The Canadian HIV Cure Enterprise (CanCURE) Team

Transcription

1 The Canadian HIV Cure Enterprise (CanCURE) Team Éric A. Cohen, PhD Laboratory of Human Retrovirology Institut de Recherches Cliniques de Montréal (IRCM) How close are we to a cure? HIV Endgame Conference, Toronto October 25,

2 Disclosure Éric A. Cohen I have no relationships with commercial interests to disclose

3 Outline 1. The Canadian HIV Cure Enterprise (CANCURE) 2. Context and rationale 3. CanCURE objectives and recent progress 3

4 CanCURE Team project was initiated following a RFA on HIV Cure launched by the CIHR HIV/AIDS initiative in January 2013 CanCURE is funded for 5-years (Jan 1, Dec 31st, 2018) by the CIHR in partnership with CANFAR and IAS IRCM and the Université de Montréal are the host institution 4

5 CanCURE Mission To understand HIV persistence during antiretroviral therapy (ART) and to harness this knowledge towards the development of HIV cure interventions

6 CanCURE Team 9 Principal Investigators P. Ancuta, CR-CHUM J. Angel, U. of Ottawa E.A. Cohen, IRCM J. Estaquier, U. Laval K. Fowkes, U. Manitoba A. Mouland, McGill M. Ostrowski, U. Toronto J-P Routy, McGill M.J. Tremblay, U. Laval 19 Co-Investigators B. Bell, U. Sherbrooke J. Bell, U. Ottawa R. Bendayan, U. Toronto Z. Brumme, SFU M. Brockman, SFU C. Cheong, IRCM A. Cochrane, U. Toronto N. Chomont, CR-CHUM A. Gatignol, McGill É. Haddad, U. Montréal D. Kaufmann, CR-CHUM R. Kaul, U. Toronto A. Kumar, U. Ottawa M-A Langlois, U. Ottawa T. Murooka, U. Manitoba A. Poon, UBC C. Power, U. Alberta M. Wainberg, McGill JC Zúñiga Pflücker, U. Toronto Community Liaison R. Reinhard CanCURE Participating institutions consist of 10 Canadian Universities and affiliated research centers, including the IRCM, the Team Host Institution 6

7 Context and Rationale 7

8 Current HIV drugs do not eradicate HIV HIV infection is characterized by high levels of circulating viruses in the blood Antiretroviral drugs (HAART) are capable of suppressing HIV, even to undetectable levels However, the virus rebounds after cessation of therapy START HAART STOP Circulating virus Limit of detection Time HIV hides in reservoirs that are not sensitive to current therapies 8

9 Viral reservoirs represent the principal source of viral persistence during ART and a major obstacle to a cure 9

10 Where does HIV persists? Courtesy of Nicolas Chomont 10

11 HIV latency, a challenge for host immune defenses Deeks et al., Nature Reviews Immunology

12 HIV latency, a challenge for host immune defenses Durable reservoir indifferent to treatment or to any host defense targeting virus elements Failure of effector cell clearance due to: - Absence of viral protein expression - Viral epitope escape - Host immune exhaustion Deeks et al., Nature Reviews Immunology

13 While extensive efforts have been deployed in the direction of eliminating HIV-1 memory CD4+ T-cell, the predominant VR, much less is known about the contribution of myeloid cells and particularly macrophages to the overall HIV reservoir It will be difficult to achieve a cure for HIV-1 without considering all potential VRs

14 Macrophages Found in virtually every tissue in the body Originate from self-renewing tissue-resident macrophages and infiltrating monocyte-derived macrophages. Maintain tissue homeostasis by recognizing and disposing of apoptotic cells in a non proinflammatory manner Provide a critical front line of defense against pathogens, including viruses by eliminating infected cells by phagocytosis HIV-infected Macrophages Verrolet et al. Blood, 2014

15 Macrophages as VR candidates Permissive to productive HIV infection in vivo and in vitro (express CD4 and CCR5) (Weinberg et al.,1991; Honeycutt et al., 2016) Harbor virus for long periods of time in intracellular viruscontaining compartments (VCC) (Groot et al., 2008) They are resistant to HIV-1- induced apoptosis (Carter et al., 2008) They can harbor virus in a latent state or in a state of very low expression in vitro (Kumar et al. Viruses, 2014) Hu-MoM Honeycutt et al., 2016 Sattentau & Stevenson, 2016

16 Macrophages as VR candidates Presence of proviral DNA was detected in macrophages isolated from rectal and ileal tissue (Yukl et al., 2014) as well as myeloid cells isolated from GALT of ART-treated aviremic individuals (Josefsson et al, 2013) (Yukl et al. 2014) However, the fact that macrophage can ingest infected CD4+ T cells (Baxter et al., 2014) complicates the interpretation Sattentau & Stevenson 2016

17 Cure strategies Courtesy Nicolas Chomont 17

18 CanCURE objectives and recent progress 18

19 CanCURE Scientific Objectives 1) Identify, characterize and exploit insufficiently characterized properties of myeloid cells, especially macrophages, and additional lymphoid cell subsets within mucosal compartments that act as VRs; 2) Conduct detailed mechanistic studies aimed at understanding how these VRs are established and maintained; 3) Identify new drug candidates that reverse virus latency/persistence in multiple cross-acting VRs, and evaluate novel therapeutic strategies that enhance immune control and/or induce effective clearance of VRs; 4) Test whether immune-based therapies control or reduce VR in ART-treated HIV-infected patients in clinical trials

