Techniques describing a gradient procedure to separate exosomes from human immunodeficiency virus (HIV) particles are described. This procedure was used to isolate exosomes away from HIV particles in human plasma from HIV-infected individuals. The isolated exosomes were analyzed for cytokine/chemokine content.
Exosomes are small vesicles ranging in size from 30 nm to 100 nm that are released both constitutively and upon stimulation from a variety of cell types. They are found in a number of biological fluids and are known to carry a variety of proteins, lipids, and nucleic acid molecules. Originally thought to be little more than reservoirs for cellular debris, the roles of exosomes regulating biological processes and in diseases are increasingly appreciated.
Several methods have been described for isolating exosomes from cellular culture media and biological fluids. Due to their small size and low density, differential ultracentrifugation and/or ultrafiltration are the most commonly used techniques for exosome isolation. However, plasma of HIV-1 infected individuals contains both exosomes and HIV viral particles, which are similar in size and density. Thus, efficient separation of exosomes from HIV viral particles in human plasma has been a challenge.
To address this limitation, we developed a procedure modified from Cantin et. al., 2008 for purification of exosomes from HIV particles in human plasma. Iodixanol velocity gradients were used to separate exosomes from HIV-1 particles in the plasma of HIV-1 positive individuals. Virus particles were identified by p24 ELISA. Exosomes were identified on the basis of exosome markers acetylcholinesterase (AChE), and the CD9, CD63, and CD45 antigens. Our gradient procedure yielded exosome preparations free of virus particles. The efficient purification of exosomes from human plasma enabled us to examine the content of plasma-derived exosomes and to investigate their immune modulatory potential and other biological functions.
The HIV-1 epidemic continues to have a significant impact throughout the world. As of 2013, approximately 35 million people worldwide were living with HIV, and 2.1 million of these were newly infected individuals1. Prevention strategies and increased access to antiretroviral therapy have been helpful in reducing the overall acquisition of HIV. However, individual populations are still experiencing rises in the acquisition of HIV1. Thus, there is a need for continued efforts to address this epidemic.
One of the strongest predictors of HIV disease progression is chronic immune activation (CIA)2-10. Defined by persistently high levels of detectable cytokines and elevated expression markers on the surface of T lymphocytes, CIA has been attributed to: i) continuous dendritic cell production of Type I IFN11; (ii) direct immune activation driven by HIV proteins Tat, Nef and gp12012; (iii) translocation of bacterial proteins in gut associated immune cells6. However, the exact mechanism(s) underlying chronic, systemic immune activation in HIV infection remain to be fully elucidated.
Our research group and others have demonstrated a role of exosomes in HIV pathogenesis15-18. Our group has determined that the Nef protein is excreted from infected cells in exosomes15, and exosomal Nef (exNef) is present in the plasma of HIV-infected individuals at nanogram levels18. We have shown that bystander CD4+ T-cells exposed to exNef resulted in activation-induced cell death dependent on the CXCR4 pathway19, 20. Alternatively, monocyte/macrophages were refractory to exNef-induced apoptosis, but exhibited altered cellular functions and cytokine expression. Most recently, our group has shown exosomes isolated from the plasma of HIV-infected individuals contain a variety of pro-inflammatory cytokines. Further, naïve peripheral blood mononuclear cells exposed to plasma-derived exosomes from HIV-infected patients induced expression of CD38 on naïve and central memory CD4+ and CD8+ T cells. This likely contributes to systemic inflammation and viral propagation via bystander cell activation21, and suggests that exosomes play a significant role in HIV pathogenesis.
In investigating the role of exosomes in HIV pathogenesis, one challenge is developing techniques to efficiently separate exosomes from HIV particles while maintaining the exosomal content as well as their functional immune modulatory capability. Several methods have been described for isolating exosomes from cell culture and biological fluids22,23. Because of their small size and low density (exosomes float at a density of 1.15 – 1.19 g/ml), differential ultracentrifugation and/or ultrafiltration are the most commonly used techniques for exosome isolation23. However, HIV-infected cell culture supernatants and patients' plasma contain both exosomes and HIV-1 viral particles. Exosomes and HIV-1 particles are very similar in both size and density. Alternatively, taking advantage of the expression of unique exosomal markers such as CD63, CD45, and CD81, exosomes have been isolated using immunoaffinity capture methods23. This procedure can separate virus from exosomes. However, the drawback of this technique is the tight attachment of antibodies to the purified exosomes, which could interfere with assessment of the immunomodulatory potential of exosomes in culture.
