TRIM5-CypA融合基因与北平顶猴易感HIV-1的机制研究

天然免疫分子TRIM5α（tripartite motif protein 5α）是近年来发现的一种重要的宿主细胞内逆转录病毒限制因子。在灵长类动物细胞中，TRIM5α蛋白可以在病毒进入细胞后、逆转录前的阶段抑制HIV-1、N-MLV和EIAV等逆转录病毒的复制。由于TRIM5α分子的作用，绝大部分旧大陆猴（Old World monkey）都不能感染HIV-1。而在新大陆猴（New World monkey）中，鹰猴是唯一不感染HIV-1的灵长类动物。研究证明，鹰猴细胞中存在的TRIM5-CypA融合蛋白（owl monkey TRIM5-CypA，omTRIMCyp）介导了抗HIV-1的作用，从而使鹰猴不能感染HIV-1。研究证明，平顶猴是旧大陆猴中唯一报道可以感染HIV-1的灵长类动物，但是其感染HIV-1的机制并不清楚。根据现行的灵长类动物分类学，原属平顶猴群体（M. nemestrina group）的三个亚种分为猕猴属的三个不同种：巽他平顶猴（Sunda pig-tailed macaque，M. nemestrina），北平顶猴（Northern pig-tailed macaque，M. leonina）和明打威猴（Mentawai macaque，M. pagensis）。本论文对中国云南境内北平顶猴TRIM5基因座和感染HIV-1的相关性进行了研究。通过PCR和测序对北平顶猴基因组TRIM5基因座进行分析，发现一个CypA假基因的cDNA通过逆转座机制插入至TRIM5基因座的3’-UTR区域，形成了一个不同于鹰猴TRIM5-CypA的新型融合基因npmTRIMCyp（northern pig-tailed macaque TRIM5-CypA）。通过RT-PCR对npmTRIMCyp融合基因的转录本进行分析，我们鉴定出npmTRIMCyp共有3种不同的选择性剪接产物，分别为npmTRIMCypV1-V3。进一步克隆和测序这3种不同选择性剪接体，通过丰度和序列分析证实：npmTRIMCypV2是优势剪接体，可能在该融合基因产物的功能中发挥作用。研究发现北平顶猴npmTRIMCyp融合基因主要转录本中外显子7和8均被剪切掉。外显子7剪接丢失机制源于TRIM5第6内含子内 3’剪接位点的G/T突变。我们克隆了npmTRIMCyp融合基因cDNA的蛋白编码区ORF，并构建了重组表达npmTRIMCyp的载体，转染HeLa和HeLa-T4细胞并获得稳定表达的细胞株。通过感染HIV-1证实，npmTRIMCyp融合蛋白不能够限制HIV-1的感染和复制，这可能是北平顶猴作为旧大陆猴中唯一对HIV-1易感的灵长类动物的重要分子机制之一。通过HIV-1感染灵长类动物PBMCs实验证实，北平顶猴可以感染HIV-1。npmTRIMCyp可以有效地限制HIV-2ROD的复制，但对SIVmac239只有十分微弱的限制活性。通过构建鹰猴omTRIMCyp和北平顶猴npmTRIMCyp的置换剪接体（SWAP-1和SWAP-2），转染融合基因及其置换剪接体的CRFK细胞激光共聚焦实验证明，npmTRIMCyp、SWAP1和SWAP2在细胞内主要存在于胞浆中。稳定表达融合蛋白和置换剪接体的CRFK细胞感染HIV-1-GFP-VSVG分析表明，含omTRIMCyp外显子7的SWAP-1和SWAP-2均具有限制HIV-1活性，但SWAP-1的活性更强一些，这表明TRIM5结构域的外显子7可能在介导对HIV-1的限制活性中发挥了协同辅助作用。免疫共沉淀研究表明，npmTRIMCyp不能识别和结合HIV-1的衣壳蛋白。对北平顶猴中介导识别逆转录病毒区域的基因组部分进行了测序，共鉴定出46个多态性位点，表明在北平顶猴识别逆转录病毒衣壳区域存在较高的多态性。

