Cytotoxic T-lymphocytes (CTLs) play a crucial role in the control of HIV infection. Unfortunately, HIV possesses an arsenal of mutational and non-mutational strategies that aid it in escaping from the CTL response mounted against it by its host
1,2. One of the most worrying of these defenses, particularly for those working on vaccine design, is that HIV is readily able to vary the sequence of its HLA-I-restricted antigens
3, allowing CTL escape by a number of mechanisms
4. The most effective way for HIV to escape from CTL surveillance is to avoid displaying HLA-I-associated antigens on the surface of infected cells. While this can be achieved in part by Nef-mediated down-regulation of HLA-I, such an escape strategy has the potential to leave infected cells prone to attack by Natural Killer cells
2,5. HIV can also prevent the display of its antigens without affecting HLA-I expression by deleting its epitopes, altering the residues that anchor peptides to HLA-I, or by mutating to interfere with other aspects of the HLA-I presentation
4. Some epitopes do not escape in this way but remain presented on the cell surface in mutated forms that interfere with recognition by anti-viral T-cell receptors (TCRs)
1,4,6. However, studies in both the SIV macaque model and of natural HIV infection have ascertained that immunodeficiency viruses incur a fitness cost when they escape from some CTL responses
7-10. Patients that target the virus through these epitopes exhibit better viral control and an increased life expectancy
9. As a result, there remains hope that at least three strategies of attacking HIV via its HLA-I-associated antigens may prove useful in containing the disease when used in combination with other therapies. First, HLA-I associated antigens, from parts of the virus that are biologically constrained and therefore unable to mutate, might be targeted. Second, interventions could be designed to target epitopes where escape results in a reduction in viral fitness. A third ‘disguise detection’ strategy might target epitopes that remain on the surface of infected cells albeit in mutated form. The success of this latter strategy would be dependent on being able to also target the common variants that arise to escape from recognition by host TCRs.
Here, we test the feasibility of a ‘disguise detection’ strategy to control HIV infection using the HLA-A*02-restricted, HIV p17 Gag-derived (amino acids 77-85) antigen SLYNTVATL (SL9). This antigen is an attractive candidate for targeting virally infected cells for several reasons. First, HLA-A*02 is the most common HLA-I allele in western populations such that this epitope might be useful for viral targeting in almost half of the population. Second, 75% of HLA-A*02
+ individuals mount a CTL response against SL9
11-13 suggesting that the epitope is efficiently processed. Third, the SL9 peptide sequence may be under strict biological constraints, and residues within this peptide are known to be critical for p17 trimerization
14. Indeed, a correlation has been noted between the presence of natural viral escape mutants in SL9 and lower viral load, suggesting that mutational strategies used to escape from SL9 CTL result in a loss of viral fitness
15. This concept is supported by the reversion to wildtype SL9 sequences once CTL pressure is lost
15, indicating that the virus is continuously walking a tightrope between immune escape and fitness. Fourth, the common viral escape variants in SL9 interfere with TCR binding rather than HLA-A*02 binding
6,16; thus these variant peptides are still presented on the surface of HIV-infected cells and are therefore available for targeting by ‘disguise detection’ strategies. Fifth, SL9 adopts a conformation that is distinct from that of other HLA-A*02-bound peptides and which allows the potential for several backbone-directed hydrogen bonds with the TCR
17. This potentially reduces the impact of substitutions in individual SL9 amino acid side chains on TCR engagement increasing the likelihood that a TCR can be engineered to recognize many escape variants.