Renal Volume Measurement to Detect Early Kidney Disease

口腔在HIV-1感染的发病机制中起两个重要作用。第一，口腔粘膜，特别是扁桃体，可能是母婴HIV-1主要传播的靶点，通过出生时接触阴道液、出生后接触母乳和男性被动口交。其次，扁桃体可能作为粘膜和全身免疫应答的诱导部位，可以在局部和远处部位（特别是宫颈阴道粘膜）提供针对HIV-1传播的保护，这一作用不太受重视，但同样重要。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应答的效率，并为粘膜免疫提供了一种可获得和可接受的途径。因此，我们建议在局部和远处粘膜部位（口咽和阴道）以及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 这些肱骨和细胞反应的解剖学分布，我们将提供一个临床和免疫学基础的发展，有效的粘膜疫苗对原发性HIV-1感染。我们的概念是在感染建立之前在粘膜处提供保护，并具有增加安全性的系统组件。我们将采用RNA病毒疫苗模型（粘膜活减毒流感病毒）来提高这种方法的可行性，因为适当的HIV-1疫苗抗原变得可用（例如，稳定的免疫原性寡聚体gp 120/gp 41; 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以及血液中诱导功能性抗病毒免疫应答; 2)粘液素免疫可激发粘膜中的体液应答和淋巴细胞中的CTL应答。 全身隔室;和 3)扁桃体作为口咽免疫的主要诱导部位，其缺失将损害局部、阴道和全身反应。

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.