Bower Mark, Veraitch Ophelia, Szydlo Richard, Charles Peter, Kelleher Peter, Gazzard Brian, Nelson Mark, Stebbing Justin
Department of Oncology, HIV Medicine and Immunology, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom.
Blood. 2009 May 7;113(19):4521-4. doi: 10.1182/blood-2008-12-197053. Epub 2009 Feb 17.
Recent data highlight the importance of inflammatory markers during human immunodeficiency virus type 1 (HIV) infection. HIV-associated multicentric Castleman disease (HIV-MCD) presents with systemic symptoms attributed to cytokine disarray, and we have previously shown that the use of the anti-CD20 monoclonal antibody rituximab induces clinical remissions. Before and during successful rituximab therapy, 15 plasma cytokines were measured as were adaptive (CD4, CD8, CD19) and innate (CD16/56) immune cell populations and HIV-1 viral loads. A significant reduction from baseline of the CD19 B-cell count, consistent with rituximab's mechanism of action, was observed. Markedly elevated cytokine levels were observed before rituximab therapy, and a reduction from baseline values with rituximab therapy was observed for interleukin (IL)-5, IL-6, and IL-10. Therapies that reduce the inflammatory cytokine response are likely to be successful in a range of diseases, including HIV-MCD, and in the future may be used to guide therapeutic strategies.
近期数据凸显了炎症标志物在1型人类免疫缺陷病毒（HIV）感染过程中的重要性。HIV相关多中心Castleman病（HIV-MCD）表现出因细胞因子紊乱所致的全身症状，并且我们之前已经表明，使用抗CD20单克隆抗体利妥昔单抗可诱导临床缓解。在成功的利妥昔单抗治疗前及治疗期间，检测了15种血浆细胞因子、适应性（CD4、CD8、CD19）和固有（CD16/56）免疫细胞群以及HIV-1病毒载量。观察到CD19 B细胞计数较基线有显著降低，这与利妥昔单抗的作用机制相符。在利妥昔单抗治疗前观察到细胞因子水平显著升高，并且利妥昔单抗治疗后白细胞介素（IL）-5、IL-6和IL-10较基线值降低。降低炎症细胞因子反应的疗法在包括HIV-MCD在内的一系列疾病中可能会取得成功，并且未来可能用于指导治疗策略。
