Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms.
Accelerated aging in perinatally HIV-infected children: clinical manifestations and pathogenetic mechanisms.
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DOI：
10.18632/aging.101622
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发表时间：
2018-11-11
期刊：
影响因子：
--
通讯作者：
De Rossi A
中科院分区：
文献类型：
--
作者：
Chiappini E;Bianconi M;Dalzini A;Petrara MR;Galli L;Giaquinto C;De Rossi A
背景：在HIV感染的成年人中，早老和相关疾病已被记录在案。目前还出现了关于感染艾滋病毒儿童加速衰老的数据。研究方法：使用适当的关键词，包括“衰老”、“儿童”、“HIV”、“AIDS”、“免疫衰老”、“发病机制”、“临床状况”，对2004-2017年PubMed上以英文发表的研究进行了叙述性综述。结果如下：HIV感染儿童的B和T细胞的过早免疫衰老表型是通过免疫系统激活和慢性炎症介导的。已通过病原体相关分子模式（PAMPS）水平升高、线粒体损伤增加、促炎细胞因子水平升高以及sCD 14水平与活化CD 8+细胞百分比之间的正相关性记录了正在进行的炎症过程。其他报道的过早衰老的特征包括细胞复制性衰老，与加速的端粒缩短有关。最后，与年龄相关的甲基化模式和其他表观遗传修饰的加速在HIV感染的儿童中已经被描述。所有这些特征可能有利于与早衰相关的临床表现。应仔细监测脂质和骨代谢、癌症、心血管、肾脏和神经系统，特别是可检测到病毒血症和/或CD 4/CD 8比值倒置的儿童。结论：HIV感染儿童的衰老过程影响其生命质量和寿命。需要进一步研究涉及早衰的机制，以寻找潜在的治疗靶点。
Background: Premature aging and related diseases have been documented in HIV-infected adults. Data are now emerging also regarding accelerated aging process in HIV-infected children. Methods: A narrative review was performed searching studies on PubMed published in English language in 2004-2017, using appropriate key words, including “aging”, “children”, “HIV”, “AIDS”, “immunosenescence”, “pathogenesis”, “clinical conditions”. Results: Premature immunosenescence phenotype of B and T cells in HIV-infected children is mediated through immune system activation and chronic inflammation. Ongoing inflammation processes have been documented by increased levels of pathogen-associated molecular patterns (PAMPS), increased mitochondrial damage, higher levels of pro-inflammatory cytokines, and a positive correlation between sCD14 levels and percentages of activated CD8+ cells. Other reported features of premature aging include cellular replicative senescence, linked to an accelerated telomeres shortening. Finally, acceleration of age-associated methylation pattern and other epigenetic modifications have been described in HIV-infected children. All these features may favor the clinical manifestations related to premature aging. Lipid and bone metabolism, cancers, cardiovascular, renal, and neurological systems should be carefully monitored, particularly in children with detectable viremia and/or with CD4/CD8 ratio inversion. Conclusion: Aging processes in children with HIV infection impact their quality and length of life. Further studies regarding the mechanisms involved in premature aging are needed to search for potential targets of treatment.
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