HIV-1, the most common type of the virus that causes AIDS, has proved to
be tenacious, inserting its genome permanently into its victims' DNA,
forcing patients to take a lifelong drug regimen to control the virus
and prevent a fresh attack. Now, a team of Temple University School of
Medicine researchers has designed a way to snip out the integrated HIV-1
genes for good.
Credit: CDC/C. Goldsmith, P. Feorino, E. L. Palmer, W. R. McManus
"This is one important step on the path toward a permanent cure for
AIDS," says Kamel Khalili, PhD, Professor and Chair of the Department of
Neuroscience at Temple. Khalili and his colleague, Wenhui Hu, MD, PhD,
Associate Professor of Neuroscience at Temple, led the work which marks
the first successful attempt to eliminate latent HIV-1 virus from human
cells. "It's an exciting discovery, but it's not yet ready to go into
the clinic. It's a proof of concept that we're moving in the right
direction," added Dr. Khalili, who is also Director of the Center for
Neurovirology and Director of the Comprehensive NeuroAIDS Center at
Temple.
In a study published July 21 by the Proceedings of the National Academy of Sciences,
Khalili and colleagues detail how they created molecular tools to
delete the HIV-1 proviral DNA. When deployed, a combination of a
DNA-snipping enzyme called a nuclease and a targeting strand of RNA
called a guide RNA (gRNA) hunt down the viral genome and excise the
HIV-1 DNA. From there, the cell's gene repair machinery takes over,
soldering the loose ends of the genome back together -- resulting in
virus-free cells.
"Since HIV-1 is never cleared by the immune system, removal of the
virus is required in order to cure the disease," says Khalili, whose
research focuses on the neuropathogenesis of viral infections. The same
technique could theoretically be used against a variety of viruses, he
says.
The research shows that these molecular tools also hold promise as a
therapeutic vaccine; cells armed with the nuclease-RNA combination
proved impervious to HIV infection.
Worldwide, more than 33 million people have HIV, including more than 1
million in the United States. Every year, another 50,000 Americans
contract the virus, according to the U.S. Centers for Disease Control
and Prevention.
Although highly active antiretroviral therapy (HAART) has controlled
HIV-1 for infected people in the developed world over the last 15 years,
the virus can rage again with any interruption in treatment. Even when
HIV-1 replication is well controlled with HAART, the lingering HIV-1
presence has health consequences. "The low level replication of HIV-1
makes patients more likely to suffer from diseases usually associated
with aging," Khalili says. These include cardiomyopathy -- a weakening
of the heart muscle -- bone disease, kidney disease, and neurocognitive
disorders. "These problems are often exacerbated by the toxic drugs that
must be taken to control the virus," Khalili adds.
Researchers based the two-part HIV-1 editor on a system that evolved
as a bacterial defense mechanism to protect against infection, Khalili
says. Khalili's lab engineered a 20-nucleotide strand of gRNA to target
the HIV-1 DNA and paired it with Cas9. The gRNA targets the control
region of the gene called the long terminal repeat (LTR). LTRs are
present on both ends of the HIV-1 genome. By targeting both LTRs, the
Cas9 nuclease can snip out the 9,709-nucleotides that comprise the HIV-1
genome. To avoid any risk of the gRNA accidentally binding with any
part of the patient's genome, the researchers selected nucleotide
sequences that do not appear in any coding sequences of human DNA,
thereby avoiding off-target effects and subsequent cellular DNA damage.
The editing process was successful in several cell types that can
harbor HIV-1, including microglia and macrophages, as well as in
T-lymphocytes. "T-cells and monocytic cells are the main cell types
infected by HIV-1, so they are the most important targets for this
technology," Khalili says.
The HIV-1 eradication approach faces several significant challenges
before the technique is ready for patients, Khalili says. The
researchers must devise a method to deliver the therapeutic agent to
every single infected cell. Finally, because HIV-1 is prone to
mutations, treatment may need to be individualized for each patient's
unique viral sequences.
"We are working on a number of strategies so we can take the
construct into preclinical studies," Khalili says. "We want to eradicate
every single copy of HIV-1 from the patient. That will cure AIDS. I
think this technology is the way we can do it."
Journal Reference:
- W. Hu, R. Kaminski, F. Yang, Y. Zhang, L. Cosentino, F. Li, B. Luo, D. Alvarez-Carbonell, Y. Garcia-Mesa, J. Karn, X. Mo, K. Khalili. RNA-directed gene editing specifically eradicates latent and prevents new HIV-1 infection. Proceedings of the National Academy of Sciences, 2014; DOI: 10.1073/pnas.1405186111
Courtesy: ScienceDaily
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