AIDS virus-neutralizing antibody induction reciprocal to a PI3K gain-of-function disease

Reviewer #1 (Public Review):

This work describes the induction of SIV-specific NAb responses in rhesus macaques infected with SIVmac239, a neutralization-resistant virus. Typically, host NAb responses are not detected in animals infected with SIVmac239. In this work, seventy SIVmac239-infected macaques were retrospectively screened for NAb responses and a subset of nine animals were identified as NAb-inducers. The viral genomes from 7/9 animals that induced NAb responses were found to encode nonsynonymous mutation in the Nef gene (amino acid G63E). In contrast, Nef G63E mutation was found only in 2/19 NAb non-inducers - implicating that the Nef G63E mutation is selected in NAb inducers. Measurement of Nef G63E frequencies in plasma viruses suggested that Nef G63E selection preceded NAb induction. Nef G63E mutation was found to mediate escape from Nef-specific CD8+ T-cell responses. To examine the functional phenotype of Nef G63E mutant, its effect on downmodulation of Nef-interacting host proteins was examined. Infection of rhesus and cynomolgus macaque CD4+ T cell lines with WT or Nef G63E mutant SIV suggested that Nef mutant reduces S473 phosphorylation of AKT. Using flow cytometry-based proximity ligation assay, it was shown that Nef G63E mutation reduced binding of Nef to PI3K p85/p110 and mTORC2 GβL/mLST8 and MTOR components - kinase complex responsible AKT-S473 phosphorylation. In vitro B-cell Nef invasion and in vivo imaging/flow cytometry-based assays were employed to suggest that Nef from infected cells can target Env-specific B cells. Lastly, it was determined that NAb inducers have significantly higher Env-specific B-cells responses after Nef G63E selection when compared to NAb non-inducers. Finally, a corollary was drawn between the Nef G63E-associated B-cell/NAb induction phenotype and activated PI3K delta syndrome (APDS), which is caused by activating GOF mutations in PI3K, to suggest that Nef G63E-meidated induction of NAb response is reciprocal to APDS.

Strengths:
This study aims to understand the viral-host interaction that governs NAb induction in SIVmac239-infected macaques - this could enable identification of determinants important for induction of NAb responses against hard-to-neutralize tier-2/3 HIV variants. The finding that SIV-specific B-cell responses are induced following Nef G63E CD8+ T-cell escape mutant selection argue for an evolutionary trade-off between CTL escape and NAb induction. Exploitation of such a cellular-humoral immune axis could be important for HIV/AIDS vaccine efforts.

Although more validation and mechanistic basis are needed, the corollary between PI3K hyperactive signaling during autoimmune disorders and Nef-mediated abrogated PI3K signaling could help identify novel targets and modalities for targeting immune disorders and viral infections.

Weaknesses:
Although the paper does have strengths in principle, the weaknesses of the paper are that the mechanistic basis of Nef-mediated induction of NAb responses are not directly examined. For example, it remains unclear whether SIVmac239 with engineered G63E mutation in Nef would induce faster and potent NAb responses. A macaque challenge study is needed to address this point.

As presented, the central premise of the paper involves infected cell-generated Nef (WT or G63E mutant) being targeted to adjacent Env-specific B cells. However, it remains unclear how this is transfer takes place. A direct evidence demonstrating CD4+ T cell-associated and/or cell-free Nef being transferred to B-cell is needed to address this concern.

The interaction between Nef and PI3K signaling components (p85, p110, GβL/mLST8, and MTOR) has been explored using PLA assay, however, this requires validation using additional biochemical and/or immunoprecipitation-based approaches. For example, is Nef (WT or mutant form) sufficient to affect PI3K-induced phosphorylation of Akt in an in vitro kinase assay? Moreover, the details regarding the binding events of WT vs mutant Nef with PI3K signaling components is lacking in this study. Lastly, it is unclear whether the interaction of Nef with PI3K signaling components is a conserved function of all primate lentiviruses or is this SIV-specific phenotype.

It has been previously reported that the region of Nef encoding glycine at position 63 is not conserved in HIV-1 (Schindler et al, Journal of Virology 2004). Thus, does HIV-1 Nef also function in induction of NAb responses in humans? or the observed phenotype specific to SIV?

Reviewer #2 (Public Review):

It is well known that human and simian immunodeficiency viruses (HIV and SIV, respectively) evolved numerous mechanisms to compromise effective immune responses but the underlying mechanisms remain incompletely understood. Here, Yamamoto and Matano examined the humoral immune response in a large number of rhesus macaques infected with the difficult-to-neutralize SIVmac239 strain. They identified a subgroup of animals that showed significant neutralizing Ab responses. Sequence analyses revealed that in most of these animals (7/9) but only a minority in the control group (2/19) SIVmac variants containing a CD8+ T-cell escape mutation of G63E/R in the viral Nef gene emerged. They further show that this change attenuates the ability of Nef to stimulate PI3K/Akt/mTORC2 signaling. The authors propose that this induction of SIVmac239 nAb induction is reciprocal to antibody dysregulation caused by a previously identified human PI3K gain-of-function (Ref). Altogether, the results suggest that PI3K signaling plays a key role in B-cell maturation and generation of effective nAb responses.

Strengths of the study are that the authors analyzed a large number of SIVmac-infected macaques to unravel the biological significance of the known effect of the interaction of Nef with PI3K/Akt/mTORC2 signaling. This is interesting and may provide a novel means to improve humoral immune responses to HIV. Weaknesses are that only G63E and not G63R that also emerged in most animals was examined in most functional assays. Some effects of the G63E mutation seem modest and comparison to a grossly nef-defective SIVmac construct would be desirable to better assess to impact of the mutation of Nef-mediated stimulation of PI3K. While the impact of this Nef mutations on PI3K and the association with improved nAb responses is largely convincing, the results on the potential impact of soluble Nef on neighboring B cells is much less clear. SIVmac239 infects and manipulates helper CD4 T cells and these are essential for the activation and differentiation of B cells into antibody-producing plasma cells and effective humoral immune responses. Without additional functional evidence that Nef indeed specifically targets and manipulated B cells these results and conclusions should be made with much greater caution. Finally, the presentation of the results and conclusions is partly very convoluted and difficult to comprehend. Editing to improve clarity is highly recommended.