To address these limitations, we developed a procedure for purification of exosomes from HIV particles in human plasma modified from Cantin and coworkers22 using Iodixanol velocity gradients. Exosomes were found to segregate in the low-density/upper fractions of iodixanol gradients, whereas virus particles segregated in the high-density/lower fractions. Virus particles were identified by p24 ELISA and exosomes were identified using exosome markers AChE, CD9, CD63, and CD45. The upper low-density fractions collected contained exosomes which were negative for HIV-1 p24 contamination. The efficient purification and separation of exosomes from HIV particles in human plasma allows for accurate examination of the content of exosomes derived from human plasma as well as the investigation of their immune modulatory potential and the diagnostic and prognostic value of exosomes in HIV-1 pathogenesis.
A general diagram of the exosome isolation and purification procedure is provided in Figure 1. Whole blood was obtained from healthy volunteer donors and from HIV-positive individuals not receiving antiretroviral theraoy attending the Hope Clinic of Emory University and the Infectious Disease Program of Grady Health System in Atlanta, Georgia. This study was approved by the institutional review boards of Emory University and Morehouse School of Medicine. All persons participating in the study gave written and informed consent.
1. Preparation of Exosomes from Blood Plasma
2. Purification of Exosomes
3. Exosome Characterization
4. Assay for Immunomodulatory Potential
Exosomes are efficiently purified from HIV-1 positive human plasma. Isolated exosomes, identified by acetylcholinesterase (AChE) activity, segregated in lower density fractions 1-3 at the top of the iodixanol gradients, whereas virus particles, identified by HIV-1 antigen p24, segregated in the higher-density fractions (10-12, near the bottom). The presence of exosomes was further confirmed by immunoblot identification of exosome markers AChE, CD9, CD45, and CD63, and by electron microscopy (Figure 2).
Pro-inflammatory cytokines and chemokines are associated with and significantly elevated in the exosomes of HIV-1 seropositive individuals. Purified exosomes and unfractionated plasma from HIV-1 infected and HIV-1 seronegative individuals were analyzed for 21 cytokines/chemokines by multiplex assay. All 21 cytokines/chemokines were detected in exosomes isolated from HIV-1 positive individuals. Additionally, their levels were significantly elevated as compared to plasma and exosomes from HIV-1 seronegative controls (Table 1).
CD38 expression was increased on the surface of cells exposed to exosomes from HIV-1 seropositive individuals. PBMCs from uninfected human donors were exposed for 48 hr to pooled exosomes from HIV-1 seropositive or seronegative individuals and assessed for levels of the activation marker CD38 on CD4+ and CD8+ T-cells via flow cytometry. We observed that by 48 hr post-exposure, CD38 expression on the surface of naïve and central memory CD4+ and CD8+ T cells were significantly elevated in T-cells exposed to exosomes from HIV-1 positive individuals compared to HIV-negative exosome treatment and untreated controls (Figure 3).
Figure 1. Schematic representation of exosome isolation from HIV-1 positive human plasma. (A) 10 ml of peripheral blood was collected from HIV-1 seropositve and seronegative individuals. (B) EDTA blood collection tubes were centrifuged at 1,000 x g for 20 min at RT. (C) Separated plasma was transferred to 50 ml conical tubes and diluted ½ with 1x PBS and (D) centrifuged 10,000 x g for 30 min. (E) The supernatant was transferred to ultracentrifuge tubes and (F) centrifuged at 10,000 x g for 2 hr. (G, H) The supernatant was discarded and the exosome pellet re-suspended and washed in 1 ml of 1X PBS. (I) Following centrifugation, the supernatant was discarded and the pellet re-suspended in 1ml 1x PBS and overlaid on 6-18% iodixanol velocity gradient and (J) centrifuged at 250,000 x g for 2 hr. (K) Following centrifugation, 1 ml fractions from top to bottom of the gradient were transferred to 1.5 ml tubes and analyzed for AChE content and immunoblot analysis. (L) Fractions 2 and 3 were than combined and diluted with 4 ml of 1X PBS and (M) centrifuged at 400,000 x g for 2 hr. (N) Following centrifugation, the supernatant was discarded and the pellet re-suspended in 1 ml of 1X PBS for analysis of pro-inflammatory cytokine and chemokine expression. Please click here to view a larger version of this figure.
Figure 2. Exosomes are efficiently purified from human plasma. Individual iodixanol velocity gradient fractions from HIV-seropositive or seronegative individuals were subjected to (A) enzymatic assay for acetylcholinesterase (AChE), and (B) Western blot analysis for exosomal markers CD9, CD45, and CD63 and viral protein p24 and were (C) immunolabeled with anti-CD63 and examined with electron microscopy to confirm preparation of purified exosomes (C). (Figure from Konadu et al, 201421, used by permission). Please click here to view a larger version of this figure.
