Elite controllers have higher levels of perforin/GranzymeB+CD56+ CD8 T lymphocytes.

Intracellular expression of preformed perforin (A) and Granzyme B (B) is significantly higher on gated CD8 T lymphocytes from elite controllers and low viremia groups compared to uninfected controls or HIV+ART subjects. The level of CD56 expression on perforin (C) or Granzyme B (D) expressing CD8 T lymphocytes was significantly reduced in HIV+ ART treated and low viremia groups but not in elite controllers. Results in panels E-G show perforin upregulation in response to stimulation with HIV gag peptides measured with DG48 clone of anti-perforin antibody. (E) Both elite controller and low viremia group have significantly higher production of perforin upregulation in response to stimulation compared with ART treated individuals. (F). Representative sample from each infected group showing majority of CD56+ CD8 T cells upregulated perforin in response to stimulation while a minority of CD56- CD8 T cells upregulate perforin. Cells are gated on CD8 T lymphocytes. (G) Combined results from all infected groups show proportion of CD56 fraction of CD8 T cells upregulating perforin in response to stimulation with HIV peptides is significantly higher than proportion of CD56- CD8 T cell that upregulate perforin. Significantly greater proportions of CD56+ CD8 T cells degranulate (H) as well as produce IFNγ (I) in response to stimulation with HIV gag peptides. Results in G, H and I show show comparison of CD56+ and CD56- subsets irrespective of the patient's disease status.