Zunich K M, Lane H C
Transplantation Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
Hematol Oncol Clin North Am. 1991 Apr;5(2):215-28.
The progressive decline in the number and function of circulating CD4+ T lymphocytes remains the most characteristic immunologic abnormality found in persons infected with HIV. With the CD4+ cell as the central element in the immunologic cascade of events involved in antigen recognition and host defense, loss of normal CD4 number and function results in impairment of many immune functions that require induction signals by CD4 lymphocytes, including CD8 function, B lymphocyte production of immunoglobulin, NK cell function, and monocyte/macrophage function. Although CD4 cell depletion is a major factor in the pathogenesis of HIV infection, immunologic abnormalities such as impairment of responses to soluble protein antigens appear even before detectable loss of circulating CD4 cells. Progression of clinical disease occurs despite the development of antibodies to HIV proteins. Cellular immune responses have been described in a limited number of individuals, but their exact role is not yet understood. Delineation of the precise nature of the immunologic defects in HIV infection should provide the basis for the continued development of better therapeutic strategies.
循环CD4+ T淋巴细胞数量和功能的进行性下降仍然是HIV感染者中发现的最典型的免疫异常。由于CD4+细胞是参与抗原识别和宿主防御的免疫级联反应中的核心要素，正常CD4数量和功能的丧失会导致许多需要CD4淋巴细胞诱导信号的免疫功能受损，包括CD8功能、B淋巴细胞产生免疫球蛋白、NK细胞功能以及单核细胞/巨噬细胞功能。尽管CD4细胞耗竭是HIV感染发病机制中的一个主要因素，但在循环CD4细胞出现可检测到的损失之前，诸如对可溶性蛋白质抗原反应受损等免疫异常就已出现。尽管机体产生了针对HIV蛋白的抗体，但临床疾病仍会进展。在少数个体中已描述了细胞免疫反应，但其确切作用尚不清楚。明确HIV感染中免疫缺陷的确切性质应为持续开发更好的治疗策略提供依据。
