Biomarkers in immune reconstitution inflammatory syndrome: signals from pathogenesis
Biomarkers in immune reconstitution inflammatory syndrome: signals from pathogenesis
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DOI：
10.1097/coh.0b013e32833ed774
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发表时间：
2010-11-01
影响因子：
4.1
通讯作者：
French, Martyn A.
中科院分区：
文献类型：
--
作者：
Sereti, Irini;Rodger, Alison J.;French, Martyn A.
免疫重建炎症综合征（IRIS）是HIV-1感染患者在开始抗逆转录病毒治疗（ART）后不久，感染或肿瘤的反常恶化或暴露。IRIS发病机制的新认识可能有助于识别可用于预测或诊断IRIS的生物标志物。最近的免疫发病机制研究表明，随着血浆或血清趋化因子和细胞因子的升高，先天性和适应性免疫反应显著激活。炎症标志物如C反应蛋白、干扰素诱导蛋白10或干扰素g可能有助于IRIS事件的预测。此外，结核病（TB）相关的IRIS与显著的Th 1应答相关，在暴露TB的情况下，甚至在ART开始之前，这种应答也可以提高，并可能有助于早期诊断。需要大的前瞻性研究来阐明IRIS生物标志物的预测和诊断价值，并将其推进到clinic. SummaryReversation的免疫抑制ART导致夸大的病原体特异性免疫反应（称为IRIS），似乎是引发治疗前。炎症标志物、趋化因子和细胞因子表示先天性和适应性免疫激活，是经过适当验证后可以证明具有临床价值的生物标志物。
Purpose of reviewImmune reconstitution inflammatory syndrome (IRIS) is the paradoxical worsening or unmasking of an infection or neoplasm in HIV-1-infected patients shortly after antiretroviral therapy (ART) initiation. New insights into the pathogenesis of IRIS may help identify biomarkers that could be useful in predicting or diagnosing IRIS.Recent findingsStudies of immunopathogenesis have shown a signification activation of both innate and adaptive immune responses with elevation of plasma or serum chemokines and cytokines. Markers of inflammation such as C-reactive protein, interferon-inducible protein 10 or interferon g may be helpful as predictors of IRIS events. In addition, tuberculosis (TB)-associated IRIS is associated with a prominent Th1 response that can be heightened even prior to ART initiation in cases of unmasking TB, and may assist in early diagnosis. Large prospective studies are needed to elucidate the predictive and diagnostic value of IRIS biomarkers and advance them to the clinic.SummaryReversal of immunosuppression by ART leads to exaggerated pathogen-specific immune responses (known as IRIS) that appear to be primed prior to therapy. Inflammatory markers, chemokines and cytokines that signify innate and adaptive immune activation are biomarkers that could prove of clinical value after appropriate validation.