Graduation Date

Spring 5-4-2019

Document Type


Degree Name

Doctor of Philosophy (PhD)


Pharmacology and Experimental Neuroscience

First Advisor

Jialin Zheng

Second Advisor

Yunlong Huang


Despite the success of antiretroviral therapy (ART), eradication of HIV-1 from brain reservoirs remains elusive. HIV-1 brain reservoirs include perivascular macrophages that are behind the blood-brain barrier and difficult to access by ART. Macrophages express transcription factor FOXO3a and the TNF superfamily cytokine TRAIL, which are known to target HIV-1-infected macrophages for viral suppression. ONC201 is a novel and potent FOXO3a activator capable of inducing TRAIL. It can cross the blood-brain barrier, and has shown an antitumor effect in clinical trials. We hypothesized that activation of FOXO3a/TRAIL by ONC201 will reduce the size of HIV-1 brain reservoirs. Using primary human monocyte-derived macrophages, we demonstrated that ONC201 dose-dependently decreased HIV-1 replication levels as determined by HIV-1 reverse transcriptase activity assay and Western blots for p24. Consistent with data on HIV-1 replication, ONC201 also reduced integrated HIV-1 DNA in infected macrophages in two-step Alu-based nested PCR. In addition, the antiviral effect of ONC201 is applicable to different natural HIV strains and to lymphocytes, microglia and latently infected cell line. A combination of ONC201 and AZT achieved a longer and synergistic viral suppression in HIV-1 infected macrophages. The anti-HIV-1 effect of ONC201 was further validated in vivo in NOD/scid-IL-2Rgcnull mice. After intracranial injection of HIV-1-infected macrophages into the basal ganglia, we treated the mice daily with ONC201 through intraperitoneal injection for 6 days. ONC201 significantly decreased p24 levels in both the macrophages and the brain tissues, suggesting that ONC201 suppresses HIV-1 in vivo. As for the mechanisms, ONC201 treatment activated FOXO3a and induced TRAIL expression in macrophages while blocking TRAIL or knockdown of FOXO3a with siRNA reversed ONC201-mediated HIV-1 suppression, suggesting that ONC201 inhibits HIV-1 through FOXO3a and TRAIL. Furthermore, the antiviral effect of ONC201 is associated with apoptosis and autophagy. Based on these in vitro and in vivo studies, ONC201 can be a promising drug candidate to combat persistent HIV-1 infection in the brain reservoirs.

Available for download on Thursday, March 11, 2021