Cutting edge: persistent viral infection prevents tolerance induction and escapes immune control following CD28/CD40 blockade-based regimen

MA Williams, TM Onami, AB Adams… - The Journal of …, 2002 - journals.aai.org
MA Williams, TM Onami, AB Adams, MM Durham, TC Pearson, R Ahmed, CP Larsen
The Journal of Immunology, 2002journals.aai.org
A continuing concern with CD28 and/or CD40 blockade-based strategies to induce
tolerance and mixed chimerism is their potential to disrupt protective immunity to preexisting
infections. In this report, we find that preexisting persistent infection with lymphocytic
choriomeningitis virus (LCMV) clone 13 prevents the induction of tolerance, mixed
chimerism, and donor-reactive T cell deletion. Mice continue to be refractory to tolerance
induction even after viremia has been resolved and virus is present only at very low levels in …
Abstract
A continuing concern with CD28 and/or CD40 blockade-based strategies to induce tolerance and mixed chimerism is their potential to disrupt protective immunity to preexisting infections. In this report, we find that preexisting persistent infection with lymphocytic choriomeningitis virus (LCMV) clone 13 prevents the induction of tolerance, mixed chimerism, and donor-reactive T cell deletion. Mice continue to be refractory to tolerance induction even after viremia has been resolved and virus is present only at very low levels in peripheral tissues. Conversely, we find that the full tolerance regimen, or costimulation blockade alone, specifically inhibits already ongoing antiviral immune responses, leading to an inability to control viremia. These findings suggest that ongoing T cell responses continue to depend on costimulatory interactions in the setting of a chronic infection and provide insight into potential risks following costimulation blockade posed by chronic or latent viral infections such as hepatitis C, EBV, and CMV.
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