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![]() World Journal of AIDS, 2012, 2, 226-231 http://dx.doi.org/10.4236/wja.2012.23029 Published Online September 2012 (http://www.SciRP.org/journal/wja) 223 HIV-1 Primarily Targets the Innate Immune System and Only Secondarily Modulates Adaptive Immune Cell Depletion Lawrence M. Agius1,2 1Department of Pathology, Mater Dei Hospital, Tal-Qroqq, Malta; 2University of Malta Medical School, Msida, Malta. Email: [email protected], [email protected] Received April 21st, 2012; revised May 14th, 2012; accepted May 25th, 2012 ABSTRACT Persistence of HIV-1 infection allows for permissive microenvironmental conditioning in terms of contextual innate immune participation. The progression of host cell injury constitutes an additional parametric formulation in self-am- plifying modulation of the adaptive immune response in a manner that inclusively promotes the emergence of a final stage of AIDS that is both depletive and permissive for opportunistic infections and various forms of neoplasia. It is within contextual indices of promotion of depleted T-helper lymphocytes and of augmented viremic loads that manifest- tations of classic lesions emerge as the AIDS phenomenon. It is further to be realized that an apoptotic response of mul- tiple cell subtypes including T-lymphocytes includes host-cell participation within formulated settings of further persis- tence of the retroviral infection. An all-inclusive phenomenon of dendritic cell-lymphocyte synapse formulation corre- sponds to the establishment of HIV-1 infection that specifically conditions all subsequent stages in depletion of the in- jured host cells regardless of the dynamics or kinetics of the retroviral replicative infectious process itself. Keywords: HIV-1; Infection; Aids; Immune; Persistence 1. Introduction HIV-1 infection is inherently a progressive disorder that is especially productive of a chronic participation of in- jury to CD4+ T-lymphocytes within additional contex- tual conditioning of the AIDS phenomenon. This inher- ently progressive infection is suggestive in itself of a profound involvement of the innate immune system in particular. Interferon lamba 3 activates the innate im- mune system through the JAK-STAT pathway in macro- phages. It inhibits HIV-1 replication in these cells and induces many antiviral cellular factors and interferon regulatory mediators [1]. Plasmacytoid dendritic cells serve as an essential link between innate and adaptive immune systems; the fate of these cells in HIV-1 infec- tion is unclear [2]. The realization of monocyte/macro- phage participation in the accumulation of the HIV-1 virions indicates the essential character of an infection that arises primarily from innate immune defects. Macro- phages and their monocyte precursors show marked het- erogeneity and may be either proinflammatory or alter- natively activated [3]. The ongoing development of infection to multiple he- matopoietic cell lineages is a highly prominent feature of injury that is ultimately the criterion for the ensuing in- fection that is manifested primarily as acquired immune deficiency. CNS opportunistic infections vary according to HIV induced defects of innate immunity versus ab- normal adaptive immunity [4]. The emergence of cellular injury therefore constitutes the establishment of multi-lineage cellular injury that is productive of the progressive nature to the AIDS pan- demic. B lymphocyte abnormalities precede CD4(+) T cell decline [5]. 2. Cascade Events The closely parallel involvement of systems of cascade signalling in HIV-1 infected cell lines correlates espe- cially with the recombinant HIV-1 virion variants that establish themselves in the circulating blood of persis- tently infected individuals. The further emergence of highly characteristic opportunistic infections and also especially of different forms of neoplasia are further promotional events in the establishment of progression as the main pathogenic mechanisms leading to the AIDS process. Chronic immune activation appears to result from untimely innate immune responses and is believed to be implicated in dynamics of emergence of AIDS in HIV-1 infected individuals [6]. Copyright © 2012 SciRes. WJA ![]() HIV-1 Primarily Targets the Innate Immune System and Only Secondarily Modulates Adaptive Immune Cell Depletion 227 Indications of non-resolution of the HIV-1 infection arise as perpetuating involvement by a virion that is rela- tively slowly replicative but that is capable of exquisite evasion of the immune system. HIV-1 Nef appears im- portant in HIV-1 transmission by dendritic cells to acti- vated CD4(+) T cells [7]. Vpu promotes suppression of innate immunity and counteracts natural killer cells by interfering with CD1d expression and antigen presenta- tion; it also suppresses expression of NK-T and B cell antigen [8]. Recombinant variants of this retrovirus indicate the enormous capability for adaptability to a changing mi- croenvironment in terms of the further participation of injury to multiple cell types. In this regard, the essential representation of the infectious process is closely allied to a formulated recombinatio n of multiple sero-strains as further evidenced by subtypes of the HIV-1 virion M, O and N, and by the subtypes of the M variant itself. 