A possible hope for Aids patients?

The nature of the HIV virus is such that it targets the CD4 T cells, otherwise known as T helper cells. HIV patients would end up with low CD4 T cell counts.

The T helper cells have a wide variety of functions. They can activate B cells to produce antibodies, augment cytotoxic T cell memory response (Sun and Bevan, 2003) and assist macrophage in bactericidal response. HIV infects T helper cells, and with progression to Aids, the lower T helper cell numbers means that the activation of B cells, augmentation of cytotoxic T cell memory response, and assistance of macrophages are all affected. Aids patients usually die of opportunistic infections as a result of impaired immune response.

It is now possible to generate memory B cells in vitro (Arpin et al, 1995). There lies a possibility of producing memory B cells capable of raising antibodies against known pathogens in vitro from relative donors and introduce them to Aids patients. This will ensure that the Aids patients are still capable of a humoral response. Another important supplement that Aids patient should receive is the anti-CD40 antibody that is capable of acting as a CD40 ligand. CD40 ligand together with CD40 was shown to induce cytotoxic T cell response (Bourgeois et al, 2002 and Sun & Bevan, 2003). Indeed, anti-CD40 antibody was shown to induce cytotoxic T cell response that bypasses T cell help (French et al, 1995). CD40 ligand was also shown to augment macrophage response against intracellular pathogen (Andrade et al, 2005). In addition, CD40 ligand was also shown to have enhanced memory B cell surival (Avery et al, 2003).

Note: Italicized text is a recent addition of mine from a paper, which I have found recently.

Citations
1) Sun JC, Bevan MJ. Defective CD8 T cell memory following acute infection without CD4 T cell help. Science. 2003 Apr 11;300(5617):339-42.

2) Arpin C, Dechanet J, Van Kooten C, Merville P, Grouard G, Briere F, Banchereau J, Liu YJ. Generation of memory B cells and plasma cells in vitro. Science. 1995 May 5;268(5211):720-2.

3) Andrade RM, Portillo JA, Wessendarp M, Subauste CS. CD40 signaling in macrophages induces activity against an intracellular pathogen independently of gamma interferon and reactive nitrogen intermediates. Infect Immun. 2005 May;73(5):3115-23

4) C. Bourgeois, B. Rocha, C. Tanchot, Science 297, 2060 (2002)

5) French RR, Chan HT, Tutt AL, Glennie MJ. CD40 antibody evokes a cytotoxic T-cell response that eradicates lymphoma and bypasses T-cell help. Nat Med. 1999 May;5(5):548-53.

6) Avery DT, Kalled SL, Ellyard JI, Ambrose C, Bixler SA, Thien M, Brink R, Mackay F, Hodgkin PD, Tangye SG. BAFF selectively enhances the survival of plasmablasts generated from human memory B cells. J Clin Invest. 2003 Jul;112(2):286-97.