Brizzi M F, Porcu P, Porteri A, Pegoraro L
Istituto di Medicina Interna, Università, Torino, Italy.
Haematologica. 1990 Sep-Oct;75(5):454-63.
During the clinical history of HIV infection, haematological abnormalities represent a common finding which not only contributes to worsening the clinical condition but also limit the use of antibacterial as well as antiviral agents. On the basis of the regulatory role played by the immune system on haemopoiesis, in the present review the foremost derangements of the immunoregulatory circuits are first discussed. The main functional and quantitative defects of peripheral blood erythrocytes, granulocytes, platelets and monocytes are then analysed, and the different bone marrow pictures observed during the progression of the disease are described. To elucidate the physiophatogenetic mechanisms responsible for bone marrow and peripheral cytopenia, the most relevant in vitro studies are reported and discussed. These studies suggest that both a direct cytopathic effect of HIV on haemopoietic progenitors and an immune system mediated mechanism are involved. In view of the HIV selective tropism for lymphocytes and macrophages, which are a major source of haemopoietic growth factors, the new therapeutical strategies for the treatment of cytopenias based on exogenous administration of these cytokines, alone or in combination with antiviral drugs, are briefly reported.
在HIV感染的临床病程中，血液学异常是常见表现，这不仅会使临床病情恶化，还会限制抗菌药物和抗病毒药物的使用。基于免疫系统对造血的调节作用，在本综述中，首先讨论免疫调节回路的主要紊乱情况。然后分析外周血红细胞、粒细胞、血小板和单核细胞的主要功能和数量缺陷，并描述疾病进展过程中观察到的不同骨髓情况。为阐明导致骨髓和外周血细胞减少的生理病理机制，报告并讨论了最相关的体外研究。这些研究表明，HIV对造血祖细胞的直接细胞病变作用和免疫系统介导的机制均有涉及。鉴于HIV对淋巴细胞和巨噬细胞具有选择性嗜性，而淋巴细胞和巨噬细胞是造血生长因子的主要来源，简要报告了基于外源性给予这些细胞因子单独或与抗病毒药物联合治疗血细胞减少症的新治疗策略。
