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Fig. 5 | Cell & Bioscience

Fig. 5

From: Impacts of plasma microbial lipopolysaccharide translocation on B cell perturbations and anti-CD4 autoantibody production in people with HIV on suppressive antiretroviral therapy

Fig. 5

A model is proposed for increased plasma microbial product translocation–mediated B cell activation and anti-CD4 pathogenic autoantibody production leading to decreased CD4 + T cell counts in virologically suppressed PWH on ART. In our model, elevated plasma levels of LPS due to impaired mucosal barriers repeatedly stimulated the immune system resulting in increased TLR2 and TLR4 expression in B cells, with different one-time effects and high dose effects. The anti-CD4IgG–producing B cells then produced antiCD4IgGs in response to CD4 or HIV gp120-CD4. The resulting high plasma levels of antiCD4IgG induced CD4 + T cell death through ADCC, leading to the failure of immune reconstitution despite viral suppression with ART.

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