1、喜树碱类衍生物抗HIV构效关系与作用机制研究2、HIV/AIDS患者疱疹病毒感染状况及性病患者的HIV感染状况分析

1、喜树碱类衍生物抗HIV构效关系与作用机制研究 喜树碱为传统的抗肿瘤药物。本研究对经过化学结构修饰的喜树碱类衍生物进行抗HIV活性及作用机制的研究，并初步探讨了其抗HIV构效关系。 我们对喜树碱类衍生物A系列化合物A1(喜树碱)、A2(10-羟基喜树碱)及A3(7-羟基喜树碱)进行了抗HIV活性检测。化合物A1和A3有较好的抗HIV-1和抗HIV-2活性，化合物A2没有显示抗HIV活性。表明化合物A1的C-10位上-OH基团修饰可能会降低抗HIV活性，化合物A1的C-7位上-CH2OH基团修饰和C-20位-CH3缺失可能会提高其抗HIV活性。对化合物A3和A1的抗HIV机制研究发现：二者对整合酶有一定的结合活性，对慢性感染H9/HIV-1ⅢB 和Jurkat/HIV-1ⅢB细胞中病毒复制没有抑制活性、不能阻断H9/HIV-1ⅢB与正常细胞间的融合，对重组的HIV-1蛋白酶和逆转录酶没有抑制活性。化合物A1和A3不具有选择性杀伤HIV-1ⅢB慢性感染的H9和Jurkat细胞系的作用。进一步进行化合物A3诱导 H9和H9/HIV-1ⅢB、Jurkat和Jurkat/HIV-1ⅢB的凋亡实验显示，化合物A3诱导感染HIV-1ⅢB和未感染病毒细胞的凋亡没有选择性。据此我们初步认为化合物A3和A1的抗HIV作用可能与抑制整合酶活性有关，该化合物可能还作用于其它靶点。 喜树碱类衍生物B系列中化合物B1为20(S)-O - [-O-( 1'-氧基-2',2',6',6'-四甲基哌啶-4'-丁二酸)]-20-喜树碱酯，化合物B2为20(S)-O - [-N-( 1'-氧基-2',2',6',6'-四甲基-1',2',5',6'-四氢吡啶酰胺)-4'-丙氨酸)]-20-喜树碱酯)。我们对化合物B1和B2进行了抗HIV活性检测。结果显示：化合物B2有较好的抗HIV-1和抗HIV-21、喜树碱类衍生物抗HIV构效关系与作用机制研究 喜树碱为传统的抗肿瘤药物。本研究对经过化学结构修饰的喜树碱类衍生物进行抗HIV活性及作用机制的研究，并初步探讨了其抗HIV构效关系。 我们对喜树碱类衍生物A系列化合物A1(喜树碱)、A2(10-羟基喜树碱)及A3(7-羟基喜树碱)进行了抗HIV活性检测。化合物A1和A3有较好的抗HIV-1和抗HIV-2活性，化合物A2没有显示抗HIV活性。表明化合物A1的C-10位上-OH基团修饰可能会降低抗HIV活性，化合物A1的C-7位上-CH2OH基团修饰和C-20位-CH3缺失可能会提高其抗HIV活性。对化合物A3和A1的抗HIV机制研究发现：二者对整合酶有一定的结合活性，对慢性感染H9/HIV-1ⅢB 和Jurkat/HIV-1ⅢB细胞中病毒复制没有抑制活性、不能阻断H9/HIV-1ⅢB与正常细胞间的融合，对重组的HIV-1蛋白酶和逆转录酶没有抑制活性。化合物A1和A3不具有选择性杀伤HIV-1ⅢB慢性感染的H9和Jurkat细胞系的作用。进一步进行化合物A3诱导 H9和H9/HIV-1ⅢB、Jurkat和Jurkat/HIV-1ⅢB的凋亡实验显示，化合物A3诱导感染HIV-1ⅢB和未感染病毒细胞的凋亡没有选择性。据此我们初步认为化合物A3和A1的抗HIV作用可能与抑制整合酶活性有关，该化合物可能还作用于其它靶点。 喜树碱类衍生物B系列中化合物B1为20(S)-O - [-O-( 1'-氧基-2',2',6',6'-四甲基哌啶-4'-丁二酸)]-20-喜树碱酯，化合物B2为20(S)-O - [-N-( 1'-氧基-2',2',6',6'-四甲基-1',2',5',6'-四氢吡啶酰胺)-4'-丙氨酸)]-20-喜树碱酯)。我们对化合物B1和B2进行了抗HIV活性检测。结果显示：化合物B2有较好的抗HIV-1和抗HIV-2活性，而化合物B1的抗HIV活性差。表明化合物B1的C-4’位-CH2被-NH取代，同时C-3’位-CH3修饰可能会提高其抗HIV活性。对化合物B2的抗HIV机制研究发现，化合物B2对慢性感染H9/HIV-1ⅢB细胞中病毒复制没有抑制活性、不能阻断H9/HIV-1ⅢB与正常细胞间的融合，对HIV-1蛋白酶、重组的HIV-1逆转录酶及整合酶没有抑制活性。化合物B2不具有选择性杀伤HIV-1ⅢB慢性感染的H9细胞系的作用。化合物B2抗HIV的作用机制还需进一步研究。 2、HIV/AIDS患者疱疹病毒感染状况及性病患者的HIV感染状况分析 疱疹病毒是AIDS患者合并感染的常见病原体。引起人类疾病的8种疱疹病毒与HIV感染及AIDS进展、机会性感染、恶性肿瘤密切相关。为了解HIV/AIDS患者人类8型疱疹病毒感染状况，我们检测了30例AIDS患者、40例HIV携带者及70例正常对照的液标本中8型疱疹病毒感染状况。采用ELISA法检测单纯疱疹病毒1型(HSV-1)、单纯疱疹病毒2型(HSV-2)、水痘-带状疱疹病毒(VZV)和巨细胞病毒(CMV)；采用PCR法检测EB病毒(EBV)、疱疹病毒6型(HHV-6)、疱疹病毒7型(HHV-7)及疱疹病毒8型(HHV-8)。结果显示，HIV/AIDS患者中HSV-1、HSV-2、VZV、CMV、HHV-6、HHV-8 阳性率均高于健康体检者，其中AIDS患者VZV感染率与HIV携带者有显著性差异；在AIDS患者中多种疱疹病毒共感染普遍存在，必须重视HIV/AIDS患者合并疱疹病毒感染的防治。 性病可促进HIV的传播，了解性病患者的HIV感染状况及临床特征具有重要的意义。在自愿接受HIV咨询检测的基础上，对临床确诊的412例性病患者进行HIV-1/2抗体检测，并对其临床特征进行分析研究。结果显示412例性病患者的HIV检出率为2.9%。性病患者中检出HIV阳性率依次为：尖锐湿疣(6.2%)、生殖器疱疹(4.2%)、梅毒(3.4%)、淋病(1.5%)及非淋菌性尿道炎(1.0%)。83.3%合并感染HIV的性病患者存在多性伴，商业性行为普遍存在，安全套使用率极低现象。感染HIV的尖锐湿疣及生殖器疱疹患者以频繁复发为突出表现，1例合并感染HIV的梅毒患者半年即进展为神经梅毒。性病患者是HIV感染的重要高危人群，危险性行为是其感染HIV和其它性病的主要原因，应该加强性病患者的HIV检测。对临床上频繁复发的尖锐湿疣及生殖器疱疹患者、快速进展的梅毒患者应高度怀疑合并HIV感染的可能。

