免疫重建炎症综合征：当你没有免疫时，免疫的麻烦。
Immune reconstitution inflammatory syndrome: the trouble with immunity when you had none.
机构信息
Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rm 6146, 50 South Drive, Bethesda, Maryland, 20892, USA.
出版信息
Nat Rev Microbiol. 2012 Jan 9;10(2):150-6. doi: 10.1038/nrmicro2712.
Abstract
Some individuals who are infected with HIV rapidly deteriorate shortly after starting antiretroviral therapy, despite effective viral suppression. This reaction, referred to as immune reconstitution inflammatory syndrome (IRIS), is characterized by tissue-destructive inflammation and arises as CD4(+) T cells re-emerge. It has been proposed that IRIS is caused by a dysregulation of the expanding population of CD4(+) T cells specific for a co-infecting opportunistic pathogen. Here, we argue that IRIS instead results from hyper-responsiveness of the innate immune system to T cell help, a mechanism that may be shared by the many manifestations of IRIS that occur following the reversal of other types of immunosuppression in pathogen-infected hosts.
摘要
有些感染 HIV 的个体在开始抗逆转录病毒治疗后不久，尽管病毒得到有效抑制，仍会迅速恶化。这种反应被称为免疫重建炎症综合征（IRIS），其特征是组织破坏性炎症，并且随着 CD4(+)T 细胞的重新出现而出现。有人提出，IRIS 是由针对合并感染机会性病原体的 CD4(+)T 细胞的扩张群体的失调引起的。在这里，我们认为 IRIS 是由先天免疫系统对 T 细胞辅助的过度反应引起的，这种机制可能与感染宿主中其他类型免疫抑制逆转后发生的许多 IRIS 表现共享。
相似文献
1
Immune reconstitution inflammatory syndrome: the trouble with immunity when you had none.免疫重建炎症综合征：当你没有免疫时，免疫的麻烦。
Nat Rev Microbiol. 2012 Jan 9;10(2):150-6. doi: 10.1038/nrmicro2712.
2
Pathogenesis of the immune reconstitution inflammatory syndrome in HIV-infected patients.HIV 感染患者免疫重建炎症综合征的发病机制。
Curr Opin Infect Dis. 2012 Jun;25(3):312-20. doi: 10.1097/QCO.0b013e328352b664.
3
Selective expansion of polyfunctional pathogen-specific CD4(+) T cells in HIV-1-infected patients with immune reconstitution inflammatory syndrome.HIV-1 感染免疫重建炎症综合征患者中多功能病原体特异性 CD4(+) T 细胞的选择性扩增。
Blood. 2012 Mar 29;119(13):3105-12. doi: 10.1182/blood-2011-09-380840. Epub 2012 Jan 4.
4
Pathology of immune reconstitution inflammatory syndrome in multiple sclerosis with natalizumab-associated progressive multifocal leukoencephalopathy.免疫重建炎症综合征在多发性硬化症伴那他珠单抗相关性进行性多灶性白质脑病中的病理学研究。
Acta Neuropathol. 2012 Feb;123(2):235-45. doi: 10.1007/s00401-011-0900-5. Epub 2011 Nov 6.
5
Dynamics of T-Lymphocyte Activation Related to Paradoxical Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in Persons With Advanced HIV.晚期 HIV 感染者中与矛盾性结核相关免疫重建炎症综合征相关的 T 淋巴细胞激活动力学。
Front Immunol. 2021 Oct 7;12:757843. doi: 10.3389/fimmu.2021.757843. eCollection 2021.
6
Risk factors for 'unmasking immune reconstitution inflammatory syndrome' presentation of tuberculosis following combination antiretroviral therapy initiation in HIV-infected patients.在开始联合抗逆转录病毒治疗后，HIV 感染者结核病“免疫重建炎症综合征”表现的风险因素。
AIDS. 2010 Jun 19;24(10):1519-25. doi: 10.1097/qad.0b013e3283396007.
7
Immune-reconstitution Inflammatory Syndrome in Multiple Sclerosis Patients Treated With Natalizumab: A Series of 4 Cases.接受那他珠单抗治疗的多发性硬化症患者的免疫重建炎症综合征：4例病例系列
Clin Ther. 2016 Mar;38(3):670-5. doi: 10.1016/j.clinthera.2016.01.010. Epub 2016 Feb 5.
