M cells as portals of entry for HIV

Accumulating evidence points toward active uptake by mucosal antigen sampling cells as the mechanism for rectal HIV acquisition. Organized lymphoid tissue in the intestine consists of lymphoid follicles with an epithelium containing M cells specialized for uptake and transport of microorganisms, bringing them into contact with lymphoid cells. M cells have been found in the human colon and rectum, and adherence and uptake of HIV by M cells in mouse and rabbit Peyer's patches has been demonstrated in vitro. In an in vivo mouse model of viral acquisition, reovirus is actively taken up by M cells into rectal lymphoid tissue containing CD4 lymphocytes and macrophages, which are targets and replication sites for HIV. Immunization strategies for prevention of HIV transmission should include a mucosal component to prevent initial entry, since elimination from cellular sanctuaries remains an elusive goal.