu-A*01+ rhesus macaques.
Rhesus
macaques expressing the Mamu-A*01 MHC class I molecule were selected by
Mamu-A*01-specific reverse transcriptase-mediated PCR of total RNA
isolated by RNeasy (Qiagen, Chatsworth, Calif.) purification from
5 × 106 peripheral blood mononuclear cells (PBMC) as
described previously (50). Verification was achieved by
direct sequencing of PCR products (QIAquick PCR purification kit;
Qiagen) by automated sequencing on the ABI 377 sequencer. The ability
of herpesvirus papio-transformed B-lymphoblastoid cell lines from these
macaques to act as targets in p11C-specific functional cytotoxicity
assays was used to confirm the expression of the Mamu-A*01 allele.
Monkeys were maintained in accordance with the guidelines of the Animal Care and Use Committee of the National Institutes of Health (NIH) and
Guide for the Care and Use of Laboratory Animals
(38).
Immunization and SIV infection.
Macaques were immunized with
108 PFU of either MVA (n = 2) or
MVA-gag-pol (n = 4) vaccinia virus at 0, 13, 35, and 52 weeks. The construction of the MVA-gag-pol
recombinant vaccinia virus has been described previously
(50). One of the control MVA macaques inadvertently received
the MVA-gag-pol virus at the third immunization and was
therefore eliminated from the study. Four additional Mamu-A*01 macaques
received a single immunization of the nonrecombinant MVA at the 52-week
time point.
The macaques were challenged intravenously with 50 50% macaque
infectious doses of the pathogenic SIVsmE660 isolate (18, 19) 4 weeks after the final immunization. Animals were
subsequently monitored for Mamu-A*01-p11C, C-M tetramer binding on
EDTA anticoagulated samples collected at the time of challenge and 3, 7, 10, 14, 17, 21, 28, 35, and 49 days after SIV challenge. Virus
isolation from PBMC was attempted at 14 and 28 days postchallenge to
evaluate whether these animals were infected with SIV. Lymph node
biopsies were collected at 7 and 14 days after SIV challenge, and in
situ hybridization for SIV-specific RNA was performed. Viral load was monitored on EDTA-anticoagulated blood collected at 0, 3, 7, 10, 14, 21, 28, and 35 days after SIV challenge by quantitative real-time reverse transcriptase-mediated PCR assay, using procedures and primers
described previously (53). The nominal threshold sensitivity of the assay was 500 eq/ml.
Functional cytotoxicity assays.
PBMC from Mamu-A*01+ rhesus
monkeys were cultured with p11C (EGCTPYDINQML) (10 µg/ml) at a
density of 5 × 106 cells/ml. On day 3 of culture, the
medium was supplemented with recombinant human interleukin-2 (20 U/ml;
provided by Hoffmann-La Roche), and the cultures were maintained a
further 4 days. PBMC were then centrifuged over Ficoll-Hypaque and
assessed as effector cells in a standard 51Cr release assay
using U-bottomed microtiter plates containing 104 target
cells with various concentrations of effector cells. All wells were
assayed in duplicate. Autologous B-lymphoblastoid cell lines were used
as targets and were incubated with 1 µg of p11C, C-M (CTPYDINQM) or
the control peptide p11B (ALSEGCTPYDIN) per ml during overnight
51Cr labeling. Plates were incubated in a humidified
incubator at 37°C for 4 h. Specific release was calculated as
[(experimental release
spontaneous release)/(maximum
release
spontaneous release)] × 100. Spontaneous release was
<20% of maximal release with detergent (2% Triton X-100; Sigma) in
all assays.
Staining and phenotypic analysis of p11C-specific
CD8+ T lymphocytes.
