Effect of HIV infection on M.tuberculosis granuloma formation and evolution - Project Summary/Abstract
Individuals with human immunodeficiency virus type-1 (HIV) are 30x more likely to develop active tuberculosis
(TB) than those without HIV. TB is the leading cause of death among HIV patients. Mycobacterium
tuberculosis (M.tb), the causative agent of TB, is contained within granulomas, complex structures composed
of macrophages, B and T cells, and a fibrous cuff, in the tissues of patients. These structures help limit M.tb
growth, but also provide a niche for M.tb. Although increased HIV replication and altered granuloma structures
have been reported in the lungs of HIV-TB co-infected patients, no work has focused on the interaction
of M.tb and HIV specifically in granulomas and it is unclear how HIV alters M.tb granulomas. This is particularly
important as active TB develops either from early progression of a primary granuloma or reactivation from an
established latent granuloma. This proposal will investigate the effects of HIV infection on M.tb granulomas,
using our group's previously established in vitro granuloma model, which shares many features with human TB
granulomas, including cell aggregation, composition, and altered bacterial growth without clearance. The
granulomas in this model are generated by adding M.tb to human peripheral blood mononuclear cells (PBMCs)
collected from healthy latently TB infected (LTBI) or TB naïve individuals. Our data suggest that addition of
HIV-infected T cells to pre-formed in vitro M.tb granulomas generated with PBMCs from LTBI individuals
reduces granuloma stability and increases M.tb growth; whereas HIV infection increases granuloma formation
in PBMCs from TB naïve individuals and M.tb increases HIV growth in these cells. These results indicate that
the initial infection and resultant host immune status have distinct impacts on secondary infection. We
hypothesize that HIV infection in pre-formed granulomas modeling latent TB leads to exacerbated cell death,
and inhibition of macrophage and lymphocyte function. However, in TB naïve individuals, HIV-driven immune
activation promotes granuloma formation, which provides a niche for enhanced HIV replication and
M.tb growth. This proposal will investigate the seemingly conflicting evidence for granuloma disaggregation
and promotion by HIV, dependent on pre-existing M.tb infection and host immune status. The specific aims of
this proposal are to: 1) Elucidate the effect of HIV infection on pre-formed M.tb granulomas and 2) Determine
how pre-existing HIV infection affects subsequent M.tb-induced granulomas, and how this impacts HIV. For
both models, granuloma structure and function will be characterized with biochemical, and microscopy and
transcriptomic analysis of single cells. The broad, long-term objective of this research program is to
investigate the molecular mechanisms of HIV-M.tb co-morbidity, with the ultimate goal of designing
therapeutics that more effectively target HIV and M.tb, alone, and in co-infected individuals. Better
understanding of the early impact that HIV has on M.tb granulomas will help elucidate the mechanisms of rapid
exacerbation and death of the co-infected patients and design of better therapeutics active in granulomas.