3. HIV-1 Progression Indications of realization of HIV-1 progression appear to arise primarily as a consequence of chemokine and cyto- kine pathobiology as relative especially to coreceptors to the CD4+ receptor. IL-7 effectively protects the CD4(+) T cell pool during acute SIV infection in macaques [9]. The attributes of complicatin g neoplastic lesions in these patients are closely formulated consequences of the pro- longed persistence of a dual coinfection by both HIV-1 and accompanying oncogenic viruses such as human herpes virus-8, Ebstein-Barr virus and human papilloma virus subtypes. In such manner, proportional accumulation of HIV-1 virions within persistently infected host cells correlates with the emergence of depletion of the CD4+ T lympho- cytes and of the increasing circulating viremic load. Macrophages are essentially implicated in HIV-1 in- fection, viral rebound and clinical emergence of AIDS [10]. Glutathione-enhanced natural killer cells tend to suppress mycobacterial tuberculosis infection within human monocytes [11]. Establishment of the HIV-1 infection arises as a main consequence of an activation phenomenon that affects both T and B lymphocytes. In such manner, the cones- quential attributes of recombinant subtypes of coinfect- ing HIV-1 virions indicate a prominent derived character for persistence towards the development of a profound immune deficiency. High levels of viremia in the establishment of the infec- tious process reflect an adherence of patterned formula- tion within pathways and cascades that include a promi- nent paracrine microenvironmental effect. The innate immune response appears a critical factor in initial HIV transmission and dissemination, implicating type I inter- feron, defensins and whey acidic proteins [16]. Enhanced IL-2 production and improved proliferation of CD4 T helper cells are restricted to viremic individuals. When regulatory T cells are depleted from circulating mono- cytes in viremic patients, IL-10 production decreases and proinflammatory cytokines increase [17]. In this regard the participation of multiple c ellu lar lineag es co llaborates The latter phenomenon is itself a source for sequential transformation of cells towards malignant neoplastic emergence. Vpu (viral protein U) may have evolved as a promoter of human-to-human HIV-1 transmission due to an interplay between viral factors versus host restriction factors [12]. 4. Disease Setting The whole setting of attributes of HIV-1 infection is con- clusive parameter for the induction of further cellular injury that primarily includes depletion of lymphocyte subsets without in fact direct overwhelming infection of such lymphocytes. In such manner, profound immune cell depletion is a complex evolution involving by- stander effect and also the induction of apoptosis of mul- tiple cell-subtypes. Premature immunosenescence of the innate immune system may be mediated by chronic en- dotoxemia, residual viremia, telomere attrition and al- tered cellular signallin g [13]. Inflammation is an exquisite setting for the production of cellular injury in AIDS infections in a further contex- tual setting of persistent HIV-1 infection. Leukotrienes influence microglial infection and may partly control viral load in the central nervous system [14]. It is with regard to a multiplicity of step s in the production of new retroviral virions that a whole panorama of adaptive change involves an inflammatory response to the viral infection and to the persistent process of immune defi- ciency state leading generally to the AIDS process. Activation of lymphocytes characterizes the early stages of HIV-1 infection with the profound incorpora- tion of replicative viral activity especially within mono- cytes/macrophages. Type I interferon response by the innate immune system is produced by plasmacytoid den- dritic cells and appears to control HIV-1 productive in- fection and disease progression [15]. Formulated patterns include the emergence of system- atic processes of integration of the cDNA of the HIV-1 genome in manners that implicate insertional mutagene- sis. The further confounding chemokine and cytokine accompaniments by such factors as activation of the viral reverse transcriptase indicate an overall close homology of virion capability towards host-cell components as fur- ther evidenced by the persistent articulation of cellular injury to CD4+ T helper lymphocytes. 5. Viremia Copyright © 2012 SciRes. WJA ![]() HIV-1 Primarily Targets the Innate Immune System and Only Secondarily Modulates Adaptive Immune Cell Depletion 228 with the involvement of multiple cell-signalin g pathways that promote adaptive potentiality towards the host cell that is infected. Homology of genomic components of the virion correlates with the adoption of multiple parameters that belie a single main pathogenic mechanism in reach- ing establishing persisten ce of the HIV-1 infection. 