20 CanCURE Recent Progress HIV persists in CCR6+ CD4+ T cells from Colon and Blood during antiviral Therapy (Gosselin/Wiche Salinas et al., AIDS, 2016, In Press) Single-cell characterization of viral translationcompetent reservoirs in HIV-Infected individuals (Baxter et al, Cell Host & Microbe, 2016) Enhancing virion tethering by BST2/Tetherin sensitizes productively and latently HIV-infected T cells to ADCC mediated by broadly neutralizing antibodies (Pham et al., Scientific Reports) 20

21 HIV-DNA Mainly Persists in Colon and Blood CCR6+ T-Cells during ART Gosselin/Wiche-Salinas et al., AIDS, 2016, In Press 21

22 Blood Central Memory CCR6+ T-cells Are Enriched in Integrated HIV-DNA During ART Gosselin/Wiche-Salinas et al., AIDS, 2016, In Press 22

23 Superior HIV Reactivation in CCR6+ Subsets during ART The preferential persistence of HIV in colon and blood CCR6+ T-cells during ART needs to be considered for tailored HIV eradication strategies 23

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25 HIV RNA/Gag dual detection Complete method Day -1 Day 0 Day +1 CD4 T cell isolation and stimulation Surface and ICS antibody staining mrna labelling Amplication and labelling Analysis PBMCs Surface staining Amplification 2 CD4 isolation ICS for HIV-1 Gag protein Amplification 1 Label amplified probe HIV mrna Label GagPol mrna Rest or stimulate O/N Store 4 o C O/N + RNAsin Run on flow cytometer GagPol mrna Gag Protein

26 Detection of translation-competent reservoirs Baxter et al. Cell Host and Microbe 2016 This assay is currently adapted to examine HIV persistence in myeloid cells

27 IFNα Enhances Env Recognition and ADCC by PGT126 Pham et al., 29

28 ..In a BST2-Dependent Manner BST2 restriction is normally counteracted by the HIV-1 accessory protein Pham et al., 30

29 Enhancement of Virion Tethering by BST2 Sensitizes Reactivated Latent Cells to ADCC by pgt121 bnabs: PGT121 Pham et al., Restoring BST2 restriction could improve anti-hiv responses and potentially provide a means to eliminate reactivated cells in latent reservoirs 32

30 IRCM Tram NQ Pham Sabelo Lukhele Mariana Bego Frédéric Dallaire Scott Sugden Mathieu Dubé CR-CHUM Amie Baxter Daniel Kaufmann Annie Gosselin Petronela Ancuta Nicolas Chomont CanCURE Robert Reinhardt Sébastien Sabbagh Clinical Collaborators: P. Larochelle, M. Gauthier and the IRCM Clinic staff Thanks Collaborators Jean-Pierre Routy, McGill, Élie Haddad, Université de Montréal, Winfried Weissenhorn, U. Grenoble-Alpes, Frank Kirchhoff, University of Ulm, Wei Cao, MD Anderson Cancer Center, Yong-Jun Liu, Sanofi Romas Geleziunas, Gilead Mario Legault, FRQ-S AIDS Network Reagents J. Robinson, Tulane (17b) M. Nussenzweig, Rockefeller (3BNC117) M. Connors, NIH (35O22; 7H6) D. Burton; P. Poignard, Scripps (PG9; PGT121; PGT126) Idera Pharmaceuticals NIH AIDS Reagent Program IRCM Flow Cytometry Core Healthy volunteers

31 THANK YOU

32 CanCURE Mission This collaborative effort engages basic and clinical scientists as well as members of the community in a research effort to: 1. Characterize mechanisms of HIV persistence in the presence of ART 2. Develop cell-based and animal model systems in which persistent infection can be investigated and therapeutic interventions can be tested. 3. Develop new assays to accurately characterize and measure viral reservoirs 4. Generate therapeutic approaches that can ultimately be tested in human clinical trials.

33 CanCURE Research Themes Theme 1: to study the molecular, genetics and functional characteristics of HIV/SIV persistence in human and animal models (NHP and BLT mice) (Leaders: P. Ancuta & J. Estaquier) Theme 2: To define mechanisms governing HIV latency and persistence in macrophages (Leaders: M.J Tremblay & A. Mouland) Theme 3: To identify new drug candidates and therapeutic strategies aimed at eliminating HIV persistent infection and to test effective strategies in preclinical studies (Leaders: J. Angel & M. Ostrowski) Theme 4: To establish approaches, expertise and infrastructure to conduct HIV Cure clinical trials by examining whether immune-based therapies reduce or eliminate VRs in ART-treated patients (Leaders: J-P Routy & J. Angel)

34 Scientific Advisory Board ERIC J. ARTS University of Western Ontario London, CANADA MICHAEL M. LEDERMAN Case Western Reserve University University Hospitals/Case Medical Center Cleveland, USA OLIVIER SCHWARTZ Institut Pasteur Paris, FRANCE GUIDO SILVESTRI Emory University Yerkes National Primate Research Center, Atlanta, USA 34

35 Community Advisory Board Robert Reinhard CanCURE Community Liaison Shari Margolese At Large and CTN Renée Masching Canadian Aboriginal AIDS Network Tola Mbulaheni African and Caribbean Council on HIV/AIDS in Ontario Jonathan Postnikoff Positive Living BC Ron Rosenes At Large José Sousa At Large Darien Taylor At large Wangari Tharao Women s Health in Women s Hands 35