8
Skin and mucosal manifestations of immune reconstitution inflammatory syndrome in people living with HIV: a review.HIV 感染者免疫重建炎症综合征的皮肤和黏膜表现：综述。
Int J Dermatol. 2024 Jul;63(7):852-857. doi: 10.1111/ijd.17082. Epub 2024 Mar 1.
9
Shedding light on IRIS: from Pathophysiology to Treatment of Cryptococcal Meningitis and Immune Reconstitution Inflammatory Syndrome in HIV-Infected Individuals.解析免疫重建炎症综合征（IRIS）：从发病机制到新型隐球菌性脑膜炎和 HIV 感染者免疫重建炎症综合征的治疗。
HIV Med. 2019 Jan;20(1):1-10. doi: 10.1111/hiv.12676. Epub 2018 Oct 25.
10
Changes in the NK Cell Repertoire Related to Initiation of TB Treatment and Onset of Immune Reconstitution Inflammatory Syndrome in TB/HIV Co-infected Patients in Rio de Janeiro, Brazil-ANRS 12274.巴西里约热内卢结核分枝杆菌/人类免疫缺陷病毒合并感染患者开始抗结核治疗和出现免疫重建炎症综合征时 NK 细胞库的变化-ANRS 12274
Front Immunol. 2019 Aug 13;10:1800. doi: 10.3389/fimmu.2019.01800. eCollection 2019.
引用本文的文献
1
The impact of western versus agrarian diet consumption on gut microbiome composition and immune dysfunction in people living with HIV in rural and urban Zimbabwe.西方饮食与农耕饮食的摄入对津巴布韦农村和城市地区艾滋病毒感染者肠道微生物群组成及免疫功能障碍的影响
bioRxiv. 2025 Jul 22:2025.07.18.665619. doi: 10.1101/2025.07.18.665619.
2
Impact of cerebrospinal fluid leukocyte infiltration and activated neuroimmune mediators on survival with HIV-associated cryptococcal meningitis.脑脊液白细胞浸润和活化的神经免疫介质对HIV相关隐球菌性脑膜炎患者生存的影响。
PLoS Negl Trop Dis. 2025 Feb 10;19(2):e0012873. doi: 10.1371/journal.pntd.0012873. eCollection 2025 Feb.
3
Mpox Recrudescence after SARS-CoV-2 Coinfection in a Patient with AIDS.一名艾滋病患者在感染新型冠状病毒后出现猴痘复发
Am J Trop Med Hyg. 2024 Dec 31;112(3):677-681. doi: 10.4269/ajtmh.24-0304. Print 2025 Mar 5.
4
Impact of Cerebrospinal Fluid Leukocyte Infiltration and Neuroimmmune Mediators on Survival with HIV-Associated Cryptococcal Meningitis.脑脊液白细胞浸润和神经免疫介质对HIV相关隐球菌性脑膜炎患者生存的影响
medRxiv. 2024 May 31:2024.05.29.24308130. doi: 10.1101/2024.05.29.24308130.
5
Fatal pulmonary hemorrhage, pneumothorax and skin necrosis caused by IRIS to an Aspergillus flavus infection in a young patient with metamizole associated agranulocytosis.异烟肼相关粒细胞缺乏症患者曲霉属感染致免疫重建炎症综合征引起致命性肺出血、气胸和皮肤坏死
Infection. 2024 Apr;52(2):685-690. doi: 10.1007/s15010-023-02149-x. Epub 2023 Dec 22.
6
Current knowledge of the immune reconstitution inflammatory syndrome in Whipple disease: a review.目前对 Whipple 病免疫重建炎症综合征的认识：综述。
Front Immunol. 2023 Oct 13;14:1265414. doi: 10.3389/fimmu.2023.1265414. eCollection 2023.
7
Changes in the balance of Th17/Treg cells and oxidative stress markers in patients with HIV‑associated pulmonary tuberculosis who develop IRIS.发生免疫重建炎症综合征的HIV相关肺结核患者中Th17/Treg细胞平衡及氧化应激标志物的变化
Exp Ther Med. 2023 Apr 21;25(6):271. doi: 10.3892/etm.2023.11970. eCollection 2023 Jun.