The monoclonal antibodies (MAbs)
used in this study were directly coupled to fluorescein isothiocyanate
(FITC), phycoerythrin (PE), phycoerythrin-Texas red (ECD), or
allophycocyanin (APC). The following MAbs were used: anti-CD8
(Leu2a)-FITC and anti-CD62L (Leu8)-PE (Becton Dickinson, San Jose,
Calif.), anti-CD8
(2ST8-5H7)-ECD, anti-CD11a (25.3.1)-PE,
anti-CD45RA (2H4)-PE (Beckman-Coulter, Inc.), and anti-CD95
(DX2)-PE (Caltag, Burlingame, Calif.). MAb FN18, which recognizes
rhesus CD3, a gift from D. M. Neville, Jr., NIH, Bethesda, Md.,
was directly coupled to APC. The three reagents Alexa 488-coupled
tetrameric Mamu-A*01/p11C, C-M complex, anti-CD8
-ECD, and
anti-rhesus CD3-APC were used either with anti-CD11a-PE,
anti-CD45RA-PE, anti-CD62L-PE, or anti-CD95-PE to perform four-color
flow cytometric analyses. Since nearly all of the tetrameric
Mamu-A*01-p11C, C-M complex-binding T cells express the CD8
molecules, all analyses were performed by gating on
CD8
+ CD3+ cells. The PE-coupled
tetrameric Mamu-A*01-p11C, C-M complex was used with anti-CD8
-FITC
in conjunction with anti-CD8
-ECD and anti-rhesus CD3-APC. The
tetramer staining of CD8
+ cells was performed on
gated CD3+ cells since the CD8
-specific MAb used in
this study binds occasionally to natural killer cells of rhesus
monkeys. Alexa 488 or PE-coupled tetrameric Mamu-A*01-p11C, C-M
complex (0.5 µg) was used in conjunction with the directly labeled
MAbs to stain either 100 µl of fresh whole blood or 5 × 105 lymphocytes isolated by density centrifugation over
Ficoll diatrizoate following in vitro culture. Samples were analyzed on
a Coulter EPICS Elite ESP as described previously (50). Data
presentation was performed using WinMDI software version 2.7 (Joseph
Trotter, La Jolla, Calif.) and Microsoft PowerPoint 97 software
(Microsoft, Redmond, Calif.).
Statistical analyses.
The Wilcoxon rank sum test was used
for comparison of plasma SIV RNA levels between groups. The Spearman
rank correlation test was used for associations between viral RNA
levels and the percentage of tetramer+ CD8+ T
cells, both before and after SIV challenge. StatXact version 4.0.1 (CYTEL Software Corp., Cambridge, Mass.) was used to calculate the
P values by exact methods that take into account the small numbers of observations.
 |
RESULTS |
This study evaluated the individual contribution of Gag-Pol
antigens and Gag-specific CTL to protection in the SIV-macaque model
using rhesus monkeys that expressed the Mamu-A*01 MHC class I molecule.
As described previously, the MVA-gag-pol recombinant induced
a potent SIV Gag-specific CTL response, as measured by both functional
assays and binding of Mamu-A*01 MHC class I-p11C tetrameric complex to
CD8+ T lymphocytes (50). All macaques immunized
with the MVA-gag-pol recombinant developed circulating
Gag-specific CD8+ CTL after the second immunization
(50), as summarized in Fig. 1A. Two additional boosts with the
MVA-gag-pol recombinant virus were administered, and
functional CTL and binding of the tetrameric complex to
CD8+ lymphocytes were monitored sequentially throughout the
remainder of the immunization protocol (Table
1). As shown in Fig. 1A, the most
significant boost in tetramer+ CD8+ T cells was
observed after the second immunization, with a less robust response
following the third immunization. The third immunization did not boost
tetramer levels to the levels achieved after the second immunization,
with the exception of macaque 446. Regardless of the peak level
achieved after the third immunization, the percentage of
CD8+ T cells that bound the tetramer had waned to low
levels by the time of the fourth immunization. The fourth boost had
very little effect (Table 1 and Fig. 1A), and tetramer+
CD8+ T cells ranged from 0.3 to 0.8% by the time of SIV
challenge 4 weeks later. The response to immunization of the four
macaques varied significantly; two macaques achieved tetramer levels
similar to those reported during SIV infection, whereas responses in
two macaques were relatively weak despite repeated boosting (Table 1).