HIV-1 C亚型gp120重组腺病毒载体的构建及gp120负载人树突状细胞疫苗的初步研究

获得性免疫缺陷综合征(AIDS)是一种由人类免疫缺陷病毒(HIV)引起的，以全身免疫系统受到严重损害为特征的传染性疾病。从目前HIV-1的流行趋势来看，HIV-1 C亚型已经成为全球最主要的流行株之一，因此，针对HIV-1 C亚型的疫苗设计颇为重要。gp120作为HIV-1的包膜糖蛋白，能够诱导广泛的中和抗体反应，中和进入机体的病毒粒子，阻止病毒早期感染，所以本实验选取HIV-1 C亚型密码子优化的gp120作为免疫原进行研究。目前的疫苗研究中，腺病毒载体是较理想的病毒载体之一，具有安全性好、外源基因容纳量大、感染效率高、操作简便等优点。我们以复制缺陷型腺病毒为载体，构建了表达HIV-1 C亚型密码子优化的gp120的重组腺病毒vAd-gp120，经Western Blot方法检测到了gp120蛋白的表达。树突状细胞（DC）是已知最强的抗原呈递细胞(APC)，也是目前发现的唯一能够刺激初始型T细胞增殖的细胞。经抗原致敏的DC可通过MHC-Ⅰ、MHC-Ⅱ途径递呈抗原，并激活T细胞，从而激发体内的体液免疫和特异性细胞免疫反应。我们利用Amaxa系统将HIV-1 C亚型gp120基因转入人外周血单核细胞来源的DC，构建了以DC为载体的治疗性疫苗，并对其功能进行初步研究，发现负载gp120的DC能够显著刺激淋巴细胞的增殖、增强CD8T细胞表面活化分子CD25的表达以及促进CD8T细胞分泌++IFN-γ，为下一步DC治疗性疫苗的体内研究奠定了基础。