6. Activation It is in terms of adherence of host-cell response as activ- tion mechanisms that promote a realization of cellular injury that there is included widespread apoptosis of T helper lymphocytes. Correlates of a promotional nature that are mainly characterized by a marked activation of lymphocyte sub- sets include the formulation for further persistence of cell injury within contextual reproduction of multiple promi- nent lineage participations. Plasmacytoid dendritic cells possibly enable HIV-1 elite controllers to control HIV-1 viremia [18]. Activated nervous system mononuclear phagocytes and astrocytes expressing HIV-1 gene prod- ucts in specific patterns may promote neurodegeneration [19]. It is in a microenvironmentally conditioned in- flammatory response that parameters of spread of the HIV-1 virus include the evolution of viral resistance to various drug treatment protocols that is commonly seen in patients treated with anti-retroviral therapy. Included participation of multiple cell-type infection in HIV-1 phases of evolution allow for the development of specific regulatory disorders that incorporate the persis- tent infection. Intrinsic antiviral immunity tends to re- strict infection by blocking viral replication directly in an immediate manner [20]. Replicative activity of the retro- virus is accompanied by a very high mutability that self-promotes the ensuing infection as productive of the AIDS stage of infection. 7. Aids Phase In terms of such ongoing participation of cellular injury in the creation of a conducive setting for persistence of the HIV-1 infection, it is a dual involvement of inflam- matory reactivity with the emergence of subsequent se- vere immune deficiency that permits evolution of pat- terns of modulated participation of such cellular injury to lymphocyte depletion and AIDS phase establishment. Toll-like receptors as innate immune components induce activation of NF-kappaB that in turn promotes HIV-1 replication [21]. Humanized mice are optimal for study- ing HIV-1 immunopathogenesis and for the development of novel immune-based th erapies [22]. Indicative inclusion of mutability would allow for the acquisition of a capability for pronounced depletion of immune cells as these relate particularly to impaired ex- pression of human histocompatibility antigens. The den- dritic cells in particular appear a primal form of pattern ed involvement in patients infected with HIV-1. It is in terms of augmented activation of immune cells on the one hand and o f impaired resolution of the cellular injury that inflammatory microenvironmental paracrine effect further promotes the emergence of injury to lymph nodes and gastrointestinal associated lymphoid tissue. Fibrosis accompanies a severely progressive lymphocytic deple- tion in modes of further involvement of the innate im- mune system in particular. Dendritic cells are partici- pants in the production of spread of the HIV-1 infection as evidenced by monocytes/macrophages that accumulate highly replicative sites for the retrovirus. Polymorphisms of innate immune genes affecting Toll-like receptors and defensins modulate progression of HIV-1 infection in children [23]. Inclusion dynamics of the virion particles promote establishment of inte- grated viral genomes within host-cell genomes as indi- cated by the elaborate phases of entry and attachment to the cell membrane, the reverse transcription of the viral RNA genome and the formulation of transport of viral components from the nucleus to the cytoplasm and plas- malemma. CD4 binding site directed inhibitors (mono- clonal antibodies) act preferentially by blocking free vi- rus transmission while still allowing HIV-1 to spread through cell-cell contacts [24]. The failure to recognize a single essential pathogenic step in HIV-1 infection is symptomatic of a variety of inducing environments that promote the production of further attributes of the overall persistence of the viral replication and release. The neutralizing antibody con- stant domain functionally links innate and adaptive im- mune systems to harness innate immune response [25]. In primary HIV-1 infection there develops dysfunction of dendritic cells and this is independ ent of interaction with gp120 [26]. 8. Micro-Environment Inclusive formulations of multiple component pathways are irreducible parameters in the development of such micro-environmental conditioning. In such terms, inclusive forces such as pressure-in- duced mutability of the HIV-1 genome, including such factors as anti-retroviral drug therapy, affect the pathobi- ologic attributes of the AIDS syndrome phase. Within a range phenomenon of inclusive parameters, the HIV-1 infection arises largely as an integral component of the micro-environmental milieu of inflammation and of evolving immune deficiency. Autophagy is increasingly being implicated in pattern recognition paradigms af- fecting innate immunity [2 7]. TRIM5 as a restriction factor may indicate how the innate immune system detects distinct molecular features of HIV-1 [28]. Copyright © 2012 SciRes. WJA ![]() HIV-1 Primarily Targets the Innate Immune System and Only Secondarily Modulates Adaptive Immune Cell Depletion 229 Promotional attributes of cohesive participating roles in such micro-environmental conditioning indicates that HIV-1 is a privileged infectious agent that creates and modulates multiple facets of inclusive formulation