MRC National Institute for Medical Research, London, UK.
Eur J Immunol. 2013 Aug;43(8):1995-2002. doi: 10.1002/eji.201343632.
HIV-1 patients co-infected with some pathogens are at risk of developing the immune reconstitution inflammatory syndrome (IRIS) when initiating antiretroviral therapy (ART). IRIS is characterized by inflammation leading to the clinical worsening of a treated infection or the unmasking of a previously undiagnosed condition or infection. It is commonly associated with tuberculosis (TB), 8-43% of the HIV-TB co-infected patients prescribed with antitubercular treatment and ART develop TB-IRIS. Although IRIS has been recognized for over 20 years, relatively little was known until recently about its pathogenesis. Despite these advances in understanding IRIS, there remains no immune biomarker for diagnostic or prognostic purposes. Here, we review the risk factors associated with TB-IRIS, the challenges in studying this syndrome, and how T lymphocytes, dysregulated cytokine responses, and innate immunity may contribute to the development of TB-IRIS.
HIV-1 患者合并某些病原体感染时，在开始抗逆转录病毒治疗（ART）时，可能会发生免疫重建炎症综合征（IRIS）。IRIS 的特征是炎症导致治疗感染的临床恶化，或揭示以前未诊断的病症或感染。它通常与结核病（TB）相关，8-43%的 HIV-TB 合并感染患者接受抗结核治疗和 ART 后会发生 TB-IRIS。尽管 IRIS 已经被认识了 20 多年，但直到最近才对其发病机制有了相对较少的了解。尽管对 IRIS 的认识取得了这些进展，但目前仍然没有用于诊断或预后目的的免疫生物标志物。在这里，我们回顾了与 TB-IRIS 相关的危险因素、研究该综合征的挑战，以及 T 淋巴细胞、失调的细胞因子反应和固有免疫如何可能导致 TB-IRIS 的发展。