青蒿素衍生物和某些天然化合物抗HIV-1活性的研究

对生活在发展中国家的90%以上的HIV感染者而言，现有FDA已批准的抗HIV药物的价格十分昂贵。中国也是发展中国家，但HIV感染者已遍布全国，其数量正急剧增长，这必将对生产力和国民经济建设产生严重影响。为预防艾滋病蔓延，我们在进行宣传教育的同时，务必研制开发有我国特色的、高效的、便宜的抗HIV药物。因此，我们在抗猴逆转录D型病毒（SRV1）活性研究基础上，对SM458等24个青蒿素衍生物进行了抗HIV-1活性的深入研究。同时，为充分利用我国丰富的自然资源，我们还研究了20个天然化合物和中草药配方。除应用MTT比色法外，我们还采用了另外3种体外抗HIV-1活性研究的实验，如合胞体形成抑制，间接免疫荧光法（IFA），p24半定量ELISA等。此外，我们还研究了SM458、SM486和肝龙与AZT的协同作用，并进一步重复了SM458和SM486抗SRV1活性的研究。结果表明：AZT的抗SRV1/HIV-1活性十分显著，SM458和SM486 也有较高的抗SRV1活性，其选择指数均接近100；但除了SM458较稳定地表现微弱的抗HIV-1活性外，其它23个青蒿素衍生物没有活性；为初步探索SM458和SM486抗SRV1/HIV-1活性差异的机理，我们进行细胞融合阻断实验，结果表明其作用靶点并非融合。由此说明：SRV1虽然与HIV-1同属灵长类逆传录病毒，但以SRV1进行的抗病毒研究结果，不能完全与抗HIV-1的活性相符合，必须以直接用HIV-1所做的研究为依据。令人鼓舞的是，肝龙表现稳定的抗HIV-1活性，值得进一步深入研究。而其它19个样品中，仅桑黄素、桑白皮和GE-II表现很微弱的活性，JK028和V1-1-Na有待确证。SM458、SM486和肝龙与AZT无协同作用。

The chemical resolution of racemic cis-2-hydroxymethyl-5(cytosine-1 '-yl)-1,3-oxathiolane (BCH-189)-one direct method to obtain lamivudine as anti-HIV and anti-HBV agent

Racemic cis-BCH-189 can be resolved to (-)-enantiomer (lamivudine) and (+)-enantiomer by esterification of cis-2-hydroxymethyl-5-(N-4(')-acetylcytosine-1'-yl)-1,3-oxathiolane and (+)-menthyl chloroformate in CH3CN with pyridine as base. The two diastereomers of ester were seperated by recrystallization in methanol at 0degreesC. Lamivudine was obtained by deprotection of (-)-diastereomer with high yield.

