HIV-1 infection and AIDS dementia are influenced by a mutant MCP-1 allele linked to increased monocyte infiltration of tissues and MCP-1 levels.
Studies in humans and in experimental models of HIV-1 infection indicate an important role for monocyte chemoattractant protein-1 (MCP-1; also known as CC chemokine ligand 2), a potent chemoattractant and activator of mononuclear phagocytes (MP) in the pathogenesis of HIV-associated dementia (HAD). We determined the influence of genetic variation in MCP-1 on HIV-1 pathogenesis in large cohorts of HIV-1-infected adults and children. In adults, homozygosity for the MCP-1 -2578G allele was associated with a 50% reduction in the risk of acquiring HIV-1. However, once HIV-1 infection was established, this same MCP-1 genotype was associated with accelerated disease progression and a 4.5-fold increased risk of HAD. We examined the molecular and cellular basis for these genotype-phenotype associations and found that the mutant MCP-1 -2578G allele conferred greater transcriptional activity via differential DNA-protein interactions, enhanced protein production in vitro, increased serum MCP-1 levels, as well as MP infiltration into tissues. Thus, MCP-1 expression had a two-edged role in HIV-1 infection: it afforded partial protection from viral infection, but during infection, its proinflammatory properties and ability to up-regulate HIV-1 replication collectively may contribute to accelerated disease progression and increased risk of dementia. Our findings suggest that MCP-1 antagonists may be useful in HIV-1 infection, especially for HAD, and that HIV+ individuals possessing the MCP-1 -2578G allele may benefit from early initiation of antiretroviral drugs that effectively cross the blood-brain barrier. In a broader context, the MCP-1 -2578G allele may serve as a genetic determinant of outcome of other disease states in which MP-mediated tissue injury is central to disease pathogenesis.
Gonzalez
Enrique
E
Veterans Administration Research Center for AIDS and HIV-1 Infection and University of Texas Health Science Center, San Antonio, TX 78229, USA.
Rovin
Brad H
BH
Sen
Luisa
L
Cooke
Glen
G
Dhanda
Rahul
R
Mummidi
Srinivas
S
Kulkarni
Hemant
H
Bamshad
Michael J
MJ
Telles
Vanessa
V
Anderson
Stephanie A
SA
Walter
Elizabeth A
EA
Stephan
Kevin T
KT
Deucher
Michael
M
Mangano
Andrea
A
Bologna
Rosa
R
Ahuja
Seema S
SS
Dolan
Matthew J
MJ
Ahuja
Sunil K
SK
D015526:AIDS Dementia Complex / Q000235:genetics* / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000483:Alleles; D018932:Chemokine CCL2 / Q000235:genetics* / Q000378:metabolism; D002648:Child; D015331:Cohort Studies; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000235:genetics* / Q000378:metabolism / Q000473:pathology*; D015497:HIV-1; D006239:Haplotypes; D006801:Humans; D009000:Monocytes / Q000473:pathology*; D009154:Mutation; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D012307:Risk Factors
D018932:Chemokine CCL2