that are directed primarily in the creation of recombinant forms of the virion in the individual patient with AIDS. It is further to be noted that the innate immune system in- volvement accounts for the establishment of multiple facets of involvement as coreceptivity as promoted by disordered chemokine and cytokine biology. Host inva- sion and viral replication appear orchestrated by Nef ac- tions in macrophages including receptor expression, in- tracellular signalling and production of mediators of in- flamma tion [29]. Of particular relevance is the dendritic cell-lympho- cyte/macrophage synapse in infectious modes of modu- lated effect leading to a process of accumulation relevant towards the ongoing persistence of the infection by HIV-1 virus. Virological synapses between infected den- dritic/T lymphocytes and uninfected T cells may very well prove the do minant mode of HIV-1 spread [30]. Th e attributes of activation of lymphocytes are clearly also a modulation step in the evolution of the retroviral infec- tion as an established persistence of further induction in microenvironmental conditioning. The emergence of multiple forms of neoplasia in the AIDS patient is sug- gestive also of endothelial cell participation, particularly within a setting of augmenting viremic levels that circu- late in the peripheral blood. 9. Redistribution An inclusively overall parameteric redistribution of the HIV-1 virions accounts for the promotional persistence as evidenced by a clinical setting of multiple forms of opportunistic infection and of neoplastic lesions includ- ing Kaposi sarcoma, non-Hodgkin lymphoma, and cer- vical carcinoma. In such terms, implication of further evolving pathogenesis allows a permissive environment that conditions also the profound immune deficiency. In effective terms, the whole integrative phenomenon of per- sistent HIV-1 infection is a parent process of subsequent derivative pathways of essential amplifying proportions. Inflammasome genes are implicated in susceptibility to HIV-1 infection [31]. The processes of derivative pa- rameters are all-inclusive formulations that essentially modulate the innate immune pathways as primary con- stitutive targets of HIV-1 rather than as a primary infec- tion of T lymphocytes per se. It is with reference to mul- tiple inducible pathways of reproduction that macro- phages, natural killer cells and dendritic cells promote a setting of modulated permissiveness that contributes di- rectly to the establishment of the persistent nature of the HIV-1 infection. Strong antibody mediated activation of Natural Killer cells to HIV-1 Env occurs in persistent HIV-1 infection [32]. Apoptosis may be viewed as an essential reflection of such amplifying microenvironmental conditioning with regard to secondary acquisition of the T helper lympho- cyte depletion. Activation of both T and B lymphocytes appears a correlative phenomenon in itself that demarcates potenti- ality for persistence of the retroviral infection. A promo- tional accumulative viral load empowers the emergence of persistent viral infection, regardless of the degree of viral particle replication within specific cellular or im- mune cellular subsets. HIV-1 is able to productively in- fect nondividing cells as well as dividing cells at inter- phase by actively delivering its DNA into the nucleus by means of ho st nuclear impor t machine ry [33]. Replicative activity of host cells correlates with viral replication formulas and promotes the microenviron- mental conditioning that harbors further potential non- resolution of cell injury of virally infected host cells. Redistribution of lymphocytes and also of other cell- types such as dendritic cells promotes a systemically promotional effect to HIV-1 infection as also noted with regard to the AIDS phase of infection. 10. Concluding Remarks Parameters of induction and non-resolution of HIV-1 infection indicate an exquisite acquisition of a self-am- plifying range of potentialities th at specifically indicate a primary all-embracing involvement of the innate immune system; this responds by implicating in secondary fash- ion a pathobiologic activation of the adaptive immune response. Further evolution of the retroviral infection imposes pressure effects on multiple cell subtypes in a manner that implicates cytokine and chemokine modulation within a microenvironmental inflammatory milieu. The apoptosis of host cells is sharply distin ct from a dynamo- ics that solely targets such cells as replicative reservoirs of the HIV-1; this phenomenon is suggestive of a modu- lation that is specifically both an activating and dep letive inclusive formulation of viremic and host-cell co-infec- tivities. A systemic redistribution of host cell injury evolves within a contextual representation of multiple cell sub- types ranging from macrophages, dendritic cells, natural killer cells to endothelial cells in inducing persistence of the infection as the one paramount dynamics of HIV-1 involvement of the individual patient progressing to AIDS as a distinct disease phase. REFERENCES [1] M. Q. Liu, D. J. Zhou , X. Wang , W. Zhou , L. Ye and J. Copyright © 2012 SciRes. 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