De Milito Angelo
Microbiology and Tumor Biology Center, Karolinska Institutet, S 17177 Stockholm, Sweden.
Curr HIV Res. 2004 Jan;2(1):11-21. doi: 10.2174/1570162043485068.
HIV establishes a chronic and latent infection that is not eliminated by the host immune defences. The virus induces extensive damage to the immune system, through virus-related and indirect pathogenic mechanisms. Both the cellular and the humoral arms of the immune system are unable to control the infection, which ultimately results in severe exhaustion of several lymphocyte functions and increased susceptibility to secondary and opportunistic infections. A striking pathological feature induced by the persistent viral replication is the aberrant activation of cells of the immune system. Among these cells, B lymphocytes are severely damaged and show signs of phenotypic and functional alterations. In parallel to the polyclonal B cell activation and hypergammaglobulinemia, B cells from patients show impaired reactivity to immunisation and in vitro activation signals. In addition, B lymphocytes from HIV-infected subjects are primed for apoptosis. The role of protective humoral immunity in the control and clinical progression of HIV infection is still much debated and controversial. The aim of the present review is to discuss the mechanisms involved in the loss of B cell functions during HIV infection. In particular, we discuss the role that T and B cell immune activation plays for B cell polyclonal activation and loss of memory B lymphocytes. The current knowledge on B cell damage is also discussed in the context of anti-HIV therapeutic treatment.
人类免疫缺陷病毒（HIV）会引发一种慢性潜伏感染，宿主的免疫防御无法将其清除。该病毒通过与病毒相关的和间接的致病机制，对免疫系统造成广泛损害。免疫系统的细胞免疫和体液免疫分支均无法控制感染，最终导致多种淋巴细胞功能严重耗竭，并增加对继发性和机会性感染的易感性。持续的病毒复制所引发的一个显著病理特征是免疫系统细胞的异常激活。在这些细胞中，B淋巴细胞受到严重损害，并表现出表型和功能改变的迹象。与多克隆B细胞激活和高丙种球蛋白血症同时出现的是，患者的B细胞对免疫接种和体外激活信号的反应性受损。此外，来自HIV感染者的B淋巴细胞易于发生凋亡。保护性体液免疫在HIV感染的控制和临床进展中的作用仍存在诸多争议。本综述的目的是探讨HIV感染期间B细胞功能丧失所涉及的机制。特别是，我们讨论了T细胞和B细胞免疫激活在B细胞多克隆激活和记忆B淋巴细胞丧失中所起的作用。还在抗HIV治疗的背景下讨论了目前关于B细胞损伤的知识。