Figure 3. Assay for Immunomodulatory Potential. PBMCs from HIV-1 seronegative individuals were exposed to either pooled exosomes from plasma of HIV-1 seropositive (HIV+ Exo) or seronegative (HIV- Exo) individuals, left untreated, or treated with 5 µg/ml of Concanavalin A (Con A) as a positive control. After 48 hr exposure, Naïve (CD45RA+/CD62L+) , Central (TCM; CD45RA-/CD62L+) and Effector (TEM; CD45RA-/CD62L-) memory CD4+ and CD8+ T-cells were analyzed for CD38 expression by flow cytometry. Exosome concentration was normalized by total protein and added at 1 µg/ml. Error bars represent mean +/- SEM of six independent donors. Difference between groups were tested for statistical significance by the One Way ANOVA Test. *p < 0.05, **p< 0.01,***p< 0.001, ****p< 0.0001. (Figure from Konadu et al, 201421,, used by permission). Please click here to view a larger version of this figure.
Table 1. Analysis of purified exosomes and whole plasma from HIV-1 seropositive and seronegative individuals for pro-inflammatory cytokine and chemokine expression. Purified exosomes from HIV-1 seropositive or seronegative individuals were analyzed for pro-inflammatory cytokine and chemokine expression. All 21 pro-inflammatory cytokines and chemokines measured were associated with and were significantly elevated in exosomes of HIV-1 seropositive individuals compared to seronegative controls. Additionally, IL-1a, IFNa2, and CXCL10 were significantly elevated in the unfractionated plasma of HIV-1 seropositive individuals compared to seronegative controls. Difference between groups were tested for statistical significance by the Mann-Whitney U Test. *p < 0.05, **p< 0.01,***p< 0.001, ****p< 0.0001. (Figure from Konadu et al, 201421, used by permission). Please click here to view a larger version of this figure.
Chronic immune activation (CIA) and CD4+ T cell depletion are two important hallmarks of HIV-1 infection. They have been established as predictors for pathogenesis, with CIA being the best predictor. However, the underlying mechanisms driving chronic systemic immune activation and CD4+ T cell decline still have not been fully elucidated. We and other labs have developed firm evidence that exosomes secreted from HIV-1 infected cells play a role in both hallmarks.
The continuing interest in both composition and function of extracellular vesicles has led to the publication of various methods for exosome isolation from both cell culture media and biological fluids24-26. However, a barrier to investigating the role of exosomes in HIV-1 pathogenesis has been the efficient separation of exosomes from HIV-1 particles while maintaining the ability to investigate both exosome content and functional activity. We have developed a protocol for purification of exosomes from HIV-1 particles in human plasma, utilizing iodixanol velocity gradients. The HIV-positive donors used in this study had not received antiretroviral treatment and the plasma samples used for these experiments contained from 1500 to 400,000 virus particles/mL with an average of 206,000 virus particles/ml21. Thus, we demonstrate that exosomes in the plasma of HIV-1 infected individuals can be efficiently separated from HIV-1 virus particles, even when the virus loads are high. Though similar in size and density, exosomes segregated in the low-density/upper fractions of the iodixanol gradients as compared to viral particles, which segregated in the high-density/lower fractions. The exosomes prepared by the iodixanol gradient method are highly purified and free of contaminating extracellular proteins. The purity of the isolated exosomes population was confirmed using p24 ELISA and Western blot analysis for HIV-1 p24 capsid protein as well as Western analysis for exosomal markers, AChE, CD9, CD45, and CD63. Use of these markers is consistent with recently published guidelines for exosome identification27.
More physiologically relevant to immune activation, the purified exosomes from HIV-1 infected individuals were found to contain cytokines/chemokines at significantly higher concentrations than exosomes from HIV-1 seronegative controls. Moreover, exosomes from HIV-1 infected individuals were biologically active, exhibiting the ability to induce increased levels of the activation marker, CD38, on the surface of naïve and central memory CD4+ and CD8 + T cells. Collectively, these data suggest a mechanism that could drive persistent immune activation during HIV infection.
The results we were able to obtain using our exosome purification process, which combines differential centrifugation and iodixanol velocity gradient separation show the value of using highly purified exosomes for physiological and functional bioassays. The procedure does have certain pitfalls and limitations. A considerable amount of the exosomes, often a majority of the starting material as calculated by measurements of AChE activity, are lost during the process. In addition, the procedure is also time consuming and requires access to expensive equipment. Finally, the generation of the iodixanol gradients using the gradient fromer apparatus requires considerable practice to ensure reproducibility. An alternative method for gradient generation might be to prepare a graded series of iodixanol solutions, followed by careful layering of the solutions into centrifuge tubes and incubating O/N to allow the gradients to form. However, we have not tested this alternative.
