Iqbal Shehzad M, Kaul Rupert
Department of Medicine, University of Toronto, Toronto, ON, Canada.
Am J Reprod Immunol. 2008 Jan;59(1):44-54. doi: 10.1111/j.1600-0897.2007.00563.x.
Most human immunodeficiency virus (HIV) is acquired during sex, across a mucosal membrane. Despite many advances in our understanding of HIV pathogenesis, the initial events during mucosal transmission have been poorly characterized, and a better understanding of these events will probably be a key to the development of successful microbicide(s) and/or a preventative HIV vaccine. While a vast majority of mucosal HIV exposures do not result in productive infection, implying that innate mucosal immune defenses are highly protective, failure of these mucosal defenses resulted in over 3 million new HIV infections in 2006. We review recent findings regarding HIV mucosal immunopathogenesis, emphasizing the importance of innate immunity in natural protection from infection, and examine how natural or induced perturbations in the mucosal innate system may underpin HIV transmission. Given the great challenges to the development of HIV microbicides and vaccines, identification and enhancement of 'natural' innate immune defenses present attractive avenues for development of safe, non-toxic microbicides.
大多数人类免疫缺陷病毒（HIV）是在性行为过程中通过黏膜获得的。尽管我们对HIV发病机制的理解有了许多进展，但黏膜传播期间的初始事件仍未得到充分描述，更好地了解这些事件可能是成功开发杀微生物剂和/或预防性HIV疫苗的关键。虽然绝大多数黏膜暴露于HIV并不会导致感染，但这意味着先天性黏膜免疫防御具有高度保护作用，但这些黏膜防御的失效在2006年导致了超过300万例新的HIV感染。我们回顾了关于HIV黏膜免疫发病机制的最新研究结果，强调先天性免疫在自然抗感染中的重要性，并研究黏膜先天性系统中的自然或诱导性扰动如何可能成为HIV传播的基础。鉴于开发HIV杀微生物剂和疫苗面临巨大挑战，识别和增强“天然”先天性免疫防御为开发安全、无毒的杀微生物剂提供了有吸引力的途径。