具有抗HIV病毒活性的杂多酸HPA－23与谷胱甘肽的作用

以谷胱甘肽作为病毒包络蛋白的模拟物，用ＮＭＲ方法研究了与具有抗爱滋病病毒活性杂多酸ＨＰＡ－２３的作用．对不同配比的ＨＰＡ－２３和谷胱甘肽混合物的１Ｈ和１８３ＷＮＭＲ谱研究结果表明，还原型和氧化型谷胱甘肽均以Ｃ末端ＣＯＯ－与ＨＰＡ－２３骨架的钨原子配位，还原型谷胱甘肽侧链上的巯基（ＳＨ）也参加配位．ＣＯＳＹ谱证明了ＳＨ配位为慢交换反应．早在七十年代初，人们就发现杂多酸具有抗病毒活性［１，２］．最近报道［ＮＨ４］１８［ＮａＳｂ９Ｗ２１Ｏ８８］·２４Ｈ２Ｏ（结构代号为ＨＰＡ－２３）具有很高的抗爱滋病病毒活性，在法国已进入临床应用［３］．但从分子水平研究杂多酸化合物抗病毒的机理．目前尚未见到国内外报道．而作为病毒可以广义地看作由一个蛋白外壳包裹，内部则为核酸．爱滋病病毒同样由两层蛋白所包裹，与宿主细胞发生吸附作用主要是通过外层包络蛋白（ＧＰ１２０）［４］，该蛋白的活性组份是一个由８个氨基酸组成的Ｔ（Ａｌａ－Ｓｅｒ－Ｔｈｒ－Ｔｈｒ－Ｔｈｒ－Ａｓｎ－Ｔｙｒ－Ｔｈｎ）肽段［５］．我们以容易得到的三肽一谷胱甘肽作为病毒包络蛋白的模拟物，用ＮＭＲ方法研究杂多酸ＨＰＡ－２３与它的作用．结果表明还原型和氧化型谷胱甘肽均以Ｃ末端Ｃ

Toward a comprehensive care of HIV patients: Finding a strategy to detect depression in a Spanish HIV cohort

Depression is a common but frequently undiagnosed feature in individuals with HIV infection. To find a strategy to detect depression in a non-specialized clinical setting, the overall performance of the Hospital Anxiety and Depression Scale (HADS) and the depression identification questions proposed by the European AIDS Clinical Society (EACS) guidelines were assessed in a descriptive cross-sectional study of 113 patients with HIV infection. The clinician asked the two screening questions that were proposed under the EACS guidelines and requested patients to complete the HADS. A psychiatrist or psychologist administered semi-structured clinical interviews to yield psychiatric diagnoses of depression (gold standard). A receiver operating characteristic (ROC) analysis for the HADS-Depression (HADS-D) subscale indicated that the best sensitivity and specificity were obtained between the cut-off points of 5 and 8, and the ROC curve for the HADS-Total (HADS-T) indicated that the best cut-off points were between 12 and 14. There were no statistically significant differences in the correlations of the EACS (considering positive responses to one [A] or both questions [B]), the HADS-D ≥ 8 or the HADS-T ≥ 12 with the gold standard. The study concludes that both approaches (the two EACS questions and the HADS-D subscale) are appropriate depression-screening methods in HIV population. We believe that using the EACS-B and the HADS-D subscale in a two-step approach allows for rapid, assumable and accurate clinical diagnosis in non-psychiatric hospital settings.

HIV/AIDS and national security

McInnes, C., 'HIV/AIDS and national security', in: AIDS and Governance, N. Poku, A. Whiteside and B. Sandkjaer (eds.),(Aldershot: Ashgate, 2007), pp.93-111 RAE2008

Shifting the Burden of HIV/AIDS

As the economic burden of HIV/AIDS increases in sub-Saharan Africa, the allocation of the burden among levels and sectors of societies is changing. The private sector has greater scope than government, households, or NGOs to avoid the economic burden of AIDS, and a systematic shifting of the burden away from the private sector is underway. Common practices that shift the AIDS burden from businesses to households and government include pre-employment screening, reduced employee benefits, restructured employment contracts, outsourcing of less skilled jobs, selective retrenchments, and changes in production technologies. In South Africa, more than two thirds of large employers have reduced health care benefits or required larger contributions by employees. Most firms have replaced defined benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined contribution funds, which eliminate firm risk but provide little to families of younger workers who die of AIDS. Contracting out of previously permanent jobs also shields firms from costs while leaving households and government to care for affected workers and their families. Many of these changes are responses to globalization and would have occurred in the absence of AIDS, but they are devastating for employees with HIV/AIDS. This paper argues that the shifting of the economic burden of AIDS is a predictable response by business to which a thoughtful public policy response is needed. Countries should make explicit decisions about each sector’s responsibilities if a socially desirable allocation is to be achieved.