The experimental protocol described here for isolation and separation of exosomes from HIV-1 particles in human plasma is an effective method to ensure the purity of exosomes. Use of this method has led to exciting avenues for future inquiry regarding the role of exosomes in HIV-1 pathogenesis and could equally be used in inquiries for other biological processes.
The authors have nothing to disclose.
We thank the following people: Jane Chu, Cameron Tran, James Lillard, Mafuz Khan, Masebonang Albert, Ken Rogers, and Syed A. Ali. Kateena Addae-Konadu was supported by UNCF/Merck Graduate Research Fellowship, American Medical Association Foundation, CRECD Grant 8R25MD007589-10, and NIH NIGMS MBRS Grant R25 GM058268. This work was supported by NIMHD grants 8G12MD007602, and 8U54MD007588, NIAID grant 1R21AI095150-01A1, Georgia Research Alliance grant GRA.VAC08.W, and Emory CFAR grant P30 A1050409.
BD Vacutainer EDTA tubes (10ml) | Becton Dickinson | 368589 | pink top tubes |
Lymphoprep Ficoll reagent | Cosmo Bio | AXS-1114545 | |
Optiprep iodixanol reagent | Sigma | D1556 | |
14ml ultracentrifuge tubes | Beckman Coulter | 344060 | ultraclear tubes |
Gradient Former Model 485 | BIO-RAD | 165-4120 | |
Acetylthiocholine iodide | Sigma | 1480 | |
Benzoic Acid | Sigma | D8130 | |
Sodium Bicarbonate | Sigma | S5761 | |
Acetyl Cholinesterase | Sigma | C3389 | |
96-well clear microtiter plate | Medical Supply Partners | TR5003 | |
SpectraMax 190 microplate reader | Molecular Devices | 190 | Fluorescent plate reader |
Criterion Gel Electrophoresis Cell | BIO-RAD | 165-6001 | |
Transblot Gel | BIO-RAD | 170-3910 | |
Transfer Cell | |||
Tris-HCl Criterion precast gels | BIO-RAD | 567-1093 | |
Anti-CD45 antibody | Abcam | Ab10558 | |
CD63 Antibody (H-193) | Santa Cruz Biotech, Inc. | SC-15363 | |
CD9 Antibody (H-110) | Santa Cruz Biotech, Inc. | SC-9148 | |
Rabbit pAb p24 HIV-1 | ImmunoDX, LLC | 1303 | |
Nitrocellulose membrane | BIO-RAD | G1472430 | |
Tris Buffered Saline | BIO-RAD | 170-6435 | |
HRP-conjugated IgG (H+L) secondary antibody | Thermo Scientific | 31460 | Goat-Anti-Rabbit |
HRP-conjugated IgG (H+L) secondary antibody | Thermo Scientific | 31430 | Goat-Anti-Mouse |
Western Blotting Luminol Reagent | Santa Cruz Biotech, Inc. | SC-2048 | |
GE LAS-4010 Imager | GE Healthcare | LAS-4010 | |
Human Procarta Cytokine Immunoassay Kit | Affymetrix | N/A | Custom immunoassay panel |
Bio-Plex 200 Immunobead Reader | BIO-RAD | 171-000201 | |
Coulter Z2 Particle Counter | Beckman Coulter | 383552 | Cell counter |
Alexa Fluor 700-labeled anti-CD3 | BD Bioscience (UCHT1) | 300424 | |
APC/Cy7-labeled anti-CD4 | Biolegend (OKT4) | 317418 | |
PerCP-labeled anti-CD4 | BD Bioscience (RPA-T8) | 550631 | |
V450-labeled anti-CD8 | BD Bioscience (RPA-T8) | 560347 | |
Biotin-labeled anti-CD45RA | BD Bioscience (HI100) | 555487 | |
PE/Cy7-labeled anti-CD62L | Biolegend (DREG-56) | 304822 | |
PE/Cy5-labeled anti-CD38 | Biolegend (HIT2) | 303508 | |
APC/Cy7-labeled anti-HLADR | Biolegend (L243) | 307618 | |
PE-Texas Red-labeled anti-streptavidin | BD Bioscience | 551487 | |
PE/Cy5-labeled mouse IgG1K | Biolegend (MOPC-21) | 400116 | |
APC/Cy7-labeled mouse IgG2aK | Biolegend (MOPC-173) | 400229 |