Title: The Challenge of IL-2 Immunotherapy in HIV Disease: “No through Road” or Turning Point?
VOLUME: 6 ISSUE: 3
Author(s):Giulia Marchetti, Camilla Tincati, Antonella d'Arminio Monforte and Andrea Gori
Affiliation:Clinic of Infectious Diseases and Tropical Medicine, Department of Medicine, Surgery and Dentistry,“San Paolo” Hospital, University of Milan, Via A. di Rudini, 8 - 20147 Milan, Italy.
Keywords:HAART, immune reconstitution, immunotherapy, interleukin-2
Abstract: The perception of HAART failure in achieving broadest immune reconstitution has further strengthened the rationale to widely explore new adjuvant immunotherapy. Most work has been performed on IL-2, given its potential to correct HIV-driven immune defects, possibly translating in enhanced immune competency. This is a literature review report reviewing different trials on IL-2 immunotherapy in HIV/AIDS in the past ten years through the Cochrane and NIH review database. IL-2 can benefit severely compromised patients, either HAART-naive or lacking HAART-driven immune rescue. Furthermore, by sparing HAART-related toxicity, IL-2 is indicated within treatment interruptions or immunization protocols. Important clinical insights stem from the IL-2-mediated immune reconstitution, with a rise in long-term peripheral T-cell turnover, survival and functional markers. Furthermore, IL-2 immunotherapy proved to interfere with cytokine networks with specific regulatory functions over T-cell homeostasis and function. Despite the plethora of immunological findings exploring the intriguing hypothesis that IL-2 might contribute to amend the skewed T-cell immunophenotype and cytokine milieu in HIV/AIDS, major question on the actual clinical impact remain unanswered. This review is meant to thoroughly explore the possibility that the immunological advantages described during IL-2 immunotherapy might translate into actual clinical benefits in the treatment of HIV/AIDS disease.