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FIG. 1.
(A) Tetramer+ CD8+ T cells in
whole blood of MVA-gag-pol-immunized rhesus monkeys after
immunizations. Arrows show the weeks at which the animals were
immunized. (B and C) Tetramer+ CD8+ T cells in
whole blood after SIV challenge of MVA-gag-pol-immunized and
MVA-immunized animals, respectively.
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TABLE 1.
PBL of MVA-gag-pol-vaccinated
Mamu-A*01+ rhesus macaques demonstrate
tetramer+ CD8+ T cells and functional CTL
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Figure 2 illustrates tetramer staining of
CD8+ T cells from one representative
MVA-gag-pol-immunized animal. Both fresh whole blood
peripheral blood lymphocytes (PBL) and Ficoll-isolated PBL cultured for
7 days with the Gag epitope peptide p11C were analyzed by flow
cytometry for tetramer+ CD8+ T cells. An
increase in tetramer-binding cells was seen in both fresh and cultured
PBL after the third immunization. However, after the fourth
immunization, little difference was observed in the levels of
tetramer-binding cells. The cultured cells were also assessed for
functional cytotoxic activity in chromium release assays. As shown in
Table 1, only PBL from MVA-gag-pol-immunized animals showed
p11C, C-M-specific lytic activity. Thus p11C, C-M-specific CTL were
observed by both tetramer binding and functional assays in PBL of the
MVA-gag-pol-immunized but not the MVA-immunized macaques.

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FIG. 2.
Tetrameric Mamu-A*01-p11C, C-M complex bound to
CD8+ T cells in peripheral blood of a vaccinated rhesus
macaque (443) after immunizations with MVA-gag-pol. Flow
cytometry histograms illustrating tetramer binding to gated
CD8 + CD3+ T lymphocytes are shown for
both fresh PBL and p11C-stimulated PBL for days 0 and 7 after the third
and fourth immunizations. The values indicate the percentage of
CD8 + T lymphocytes that bound tetramer.
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Anamnestic CTL responses after SIV challenge.
Four weeks after
the fourth immunization, the monkeys were challenged intravenously with
50 50% macaque infectious doses of the pathogenic, uncloned SIVsmE660
virus (18). Five Mamu-A*01+ rhesus macaques
immunized with nonrecombinant MVA were challenged in parallel. One of
these animals received nonrecombinant MVA on the same schedule as the
SIV-immunized macaques. Four additional Mamu-A*01+ macaques
were added to the study prior to the last immunization to permit valid
comparisons of viral load parameters following viral challenge. All
nine macaques became infected, as evidenced by rescue of infectious
virus from PBMC and lymph node mononuclear cells at 2, 4, and 8 weeks
after SIV challenge (data not shown).
As shown in Fig.
1B and C, an increase in the number of
tetramer
+ CD8
+ T cells was observed following
SIV challenge in all macaques.
However, the magnitude of the peak
percentage of tetramer
+ CD8
+ T cells was much
greater in animals immunized with MVA-
gag-pol (Fig.
1B), as
compared by the Wilcoxon rank sum test to those
immunized with MVA
(Fig.
1C) (
P = 0.016). The kinetics of appearance
of
tetramer
+ cells was also more rapid in the group immunized
with MVA-
gag-pol (10 days) than in those that received MVA
(14 days). The magnitude
of the anamnestic response also varied between
the SIV-immunized
macaques, with two macaques (442 and 449) achieving
levels of
20% of circulating CD8
+ T cells specific for the
SIV Gag p11C, C-M epitope. These two
macaques also exhibited the
highest primary plasma viremia (442
and 449; Fig.
