Renal Volume Measurement to Detect Early Kidney Disease

口腔在HIV-1感染的发病机制中起着两个重要的作用。首先，口腔粘膜，特别是扁桃体，可能通过出生时暴露于阴道液，出生后接触母乳，以及男性被动口交期间，提供艾滋病毒-1从母亲到婴儿的主要传播目标。其次，扁桃体作为粘膜和系统免疫反应的诱导部位，可能起到的作用不那么受欢迎，但同样关键，它可以提供保护，防止艾滋病毒-1在本地和远程部位传播，特别是宫颈阴道粘膜。在这种防御作用中，口咽提供了一个独特的窗口来表征粘膜免疫反应的效率，并为粘膜免疫提供了一条可接近和可接受的途径。因此，我们建议在局部和远端粘膜部位(口咽和阴道)以及在体循环中表征病毒疫苗鼻腔免疫的反应。我们建议通过理解归纳要求和 这些体液和细胞反应的解剖分布，我们将为发展有效的针对HIV-1原发感染的粘膜疫苗提供临床和免疫学基础。我们的概念是在感染确定之前，通过系统性组件在粘膜上提供保护，以增加安全性。我们将使用RNA病毒疫苗模型(粘膜减毒活流感病毒)来提高这种方法的可行性，因为有合适的HIV-1疫苗抗原可用(例如，稳定的免疫原性寡聚体gp120/gp41；DNA蛋白质或载体疫苗)。假设： 1)咽部免疫在局部和远端粘膜部位及血液中诱导功能性抗病毒免疫反应； 2)粘膜免疫既能引起粘膜的体液反应，又能引起小鼠的CTL反应。 全身隔间；以及 3)扁桃体是口咽免疫的主要诱导部位，缺乏扁桃体将损害局部、阴道和全身的反应。

The oral cavity serves two essential roles in the pathogenesis of HIV-1 infection. First, the oral mucosae, particularly tonsils, may provide a target of primary HIV-1 transmission from mother to infant through exposure to vaginal fluids at birth and to breast milk after birth and during passive oral sex among men. Second, tonsils may serve a less well-appreciated but no less critical role as the inductive sites for mucosal and systemic immune responses that can provide protection against HIV-1 transmission at both local and distant sites, particularly the cervicovaginal mucosae. In this defensive role, the oropharynx offers a unique window to characterize the efficiency of mucosal immune responses and confers an accessible and acceptable route for mucosal immunization. Thus, we propose to characterize responses to nasal immunization with a viral vaccine at local and distant mucosal sites (oropharynx and vagina), and in the systemic circulation. We propose that by understanding the inductive requirements and the anatomic distribution of these humeral and cellular responses, we will provide a clinical and immunologic basis for the development of effective mucosal vaccination against primary HIV-1 infection. Our concept is to provide protection at the mucosa, before infection is established, with a systemic component for added security. We will employ an RNA virus vaccine model (mucosal live attenuated influenzavirus) to advance the viability of such an approach as appropriate HIV-1 vaccine antigens become available (e.g., stable immunogenic oligomeric gp120/gp41; DNA-protein or-vector vaccines). Hypotheses: 1) Qrophayngeal immunization induces functional antiviral immune responses at local and distal mucosal sites and in blood; 2) Mucosal immunization elicits both humeral responses in the mucosa and CTL responses in the systemic compartment; and 3) Tonsils serve as the primary inductive sites for oropharyngeal immunization, and their absence will compromise local, vaginal, and systemic responses.