Rationing Antiretroviral Therapy for HIV/AIDS in Africa: Efficiency, Equity, and Reality

Background: Rationing of access to antiretroviral therapy already exists in sub-Saharan Africa and will intensify as national treatment programs develop. The number of people who are medically eligible for therapy will far exceed the human, infrastructural, and financial resources available, making rationing of public treatment services inevitable. Methods: We identified 15 criteria by which antiretroviral therapy could be rationed in African countries and analyzed the resulting rationing systems across 5 domains: clinical effectiveness, implementation feasibility, cost, economic efficiency, and social equity. Findings: Rationing can be explicit or implicit. Access to treatment can be explicitly targeted to priority subpopulations such as mothers of newborns, skilled workers, students, or poor people. Explicit conditions can also be set that cause differential access, such as residence in a designated geographic area, co-payment, access to testing, or a demonstrated commitment to adhere to therapy. Implicit rationing on the basis of first-come, first-served or queuing will arise when no explicit system is enforced; implicit systems almost always allow a high degree of queue-jumping by the elite. There is a direct tradeoff between economic efficiency and social equity. Interpretation: Rationing is inevitable in most countries for some period of time. Without deliberate social policy decisions, implicit rationing systems that are neither efficient nor equitable will prevail. Governments that make deliberate choices, and then explain and defend those choices to their constituencies, are more likely to achieve a socially desirable outcome from the large investments now being made than are those that allow queuing and queue-jumping to dominate.

Treatment of HIV/AIDS at South Africa's Largest Employers: Myth and Reality

Background: In the past three years, many large employers in South Africa have announced publicly their intention of making antiretroviral treatment (ART) available to employees. Reports of the scope and success of these programs have been mostly anecdotal. This study surveyed the largest private sector employers in South Africa to determine the proportion of employees with access to ART through employer-sponsored HIV/AIDS treatment programs. Methods: All 64 private sector and parastatal employers in South Africa with more than 6,000 employees were identified and contacted. Those that agreed to participate were interviewed by telephone using a structured questionnaire. Results: 52 companies agreed to participate. Among these companies, 63% of employees had access to employer-sponsored care and treatment for HIV/AIDS. Access varied widely by sector, however. Approximately 27% of suspected HIV-positive employees were enrolled in HIV/AIDS disease management programs, or 4.4% of the workforce overall. Fewer than 4,000 employees in the entire sample were receiving antiretroviral therapy. In-house (employer) disease management programs and independent disease management programs achieved higher uptake of services than did medical aid schemes. Conclusions: Publicity by large employers about their treatment programs should be interpreted cautiously. While there is a high level of access to treatment, uptake of services is low and only a small fraction of employees medically eligible for antiretroviral therapy are receiving it.

The Private Sector and HIV/AIDS in Africa: Taking Stock of Six Years of Applied Research

Background: Until recently, little was known about the costs of the HIV/AIDS epidemic to businesses in Africa and business responses to the epidemic. This paper synthesizes the results of a set of studies conducted between 1999 and 2006 and draws conclusions about the role of the private sector in Africa’s response to AIDS. Methods: Detailed human resource, financial, and medical data were collected from 14 large private and parastatal companies in South Africa, Uganda, Kenya, Zambia, and Ethiopia. Surveys of small and medium-sized enterprises (SMEs) were conducted in South Africa, Kenya, and Zambia. Large companies’ responses or potential responses to the epidemic were investigated in South Africa, Uganda, Kenya, Zambia, and Rwanda. Results: Among the large companies, estimated workforce HIV prevalence ranged from 5%¬37%. The average cost per employee lost to AIDS varied from 0.5-5.6 times the average annual compensation of the employee affected. Labor cost increases as a result of AIDS were estimated at anywhere from 0.6%-10.8% but exceeded 3% at only 2 of 14 companies. Treatment of eligible employees with ART at a cost of $360/patient/year was shown to have positive financial returns for most but not all companies. Uptake of employer-provided testing and treatment services varied widely. Among SMEs, HIV prevalence in the workforce was estimated at 10%-26%. SME managers consistently reported low AIDS-related employee attrition, little concern about the impacts of AIDS on their companies, and relatively little interest in taking action, and fewer than half had ever discussed AIDS with their senior staff. AIDS was estimated to increase the average operating costs of small tourism companies in Zambia by less than 1%; labor cost increases in other sectors were probably smaller. Conclusions: Although there was wide variation among the firms studied, clear patterns emerged that will permit some prediction of impacts and responses in the future.