8
Interplay between systemic inflammation, anemia, and mycobacterial dissemination and its impact on mortality in TB-associated HIV: a prospective cohort study.系统性炎症、贫血与分枝杆菌播散之间的相互作用及其对结核分枝杆菌/人类免疫缺陷病毒（TB/HIV）相关患者死亡的影响：一项前瞻性队列研究。
Front Immunol. 2023 Apr 18;14:1177432. doi: 10.3389/fimmu.2023.1177432. eCollection 2023.
9
Exploiting antifungal immunity in the clinical context.在临床环境中利用抗真菌免疫。
Semin Immunol. 2023 May;67:101752. doi: 10.1016/j.smim.2023.101752. Epub 2023 Mar 29.
10
Phenotypic Profile of -Specific CD4 T-Cell Responses in People With Advanced Human Immunodeficiency Virus Who Develop Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome.患有晚期人类免疫缺陷病毒且发生与结核病相关的免疫重建炎症综合征患者中特异性 CD4 T 细胞反应的表型特征
Open Forum Infect Dis. 2022 Oct 17;10(1):ofac546. doi: 10.1093/ofid/ofac546. eCollection 2023 Jan.
本文引用的文献
1
Integration of antiretroviral therapy with tuberculosis treatment.抗逆转录病毒疗法与结核病治疗的整合。
N Engl J Med. 2011 Oct 20;365(16):1492-501. doi: 10.1056/NEJMoa1014181.
2
Timing of antiretroviral therapy for HIV-1 infection and tuberculosis.抗逆转录病毒疗法治疗 HIV-1 感染和结核病的时机。
N Engl J Med. 2011 Oct 20;365(16):1482-91. doi: 10.1056/NEJMoa1013607.
3
Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis. 艾滋病病毒感染者合并结核病时，早期与晚期开始抗逆转录病毒治疗的效果比较。
N Engl J Med. 2011 Oct 20;365(16):1471-81. doi: 10.1056/NEJMoa1013911.
4
Normal T cell homeostasis: the conversion of naive cells into memory-phenotype cells.正常 T 细胞稳态：幼稚细胞向记忆表型细胞的转化。
Nat Immunol. 2011 Jun;12(6):478-84. doi: 10.1038/ni.2018.
5
Opportunistic infection-associated immune reconstitution syndrome in transplant recipients.移植受者机会性感染相关免疫重建综合征。
Clin Infect Dis. 2011 Jul 15;53(2):168-76. doi: 10.1093/cid/cir276.
6
TLR2-induced cytokine responses may characterize HIV-infected patients experiencing mycobacterial immune restoration disease.TLR2 诱导的细胞因子反应可能是发生分枝杆菌免疫重建疾病的 HIV 感染患者的特征。
AIDS. 2011 Jul 31;25(12):1455-60. doi: 10.1097/QAD.0b013e328348fb18.
7
Timing of initiation of antiretroviral therapy in human immunodeficiency virus (HIV)--associated tuberculous meningitis.人类免疫缺陷病毒（HIV）相关结核性脑膜炎患者开始抗逆转录病毒治疗的时机。
Clin Infect Dis. 2011 Jun;52(11):1374-83. doi: 10.1093/cid/cir230.
8
Higher levels of CRP, D-dimer, IL-6, and hyaluronic acid before initiation of antiretroviral therapy (ART) are associated with increased risk of AIDS or death.在开始抗逆转录病毒治疗（ART）之前，CRP、D-二聚体、IL-6 和透明质酸水平较高与艾滋病或死亡风险增加相关。
J Infect Dis. 2011 Jun 1;203(11):1637-46. doi: 10.1093/infdis/jir134.
9
Immune reconstitution inflammatory syndrome and the central nervous system.免疫重建炎症综合征与中枢神经系统。
Curr Opin Neurol. 2011 Jun;24(3):284-90. doi: 10.1097/WCO.0b013e328346be57.
10
Impact of the immune reconstitution inflammatory syndrome (IRIS) on mortality and morbidity in HIV-infected patients in Mexico.免疫重建炎症综合征（IRIS）对墨西哥 HIV 感染患者死亡率和发病率的影响。
Int J Infect Dis. 2011 Jun;15(6):e408-14. doi: 10.1016/j.ijid.2011.02.007. Epub 2011 Apr 13.
Zotero 插件