For acute self-limiting infections a vaccine is successful if it elicits memory at least as good as the natural experience; however, for persistent and chronic infections such as HIV, hepatitis C virus (HCV), human papillomavirus (HPV), and human herpes viruses, this paradigm is not applicable. At best, during persistent virus infection the person must be able to maintain the integrity of the immune system in equilibrium with controlling replicating virus. New vaccine strategies are required that elicit both potent high-avidity CD8 ؉ T-cell effector/memory and central memory responses that can clear the nidus of initial virus-infected cells at mucosal surfaces to prevent mucosal transmission or significantly curtail development of disease. The objective of an HIV-1 T-cell vaccine is to generate functional CD8 ؉ effector memory cells at mucosal portals of virus entry to prevent viral transmission. In addition, long-lived CD8 ؉ and CD4 ؉ central memory cells circulating through secondary lymphoid organs and resident in bone marrow, respectively, are needed to provide a concerted second wave of defense that can contain virus at mucosal surfaces and prevent systemic dissemination. Further understanding of factors which can influence long-lived effector and central memory cell differentiation will significantly contribute to development of effective T-cell vaccines. In this review we will focus on discussing mechanisms involved in T-cell memory and provide promising new approaches toward expanding current vaccine strategies to enhance antiviral memory. (Blood. 2010;115:1678-1689)
IntroductionA common defining characteristic of immune memory is that it is both selective and parsimonious. After resolution of primary infection a small somewhat constant fraction of cells remain depending upon initial precursor frequency and the balance between T-cell receptor (TCR) signal strength and prosurvival signals received. 1,2 Memory cells are homeostatically maintained in a progrowth state poised to respond rapidly to secondary infection. The fidelity of memory and effectiveness to thwart disease is reflected in the multifunctional character of the recalled response. Memory T cells are heterogenous in terms of phenotype, function, and anatomical locations. [3][4][5] Understanding cytokine and costimulatory signals that influence transcriptional programs regulating T-cell differentiation and memory is key to manipulating vaccine responses. Furthermore, defining different subpopulations of memory CD8 ϩ T cells by differentiation and activation markers representative of transcriptional programs associated with protective recall responses will be key to predicting vaccine efficacy.To date, strategies for targeted delivery of vaccines and inclusion of cytokines, chemokines, and immunomodulatory molecules for enhancing the magnitude of immune responses and memory have been mostly empirical. For HIV-1 vaccines this has involved the expression of HIV-1 genes, cytokines, and chemokines by in vivo delivery of plasmid DNA and recombinant v...