摘要
cART能够有效抑制艾滋病患者体内(HIV-1)复制,提高感染者外周血CD4细胞数量,显著降低HIV-1相关疾病的发病率和病死率。不过,目前仍然有约20%的患者接受cART后并不能实现免疫重建。虽然后者发生的确切机制尚不完全清楚,但是慢性HIV-1感染对肠道组织和黏膜免疫微环境的破坏可能是一个重要原因。肠道组织富含免疫细胞,容易受HIV-1攻击,造成肠道黏膜组织损伤和通透性增加,继而发生肠道菌群紊乱和肠道菌群移位。这些变化不仅可以造成患者体内整体的免疫激活和系统性慢性炎症,而且还影响病毒潜伏和cART后的免疫重建。因此,解析HIV-1慢性感染、肠道免疫损伤和肠道菌群失调之间存在的复杂关系,对于阐明艾滋病患者免疫重建失败的机制、发现新型的治疗靶点以及创建新型的治疗策略,都具有重要的参考价值。为此,本文针对慢性HIV-1感染者肠道免疫细胞和肠道菌群改变的特点及其临床意义进行综述。
Combined antiretroviral therapy(cART) can effectively suppress HIV-1 replication, increase peripheral blood CD4+ T cells counts in individuals infected with HIV-1, which greatly reduces the incidence and mortality associated with HIV-1-related diseases. However, approximately 20% of patients fail to achieve immunological reconstitution following cART administration. While the underlying mechanisms are not fully understood, the impairment of intestinal tissue and mucosal immune microenvironment due to chronic HIV-1 infection is believed to play a significant role.Intestinal tissues are enriched with immune cells and are highly susceptible to HIV-1 infection, leading to intestinal mucosal tissue damage and increased intestinal permeability, which can result in dysbiosis and translocation of the intestinal microbiota. These alterations can not only trigger overall immune activation and systemic chronic inflammation in the patients, but also impair the immune reconstitution. Therefore, understanding the complex relationship among chronic HIV-1 infection, intestinal immune damage, and intestinal flora dysfunction holds significant implications for elucidating the mechanism of immune non-responders, identifying novel therapeutic targets, and developing new therapeutic strategies. Accordingly, this article summarizes the characteristics and clinical implication of intestinal immune cells and intestinal flora changes in patients with chronic HIV-1 infection.
作者
王泽瑞
焦艳梅
洪卫国
令狐恩强
WANG Zerui;JIAO Yanmei;HONG Weiguo;LINGHU Enqiang(Senior Department of Gastroenterology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Senior Department of Infectious Diseases,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2024年第4期414-419,共6页
Chinese Journal of Aids & STD
基金
国家重点研发计划(2022YFC2304403)。
关键词
肠道免疫细胞
1型艾滋病病毒
肠道菌群紊乱
肠道菌群移位
免疫重建
系统性免疫激活
慢性炎症
intestinal immune cells
HIV-l
intestinal dysbiosis
intestinal microbial translocation
immune reconstitution
systemic immune activation
chronic inflammation
