Antiretroviral therapy-associated modulation of Th1 and Th2 immune responses in HIV-infected pregnant women
Antiretroviral therapy-associated modulation of Th1 and Th2 immune responses in HIV-infected pregnant women
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DOI：
10.1016/j.jri.2005.12.001
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发表时间：
2006-06-01
影响因子：
3.4
通讯作者：
Clerici, Mario
中科院分区：
文献类型：
--
作者：
Fiore, Simona;Newell, Marie-Louise;Clerici, Mario
成功妊娠的特点是 Th2 细胞因子增加和 Th1 细胞因子产生抑制。在 HIV 感染的疾病进展中也观察到 Th1 细胞因子向 Th2 细胞因子的转变。高效抗逆转录病毒疗法 (HAART) 可抑制 HIV 病毒血症、增加 CD4+ 细胞计数并抵消 Th1 向 Th2 的转变。我们假设，感染 HIV 且接受 HAART 治疗的孕妇早产风险增加是通过妊娠期细胞因子环境的变化介导的。在这里，我们展示了 49 名 HIV 感染女性在怀孕期间测量了 3 次外周血单核细胞 (PBMC) 中白细胞介素 (IL)-2 (Th1) 和 IL-10 (Th2) 水平的结果。估计了代表妊娠期间女性重复细胞因子（FL-2-PHA、IL-2-Env、IL-10-PHA 和 IL-10-Env）测量趋势的斜率值，并比较了早产和 HAART 使用的中值。根据 HAART 和细胞因子斜率调整的多元回归阐明了 HAART 对早产风险的额外且独立的影响。结果显示，HAART 诱导了有利的免疫调节，增加了 IL-2，减少了 IL-10。 HAART 使用和 IL-10-Env 斜率与早产风险没有显着相关，但 IL-2-PHA 斜率每增加一个单位，早产风险就会增加 8%（AOR，1.08；95% CI，1.0-1. 17；p = 0.005）。怀孕期间使用HAART对于延缓艾滋病毒疾病进展和降低母婴传播风险具有显着益处，但在成功妊娠结局方面可能会适得其反。 (c) 2005 Elsevier Ireland Ltd. 保留所有权利。
A successful pregnancy is characterised by an increase in Th2 cytokines and suppression of Th1 cytokine production. A Th1 to Th2 cytokine shift is also observed in the disease progression of HIV infection. Highly active antiretroviral therapy (HAART) suppresses HIV viremia, increases CD4+ cell counts and counteracts the Th1 to Th2 shift. We hypothesised that the increased risk of premature delivery reported in HIV-infected, HAART-treated pregnant women is mediated through changes in the cytokine environment in pregnancy. Here, we present results relating to levels of interleukin (IL)-2 (Th1) and IL-10 (Th2) in peripheral blood mononuclear cells (PBMCs) measured three times during pregnancy in 49 HIV-infected women. Slope values representing the trend of repeated cytokine (FL-2-PHA, IL-2-Env, IL-10-PHA and IL-10-Env) measurements within women during pregnancy were estimated and median values compared by prematurity and HAART use. Multiple regression adjusted for HAART and cytokine slope clarified the additional and independent effect of HAART on prematurity risk. Results showed favourable immunomodulation induced by HAART with increased IL-2 and decreased IL-10. HAART use and IL-10-Env slopes were not significantly associated with prematurity risk, but each unit increase in IL-2-PHA slope was associated with an 8% increased risk of premature delivery (AOR, 1.08; 95% CI, 1.0-1. 17; p = 0.005). HAART use in pregnancy provides significant benefits in delaying HIV disease progression and reducing the risk of mother-to-child-transmission, but may be counterproductive in terms of successful pregnancy outcome. (c) 2005 Elsevier Ireland Ltd. All rights reserved.