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Plasma Extracellular Vesicle Subtypes as Potential Biomarkers of Immune Activation in HIV-Infected Patients

Chronic immune activation and systemic inflammation during HIV infection despite effective antiretroviral therapy (ART) is associate with non-AIDS co-morbidities in people living with HIV (PLWH). Previous studies have shown that plasma levels of extracellular vesicles (EVs) may be used as immune activation or inflammatory biomarkers of HIV disease progression. Several studies have focused on microRNA and mitochondrial DNA (mtDNA) levels reached concomitantly in immune cells and EVs. We hypothesized that large and small EVs could contain different amounts of microRNA and mtDNA and that could reflect immune activation associated with elevated CD8 T cell count or low CD4/CD8 ratio in PLWH receiving ART. Plasma EVs obtained from PLWH and uninfected control were sized using dynamic light scattering and quantified using flow cytometry. Expression of mature miR-92, miR-155, miR-223 and mtDNA was measured by qRT-PCR. Positive correlation have been observed between CD8+ T cell count and large EV abundance, AChE activity in small EVs and negative correlation with miR-155 levels in small EVs. CD4/CD8 ratio was positively correlated with large EVs abundance and negatively with AChE activity in small EVs and PMN-associated copies of miR-92. MicroRNA-155 level in small EVs were positively correlated with monocyte counts. MiR-155 and mtDNA contents of large EVs were increased more than miR-92 and miR-223 contents in small EVs. A positive correlation was observed between large EVs mtDNA content and CD4 T cell count. These findings suggest that profiling the microRNA and mtDNA contents of EV might provide new functional biomarkers of immune activation and inflammation. 
 
Funding Statement: This study was funded through Canadian Institutes of Health Research (CIHR) grants MOP 188726; MOP-267056 (HIV/AIDS initiative) to C.G., MOP-03230 to J.P.R. and to C.T. for the cohort establishment and CIHR Foundation Grant FDN-143218 to M.A. for the studentship awarded to W.W.B., as well as by the Fonds de recherche du Quebec – Sante (FRQ-S) AIDS and infectious diseases network. C.T. is an FRQ-S scholar and holder of the Pfizer/Universite de Montreal chair on HIV translational Research. J-P.R. holds the Louis Lowenstein chair in Hematology & Oncology at McGill University. M-A.J. holds a CIHR Canada Research Chair tier 2 in Immuno-Virology. The infrastructure of the Centre de recherche du CHU de Quebec – Universite Laval is supportes by the FRQ-S. 
 
Declaration of Interests: The authors declare that no competing interests exist. 
 
Ethics Approval Statement: This study received approval from the ethics review boards of Centre de recherche du CHU de Quebec, Quebec, Canada and the McGill University Health Centre, Montreal, Quebec, Canada. All subjects were anonymous volunteers and provided written informed consent to participate in the study.