1B and
3), suggesting that the magnitude of the
anamnestic p11C, C-M-specific CTL response was driven by antigen
load.
The marked expansion of p11C, C-M-specific CD8 T cells during
primary
viremia was relatively transient, with the levels stabilizing
at much
lower levels (2 to 5%) by 49 to 62 days postchallenge
(Fig.
1B). In
general, the levels observed in the MVA-
gag-pol-vaccinated
macaques were higher than those observed in those immunized with
the
MVA control (Fig.
1C).

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FIG. 3.
Sequential plasma viral load measurements in
Mamu-A*01+ rhesus macaques immunized with
MVA-gag-pol (A) and MVA (B) after intravenous challenge with
SIVsmE660.
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The phenotypic properties of the CTL detected before and after
challenge were also compared by four-color flow cytometric
analysis.
The tetramer
+ CD8
+ T cells detected both before
and after SIV challenge had similar
phenotypes. These cells expressed
high levels of the activation/adhesion
molecules, CD11a and CD95, and
low levels of naive lymphocyte-associated
molecules, CD45RA and CD62L
(data not
shown).
Reduced virus load in MVA-gag-pol immunized
macaques.
Sequential plasma SIV RNA levels in all macaques were
assessed by a real-time assay (53). As can be seen in Fig.
3, a wide range in viral load was observed in both immunization groups. The macaque with the lowest viral load was within the
MVA-gag-pol-immunized group, whereas the three macaques with
the highest viremia segregated to the MVA control-vaccinated group
(Fig. 3B). Two control-vaccinated macaques (538 and 567) exhibited no
apparent control of viremia. These macaques developed only a transient
CTL response, as assessed by tetramer+ CD8+ T
cells (Fig. 1C), and failed to mount a detectable antibody response to
SIV antigens (data not shown). Consistent with this failure in immune
control of virus replication, these animals demonstrated weight loss,
persistent diarrhea, as well as neurological and respiratory signs of
disease and were euthanized at 9 and 10 weeks postchallenge. The other
three macaques in the control group have remained healthy although two
of these animals have significant lymphadenopathy.
In contrast, one of the MVA-
gag-pol-immunized macaques (443)
demonstrated impressive control of viremia, with plasma viral
RNA below
the detection limits of the assay (Fig.
3A). This animal
has maintained
normal peripheral blood CD4
+ T cells and lymph node
biopsies obtained at 13 weeks postchallenge
have no evidence of virus
expression by in situ hybridization
for SIV RNA. In addition,
consistent with extremely low viral
load, attempts to isolate virus
from PBMC collected after 8 weeks
postchallenge have been unsuccessful.
Viremia in another macaque
in the MVA-
gag-pol-immunized
group stabilized at moderately low
levels (approximately 50,000 copies/ml). This macaque has also
maintained normal numbers of
CD4
+ T cells in peripheral blood. The viremia in the
remaining two
MVA-
gag-pol-immunized macaques was more
substantial and clearly
overlapped with the range observed among the
control-vaccinated
group of macaques. Overall, a 50-fold reduction in
mean plasma
viral load (
50) was observed in the
MVA-
gag-pol-immunized group
compared to the
control-immunized group at day 49, a time that
corresponds to the
plasma viral load set point. However, due to
the small numbers of
animals studied and substantial biological
variability within the
groups, this difference was not statistically
significant (
P = 0.11).
The response to immunization is predictive of viral load set
point.
To evaluate the association between the frequency of the
Gag-specific CTL response and control of viremia, we evaluated whether the T-cell response to immunization was predictive of relative protection observed in the experimental vaccinated macaques after SIV
challenge. Data derived from restimulated cultures (Table 1) did not
yield any meaningful associations with viral load in the vaccinated
macaques. However, examination of the percent tetramer+
CD8+ T cells in fresh blood revealed considerable variation
in response to immunization. As shown in Fig. 1A, one macaque (443) had
a significantly more robust response to immunization, another (449) had
an intermediate response, and two other macaques (442 and 446) were
relatively low responders. Evaluation of the peak CTL response elicited
by immunization revealed an inverse correlation with the plasma viral
load set point following challenge, as depicted graphically in Fig.
