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HIV 感染的发病机制与治疗:从细胞、免疫系统和神经内分泌系统角度的探讨。

Pathogenesis and treatment of HIV infection: the cellular, the immune system and the neuroendocrine systems perspective.

机构信息

Institute of Immunology and Physiology, Ural Branch RAS, Ekaterinburg, Russia.

出版信息

Int Rev Immunol. 2013 Jun;32(3):282-306. doi: 10.3109/08830185.2013.779375. Epub 2013 Apr 25.

Abstract

Infections with HIV represent a great challenge for the development of strategies for an effective cure. The spectrum of diseases associated with HIV ranges from opportunistic infections and cancers to systemic physiological disorders like encephalopathy and neurocognitive impairment. A major progress in controlling HIV infection has been achieved by highly active antiretroviral therapy (HAART). However, HAART does neither eliminate the virus reservoirs in form of latently infected cells nor does it completely reconstitute immune reactivity and physiological status. Furthermore, the failure of the STEP vaccine trial and the only marginal efficacies of the RV144 trial together suggest that the causal relationships between the complex sets of viral and immunological processes that contribute to protection or disease pathogenesis are still poorly understood. Here, we provide an up-to-date overview of HIV-host interactions at the cellular, the immune system and the neuroendocrine systems level. Only by integrating this multi-level knowledge one will be able to handle the systems complexity and develop new methodologies of analysis and prediction for a functional restoration of the immune system and the health of the infected host.

摘要

HIV 感染对开发有效的治疗策略构成了巨大挑战。与 HIV 相关的疾病谱从机会性感染和癌症到全身性生理紊乱,如脑病和神经认知障碍。高效抗逆转录病毒疗法 (HAART) 的应用在控制 HIV 感染方面取得了重大进展。然而,HAART 既不能消除潜伏感染细胞形式的病毒储库,也不能完全重建免疫反应和生理状态。此外,STEP 疫苗试验的失败和 RV144 试验仅略有疗效表明,导致保护或疾病发病机制的复杂病毒和免疫过程之间的因果关系仍未被充分理解。在这里,我们提供了 HIV-宿主相互作用在细胞、免疫系统和神经内分泌系统水平的最新概述。只有综合这多层次的知识,才能处理系统的复杂性,并为免疫系统的功能恢复和受感染宿主的健康开发新的分析和预测方法。

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