Supplementary MaterialsSupplemental Digital Content aids-32-2279-s001. cells and CD206+ alveolar macrophages [20] were FACS-sorted using a BD-Aria cell-sorter to obtain highly pure populations for HIV-DNA/RNA quantifications. Of note, due to the variable and limited CD4+ T-cell quantities recovered from BAL, these measurements were not performed in all participants (Supplementary 1). HIV-DNA/RNA quantifications We measured the frequency of cells harboring total HIV-DNA (copies per million cells) using a well established assay (sensitivity of 1 1 copy/PCR reaction) [4,21] with minor modifications to the original protocol. Notably, DNA from PBMCs, matched BAL cell pellets and biopsies was extracted using the QIAamp DNA mini kit (Qiagen, Hilden, Germany) before being subjected to PCR amplification. Cell-associated HIV-RNA was quantified by ultrasensitive RT-PCR, as described previously [22]. Detailed methodology is described in Supplementary 2. Flow cytometry Multicolor flow cytometry was performed on PBMCs and BAL cells. A viability dye kit (Invitrogen, Life Technologies LTX-315 Corporation, Eugene, Oregon, USA) was used to exclude deceased cells through the CMH-1 analysis. Rate of recurrence of naive, central memory space, effector memory, differentiated terminally, and senescent T cells had been assessed on LTX-315 live Compact disc4+ T cells by Compact disc28/Compact disc45RA/Compact disc57 manifestation. Regulatory T cells (Tregs) had been LTX-315 defined as Compact disc4+Compact disc127lowCD25+FoxP3+ and manifestation of immunosuppressive ectonucleotidases Compact disc39/Compact disc73 was also evaluated. T-helper (Th) subsets had been dependant on CCR4/CCR6/CXCR3. Activated cells had been identified as Compact disc38+HLA-DR+. HIV co-receptor CCR5 was assessed. Finally, Compact disc32a as well as the connected Immunoglobulin G (check was useful for unpaired factors. Spearman’s rank relationship coefficient was computed for relationship analyses. Results Research human population Twenty-four HIV+ and eight HIV-negative (HIV?) adults had been signed up for this scholarly research as referred to in Desk ?Supplementary and Table11 4. Seven HIV+ and something HIV? participants had been current cigarette smokers. At the least three years of HIV suppression was chosen because the amount of HIV-infected cells, as determined by HIV-DNA levels in CD4+ T cells, typically declines LTX-315 during the initial 1 to 3 years of ART then reaches a stable level that does not decline further during subsequent treatment [23]. Table 1 Patient characteristics at time of bronchoscopy. (%)19 (79%)8 (100%)Ethnicity, (%)?Caucasian17 (71%)8 (100%)?Black/Caribbean3 (13%)0 (0%)?Black/African2 (8%)0 (0%)?Hispanic2 (8%)0 (%)HIV-related factorsDuration of HIV infection, years (median, IQR)15 (12, 25)CDuration of time since undetectable plasma viral loada, years (median, IQR)9 (4, 10)CAntiretroviral regimen, (%)b?Integrase inhibitor16 (67%)C?NNRTI4 (17%)?PI6 (25%)CD4+ cell count (cells/l), median (IQR)558 (430,876)536 (305,610)CD4 percentage, median (IQR)32 (27, 37)41 (37, 46)CD4/CD8 ratio0.7 (0.60, 0.97)2.35 (2.13, 3.23)Nadir CD4+ cell count (cells/l), median (IQR)232 (136, 288)CNadir CD4 percentage, median (IQR)17 (12, 27)CComorbiditiesHypertension7 (29%)2 (25%)Dyslipidemia7 (29%)0 (0%)Diabetes8 (33%)1 (13%)Previous pulmonary tuberculosis0 (0%)0 (0%)Previous pneumonia1 (4%)0 (0%)Lifestyle factorsTobacco smoker, (%)?Current7 (29%)1 (13%)?Ever12 (50%)2 (25%)?Never12 (50%)6 (75%)Cannabis smoker, (%)?Current2 (8%)2 (25%) Open in a separate window IQR, interquartile range; NNRTI, nonnucleoside reverse transcriptase inhibitor; PI, protease inhibitor. aundetectable viral load defined as blow 40 HIV RNA copies/ml. bOne patient was on a regimen containing both an integrase inhibitor and protease inhibitor; 1 patient was on a regimen containing both an integrase inhibitor and NNRTI. HIV persists in the lungs of antiretroviral therapy-treated individuals Ultrasensitive real-time PCR was performed to quantify the frequency of infected cells in matched BAL cells, bronchial biopsies and PBMCs (Supplementary 5). The levels of HIV-DNA (copies/106 cells) were significantly higher in total BAL cells compared to PBMCs and to bronchial biopsies (mean??SEM 3910??2396 versus 296.9??68.68, PBMCs in both groups (HIV+: 52.7??4.8 versus 6.79??11.3%, observed that, in contrast to the gut, Th17 cells were not preferentially lost from BAL of HIV-infected individuals [45]. Considering the limitations in performing HIV reservoir measurement on rare cell subsets from the lungs, whether lung-infiltrating Th17 cells comprise HIV reservoirs in the lungs remains an open question. We previously showed that higher levels of immunosuppressive Tregs and imbalance of effector T cells and Tregs in blood and gut mucosa are.