4A. Macaque 443, with the highest
frequency of CTL responses during the immunization period, exhibited
the lowest viral load set point (<500 copies/ml at day 49 and 63). The
macaques (442 and 446) with the weakest immune response to the
vaccination exhibited the highest viral load set point. Macaque 449, with a CTL response of intermediate frequency, was intermediate in
terms of viral load following challenge. This trend did not reach
statistical significance when analyzed by the Spearman rank correlation
due to the small number of animals evaluated (P = 0.08). A similar relationship was observed using peak tetramer levels after the second immunization or mean tetramer levels throughout the immunization period for this comparison (data not shown).

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FIG. 4.
Correlations between viral load set point and the
percent of tetramer+ CD8+ T cells in fresh
blood samples detected before and after SIV challenge. (A) Scatter plot
of the inverse correlation between viral load set point (day 49 after
SIV challenge) shown in a log scale on the y axis and the
overall peak percentage of tetramer+ CD8+ T
cells induced by vaccination on the x axis in macaques
immunized with MVA-gag-pol. (B) Inverse correlation between
viral load set point (y axis) and percent
tetramer+ CD8+ T cells (x axis) at
the same time point after SIV challenge (day 49) (P = 0.03). Macaques vaccinated with MVA-gag-pol are
indicated by their identification numbers (442, 443, 446, and 449) and
symbols in common with panel A. Macaques vaccinated with the MVA
control are shown as open diamonds. This correlation was statistically
significant (P = 0.030; r2 = 0.72)
by the Spearman rank correlation test.
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In summary, the rank order of CTL frequency achieved prior to SIV
challenge in the MVA-
gag-pol-immunized group was predictive
of the rank order of CTL frequency at viral set point. These data
suggest that the strength of the immunologic response to immunization
was a major influence on the viral set point after SIV challenge.
Since
previous studies have demonstrated that the viral set point
is an
excellent prognostic indicator (
55), response to
immunization
may also be predictive of protection from
AIDS.
Correlation of Gag-specific CTL frequency and viral load at set
point.
The correlation between frequency of Gag-specific CTL and
viral load in both groups was also assessed at sequential time points after SIV challenge by the Spearman rank correlation. The percentage of
tetramer+ CD8+ peripheral T cells did not
correlate with relative plasma virus level during primary viremia.
Thus, animals with higher anamnestic peak CTL frequencies did not
necessarily exhibit better containment of viremia. However, by day 49 after SIV challenge (a time corresponding to viral set point), a
statistically significant inverse correlation was observed between the
frequency of tetramer+ CD8+ T cells and plasma
viral load (P = 0.030; r2 =
0.72)
(Fig. 4B). Animals with a higher percentage of circulating tetramer+ CD8+ T cells had lower viral load set
points than those with a lower percentage of tetramer+
CD8+ T cells. As expected, this correlation was observed
regardless of immunization status of the macaques. There was
considerable overlap between the two groups, with control macaques
predominating at the top of the slope and
MVA-gag-pol-immunized macaques predominating at the lower
end of the slope. Overall, similar to observations in humans infected
with HIV (39), these data indicate that the level at which
the Gag-specific CTL plateau after primary viremia predicts the degree
to which viremia is contained in SIV-infected macaques. These data
suggest a functional role for p11C+ CTL in the
down-regulation of plasma viremia that occurs following primary
viremia. Alternatively, the p11C+ CTL response may be
predictive of the overall strength of the CTL response to other Gag or
Pol epitopes in these macaques.
 |
DISCUSSION |
In this study, Mamu-A*01+ rhesus macaques were
immunized with MVA expressing SIV Gag-Pol to assess (i) the ability of
this vaccine strategy to elicit SIV-specific CTL and (ii) the role of
such CTL responses in containing SIV viremia. These animals were
immunized solely with the MVA recombinant and received no subunit
antigen boosting. Thus, any protection observed in this study was
likely due to cell-mediated immune responses to SIV Gag-Pol antigens.
