Studies on the extra-neuronal cholinergic system in HIV-1 infection
Acetylcholine (ACh) is an important neurotransmitter produced in the nervous system. However, the molecule is also produced by non-neuronal cells in the body. CD4+ T cells, the main targets of HIV-1, produce it abundantly. ACh exerts its effects on cells via its nicotinic (n) and muscarinic (m) receptors that are expressed on both immune and non-immune cells in the body. ACh is well known to exert anti-inflammatory effects on immune cells. The main receptor that is indispensable for the anti-inflammatory effects of ACh is the α7 nicotinic receptor. Another molecule, secreted by activated T cells and by other cells is SLURP-1 (Secreted Ly6/uPAR-related Protein-1), which acts as an allosteric ligand for α7 and fine tunes the effects of ACh on T cells. Little is known as to how this extra-neuronal cholinergic system (ENCS) is regulated in HIV-infected individuals.  Our results show that the circulating levels of ACh and SLURP-1 do not change significantly in HIV-infected individuals, as compared to the circulating levels in healthy controls. Interestingly, higher levels of these soluble mediators were detected in HIV-infected long-term non-progressors (LTNP) who control the viral replication for more than seven years without any chemotherapy. It is tempting to speculate that the increase in levels of these two soluble mediators of the ENCS present in HIV-infected LTNPs may play a role in their ability to control HIV replication. The results from this study show that an α7 agonist decreased HIV replication, whereas a receptor antagonist increased its replication in vitro in human PHA blasts. Furthermore, hemicholinium (HC-3), a compound that inhibits the ability of the cells to produce ACh, by competing with their uptake of choline, increases the viral replication. The expression of the α7 receptor on peripheral blood CD4+ T cells, but not on monocytes, was significantly reduced (p<0.01) in HIV-infected individuals, and it was not fully restored by antiretroviral therapy (ART). Interestingly, the expression of the β2 adrenergic receptor was decreased significantly (p<0.01) on both monocytes and CD4+ T cells in HIV-infected individuals. These cells respond to norepinephrine via this receptor and secrete ACh.  Overall, the results of this study suggest that HIV causes significant modulation of different components of the ENCS in virus-infected individuals. This system could be manipulated to reduce viral replication and inflammation in these patients.
HIV Acetylcholine α7 nicotinic receptor SLURP-1 SLURP-1