# Generation of highly differentiated NK cells to synergize with broadly neutralizing antibodies to establish viral control in absence of ART

> **NIH NIH R01** · EMORY UNIVERSITY · 2024 · $799,017

## Abstract

ABSTRACT/SUMMARY
A distinguishing feature of SIV infection in African green monkeys (AGMs), a natural host species for SIV, is
the absence of viral dissemination in the lymphoid B-cell follicle (BCF) and the presence of strong NK cell-
mediated control of viral replication in the BCF and T-cell zone of secondary lymphoid tissues (SLT). In
SIVagm-infected AGMs, we identified the expansion of NK cells with a terminally-differentiated phenotype
expressing (i) high levels of CD16, an activating Fc receptor that mediates antibody-dependent cellular
cytotoxicity (ADCC), and (ii) low levels of NKG2a, an inhibitory receptor that modulates NK cell education via
interactions with MHC-E. This terminally-differentiated NK cell (NKTD) subset (NKG2alowCD16+) exhibited
adaptive-like properties and showed high cytolytic activity against target cells presenting SIV-Env peptides in
the context of MHC-E. In contrast, the formation of NKTD cells was blocked in pathogenic SIVmac infection in
rhesus macaques (RMs), and not improved with ART, in favor of a subset (NKG2ahiCD16+) with pro-
inflammatory function, such as production of IFN-γ. Remarkably, we demonstrated in SIVmac-infected, ART-
treated RMs that AGM-like profiles of adaptive NKTD cells are rescued in blood via treatment with interleukin-21
(IL-21) as a monotherapy following ART initiation. In IL-21-treated RMs, the frequency and responsiveness of
blood NKTD cells to target cells presenting SIV peptides in the context of MHC-E strongly correlated with a
reduction of SIV DNA in the gut and of replication-competent virus in SLT. Yet, we were not able to determine
if IL-21 induces NKTD cells in tissues and we showed that, after analytical ART treatment interruption (ATI) in
absence of IL-21 administration, the NKTD cells rapidly vanished, and virus then concomitantly rebounded in all
RMs. The main objectives of this proposal are (i) to define at an unprecedented level the function and
distribution of NK cells in tissues from SIV-infected, ART-treated RMs after IL-21 administration; an analysis
which in parallel will be extended to other immune cells that either produce (e.g. TFH) or are sensitive to (e.g.
antigen-presenting cells and CD8+ T cells) IL-21 signaling (Aim 1); (ii) to evaluate if the levels of NKTD cells that
are induced by early IL-21 administration can be durably prolonged after ATI in the presence of IL-21, bNAbs,
or both (Aim 1 and 2); and (iii) to test if IL-21-induced NKTD cells will synergize with a cocktail of SIV-Env
targeted broadly neutralizing antibodies (bNAbs) to induce ADCC-mediated clearance of infected cells and to
durably control viral rebound after ATI (Aim 2). Based on a large set of preliminary data, we hypothesize that
the proposed approach will allow differentiation into NKTD cells with IL-21 followed by improved bNAb targeting
and ADCC-mediated killing of those infected cells that support viral rebound following ART cessation. Using a
pre-clinical model reproducing the comple...

## Key facts

- **NIH application ID:** 10838720
- **Project number:** 1R01AI181710-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Michaela Muller-Trutwin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $799,017
- **Award type:** 1
- **Project period:** 2024-08-12 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10838720

## Citation

> US National Institutes of Health, RePORTER application 10838720, Generation of highly differentiated NK cells to synergize with broadly neutralizing antibodies to establish viral control in absence of ART (1R01AI181710-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10838720. Licensed CC0.

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