Orlando Sentinel

‘Root cause of AIDS’ now identified, 2 studies claim

- By Monte Morin

Scientists say they have discovered a key process by which the AIDS virus kills key immune cells: It triggers a preprogram­med self- destruct sequence within the cell that is intended to alert fellow immune cells of a crisis.

In papers published in the journals Science and Nature, researcher­s at the Gladstone Institutes and University of California at San Francisco wrote they had not only discovered t his l i t t l e- understood process, but also identified an existing drug that may halt it.

“Our studies have investigat­ed and identified the root cause of AIDS,” said Gilad Doitsh, a coauthor of both studies and a virologist at Gladstone, a San Francisco research facility.

“Despite some 30 years of HIV research, this key HIV/AIDS process has remained pretty much a black box,” he said in a statement.

Both studies focus on the body’s CD4 T-cells, white blood cells that help defend against infection.

These cells are also the primary target of the human immunodefi­ciency virus, or HIV, which injects its own genetic material into the immune cell, causing it to reproduce the virus many times over.

Yet there are many immune cells in which the viral reproducti­on process fails, and the host never becomes a reproducti­on factory for the virus. These cells are sometimes called “bystander” cells, and it has long puzzled scientists as to why they died, eventually leaving the body with so few immune cells that it can no longer defend against even minor illnesses.

Dr. Warner Greene, the senior author of both studies, and Gladstone’s direc- tor of virology and immunology research, wrote that after studying HIVinfecte­d tonsil and spleen tissues, he and his colleagues determined the bystander cells were dying from pyroptosis, a form of cellular suicide.

Pyroptosis, which in Greek means to go down in flames, is one of a number of preprogram­med selfdestru­ction processes that cells are equipped with.

In pyroptosis, a cell begins to swell and then bursts, releasing inflammato­ry compounds. Those compounds then attract other immune cells, which seek to fight the infection.

In the case of HIV, however, the arrival of new immune cells provides further targets for the virus, and the cycle continues.

Greene and his colleagues wrote the cell initiates pyroptosis in response to the accumulati­on of viral genetic material within the cell. Although the material is unable to create new viral particles, the cell recognizes the material as a threat and essentiall­y sacrifices itself in attempt to summon other immune cells.

“The cycle of abortive infection, inflammato­ry death and recruitmen­t of new cells likely explains how this innate host response is undermined and, in fact, centrally contribute­s to HIV pathogenes­is,” authors wrote.

Through experiment­ation, researcher­s determined that the dangerous genetic material was detected by interferon­gamma-inducible protein 16 (IFI16), which in turn activated the cell’s trigger for pyroptosis, an enzyme called caspase-1.

Armed with that knowledge, the researcher­s tested different caspase-1inhibitin­g compounds on infected tissue and found some were as effective in preventing the depletion of CD4 T-cells as viral inhibiting drugs.

Researcher­s are planning a clinical trial to determine whether one of the anti- inflammato­ry drugs tested can help stop the progressio­n of disease in HIV-infected people.

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 ?? DIPTENDU DUTTA/GETTY-AFP PHOTO ??
DIPTENDU DUTTA/GETTY-AFP PHOTO

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