The meningeal lymphatic system: a route for HIV brain migration?
The meningeal lymphatic system: a route for HIV brain migration?
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DOI：
10.1007/s13365-015-0399-y
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发表时间：
2016-06
影响因子：
3.2
通讯作者：
McGrath MS
中科院分区：
文献类型：
--
作者：
Lamers SL;Rose R;Ndhlovu LC;Nolan DJ;Salemi M;Maidji E;Stoddart CA;McGrath MS
最近，两项创新研究确定了脑膜中可能影响HIV相关神经系统疾病（HAND）发展的功能性淋巴结构。到目前为止，血管被认为是唯一的运输系统，HIV感染的单核细胞通过炎症介导的半渗透性绕过潜在的敌对血脑屏障进入大脑。一系列特异性趋化因子信号促进单核细胞通过良好支持的内皮细胞从血管迁移到周围的脑组织，在那里细胞分化成能够产生HIV感染的组织巨噬细胞。另一方面，淋巴管比血管组织更松散。它们从HIV可能持续存在的身体组织中吸收间质液，并通过不连续的内皮连接与周围组织交换各种免疫细胞（CD4+ T细胞、单核细胞、巨噬细胞和树突细胞）。我们认为，新发现的脑膜炎病毒是艾滋病毒迁移的病毒水库和脑组织期间，由于抑制性联合抗逆转录病毒治疗检测不到的血浆病毒载量的关键，从而重新定义的迁移过程中的血液淋巴转运系统。
Two innovative studies recently identified functional lymphatic structures in the meninges that may influence the development of HIV-associated neurological disorders (HAND). Until now, blood vessels were assumed to be the sole transport system by which HIV-infected monocytes entered the brain by bypassing a potentially hostile blood-brain-barrier through inflammatory-mediated semi-permeability. A cascade of specific chemokine signals promote monocyte migration from blood vessels to surrounding brain tissues via a well-supported endothelium, where the cells differentiate into tissue macrophages capable of productive HIV infection. Lymphatic vessels on the other hand are more loosely organized than blood vessels. They absorb interstitial fluid from bodily tissues where HIV may persist and exchange a variety of immune cells (CD4+ T-cells, monocytes, macrophages and dendritic cells) with surrounding tissues through discontinuous endothelial junctions. We propose that the newly discovered meningeal lymphatics are key to HIV migration among viral reservoirs and brain tissue during periods of undetectable plasma viral loads due to suppressive combinational antiretroviral therapy, thus redefining the migration process in terms of a blood-lymphatic transport system.