The MVA-gag-pol recombinant proved to be highly effective in
eliciting SIV-specific CTL. Despite waning in the CTL responses
through the period of vaccination, all immunized macaques
responded with robust anamnestic CTL responses after SIV challenge.
Immunization with MVA-gag-pol resulted in a reduction in the
plasma viral load set point compared to control vaccinated macaques,
although the difference in viral load between the two groups was not
statistically significant. Two control macaques developed high
persistent viremia characteristic of rapid progressors, a phenomenon
commonly observed with this pathogenic SIV challenge in naive macaques.
In contrast, all of the SIV-vaccinated macaques showed some degree of
containment of viremia. Indeed, the rapidly progressive disease has not
been observed in any of 22 other macaques immunized with MVA-SIV
recombinants (19, 41).
A similar but statistically significant reduction in plasma viremia was
observed in a parallel study evaluating the relative efficacy of MVA
recombinants expressing Gag-Pol, Env or a combination of Gag-Pol and
Env (40, 41). Therefore, in the absence of neutralizing
antibodies, Gag-Pol-specific CTL induced by prior immunization have a
protective effect following SIV challenge in terms of suppressing
viremia. Such a reduction of viremia has also been observed in macaques
immunized with conventional vaccinia virus expressing SIV Gag-Pol,
although Gag-specific CTL responses were not assessed (46).
A similar correlation has also been observed previously between
Nef-specific CTL responses induced by a vaccinia virus-SIV recombinant
and suppression of viral replication in macaques (15).
Cumulatively, these data suggest that induction of virus-specific CTL
responses, regardless of the antigen, provide partial protection
following challenge in primate models of AIDS. However, a combination
of antigens, as in our parallel study (41) and in studies
with conventional vaccinia virus (46), appear to offer more
solid protection than a single antigen.
Although immunization with MVA-gag-pol resulted in reduction
in the viral set point following SIV challenge, there was overlap in
the ranges between the MVA-gag-pol- and MVA
nonrecombinant-immunized macaques. This overlap is due in part to
biological variation in intrinsic susceptibility of outbred macaques to
SIV infection (27). This tremendous variability in response
to SIV infection is evident among the control macaques, with plasma
viral loads varying by as much as 4 orders of magnitude (Fig. 3). Thus,
two of the control macaques consistently exhibited relatively low levels of plasma viremia suggestive of a higher intrinsic resistance to
SIV infection than the remaining controls. Interestingly, the one
outlier animal in the correlation between plasma viral load and
tetramer percentage at set point shown in Fig. 4B was one of these
control macaques (454). The lower level of viral replication in this
macaque may have been responsible for a less robust CTL response.
Regardless of this variable, the relative response to SIV antigens
during immunization appeared to have a major influence on viral load
set point in the MVA-gag-pol-immunized animals. The effect
of immunization is best demonstrated in the
MVA-gag-pol-vaccinated macaque with the most robust CTL
response. This particular macaque maintained the highest CTL frequency
before and after SIV challenge of all study animals and was able to
control viremia to levels below the threshold of detection of the
plasma viral RNA assay. Follow-up of plasma viremia and clinical
outcome will be necessary to determine whether this control of viral
replication translates into a long-term clinical benefit. However,
previous studies have demonstrated that the plasma viral load set point
is an excellent prognostic indicator in SIV-infected macaques (19,
42, 55). Indeed, historical data from our laboratory have
demonstrated that 9 of 10 macaques with low post-acute-phase set points
remained healthy, some for as long as 5 years postchallenge (data not
shown). The macaque with an intermediate Gag-specific CTL response to immunization showed a less effective control of viremia, but still to
levels significantly less than the majority of the control MVA-immunized macaques. The two macaques with the least robust vaccine-elicited CTL responses demonstrated viral loads
indistinguishable from those of the control MVA-vaccinated animals.
