Role of T-cell reconstitution in HIV-1 antiretroviral therapy-induced bone loss

Ighovwerha Ofotokun (), Kehmia Titanji, Tatyana Vikulina, Susanne Roser-Page, Masayoshi Yamaguchi, Majd Zayzafoon, Ifor R. Williams and M. Neale Weitzmann ()
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Ighovwerha Ofotokun: Emory University School of Medicine
Kehmia Titanji: Emory University School of Medicine
Tatyana Vikulina: Emory University School of Medicine
Susanne Roser-Page: Atlanta Department of Veterans Affairs Medical Center
Masayoshi Yamaguchi: Emory University School of Medicine
Majd Zayzafoon: University of Alabama at Birmingham
Ifor R. Williams: Emory University School of Medicine
M. Neale Weitzmann: Emory University School of Medicine

Nature Communications, 2015, vol. 6, issue 1, 1-15

Abstract: Abstract HIV infection causes bone loss. We previously reported that immunosuppression-mediated B-cell production of receptor activator of NF-κB ligand (RANKL) coupled with decline in osteoprotegerin correlate with decreased bone mineral density (BMD) in untreated HIV infection. Paradoxically, antiretroviral therapy (ART) worsens bone loss although existing data suggest that such loss is largely independent of specific antiretroviral regimen. This led us to hypothesize that skeletal deterioration following HIV disease reversal with ART may be related to T-cell repopulation and/or immune reconstitution. Here we transplant T cells into immunocompromised mice to mimic ART-induced T-cell expansion. T-cell reconstitution elicits RANKL and TNFα production by B cells and/or T cells, accompanied by enhanced bone resorption and BMD loss. Reconstitution of TNFα- or RANKL-null T-cells and pharmacological TNFα antagonist all protect cortical, but not trabecular bone, revealing complex effects of T-cell reconstitution on bone turnover. These findings suggest T-cell repopulation and/or immune reconstitution as putative mechanisms for bone loss following ART initiation.

Date: 2015
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DOI: 10.1038/ncomms9282

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