Additionally, the frequency of the p11C-specific CTL following the
primary phase of infection was highly predictive of the plasma viral
load set point. Macaques with low levels of Gag-specific CTL by 7 weeks postchallenge exhibited massive viremia and were euthanized due to
progressive SIV-induced disease. Macaques in which Gag-specific CTL
stabilized at higher levels exhibited the lowest viral load set points.
Critically, the rank order of CTL frequency elicited by immunization
with MVA-gag-pol was highly predictive of the rank order of
CTL frequency at viral set point. While the number of animals evaluated
in this study was too low to allow definitive conclusions, these data
suggest that much of the spectrum in viral load observed in immunized
macaques is due to the relative effectiveness of immunization.
The tetramer data in the present study contributed a quantitative
aspect to CTL assessment that has been lacking in previous vaccine
studies in the SIV-macaque model. In this study, specific lysis, as
determined by functional assays, was indistinguishable among immunized
macaques. Perhaps because the percentage of tetramer+
CD8+ T cells can be determined from fresh cells, these
values may be more predictive of the relative strength of CTL responses
than functional assays performed on in vitro-stimulated PBMC. Since the
animals evaluated in this study expressed other MHC class I alleles in
addition to Mamu-A*01, they are likely to have mounted CTL responses to
other undefined Gag-Pol epitopes that were not assessed. Therefore, the
p11C-specific CTL responses may be indicative of the CTL responses to
other Gag-Pol epitopes induced by the MVA-gag-pol vaccine in
these animals. The p11C-specific CTL response appears to be a useful
surrogate marker to indicate more general effectiveness of immunization
in Mamu-A*01+ rhesus macaques. Comparative analyses of the
strength of CTL responses elicited by different vaccine regimens should
now be feasible using the tetramer technology. Based on the diminishing responses after the first two immunizations with the
MVA-gag-pol recombinant, immune responses generated to MVA
probably limit the usefulness of repeated immunization with this
vector. Therefore, combination of immunization strategies such as
poxvirus recombinants with DNA immunization (22, 49) are a
promising avenue for boosting CTL responses.
In summary, the present study demonstrates that recombinant MVA-SIV as
a sole immunogen generates a robust CTL response in macaques that
mediates protection from high levels of viremia following SIV
challenge. Despite waning of effector CTL prior to challenge, the
MVA-gag-pol-immunized macaques responded with vigorous
anamnestic CTL responses after SIV challenge. Critically, the macaque
with the best immunologic response to vaccination demonstrated the most
effective suppression of viremia after SIV challenge. The effectiveness
of recombinant MVA in generating SIV-specific CTL in the macaque model
suggests that MVA-based vaccines warrant evaluation for preventing HIV
infection and AIDS in humans.
 |
ACKNOWLEDGMENTS |
We thank J. D. Lifson (SAIC-NCI, Frederick, Md.) for
performing analysis of plasma viral RNA levels, N. Cooper (LVD, NIAID) for preparation of MVA stocks for animals studies, C. R. Brown (LMM, NIAID) for performing SIV-specific in situ hybridization, S. Whitted and R. Goeken (LMM, NIAID) for technical assistance, and R. Byrum (Bioqual, Inc.) for conducting the animal studies.
This study was supported in part by NIH grants AI-85343 and AI-26507.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: NIAID Twinbrook
II Facility, 12441 Parklawn Dr., Rockville, MD 20852. Phone: (301) 496-2976. Fax: (301) 480-2618. E-mail: vhirsch{at}nih.gov.
 |
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Journal of Virology, March 2000, p. 2502-2509, Vol. 74, No. 6
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Copyright © 2000, American Society for Microbiology. All rights reserved.
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