HIV-1介导的免疫病理学中的性别差异。
Sex differences in HIV-1-mediated immunopathology.
作者信息
Ziegler Susanne, Altfeld Marcus
机构信息
aDepartment of Viral Immunology, Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany bRagon Institute of MIT, MGH and Harvard, Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Curr Opin HIV AIDS. 2016 Mar;11(2):209-15. doi: 10.1097/COH.0000000000000237.
PURPOSE OF REVIEW
The article reviews our current knowledge regarding the role of sex and sex hormones in regulating innate immune responses to viral infections, which may account for the described sex differences in immunity to HIV-1.
RECENT FINDINGS
Prominent sex differences exist in various infectious and autoimmune diseases. Biological mechanisms underlying these differences include the modulation of immunological pathways by sex hormones and gene dosage effects of immunomodulatory genes encoded by the X chromosome. During HIV-1 infections, women have been shown to present with lower viral load levels in primary infection, although their progression to AIDS is faster in comparison with men when accounting for viral load levels in chronic infection. HIV-1-infected women furthermore tend to have higher levels of immune activation and interferon-stimulated gene expression in comparison with men for the same viral load, which has been associated to innate sensing of HIV-1 by Toll-like receptor 7 and the consequent interferon-α production by plasmacytoid dendritic cells.
SUMMARY
Improvement in understanding the mechanisms associated with sex differences in HIV-1-mediated immunopathology will be critical to take sex differences into consideration when designing experimental and clinical studies in HIV-1-infected populations.
综述目的
本文回顾了我们目前关于性别和性激素在调节对病毒感染的固有免疫反应中所起作用的知识，这可能解释了在对HIV-1免疫方面所描述的性别差异。
最新发现
在各种感染性和自身免疫性疾病中存在显著的性别差异。这些差异背后的生物学机制包括性激素对免疫途径的调节以及X染色体编码的免疫调节基因的基因剂量效应。在HIV-1感染期间，女性在初次感染时病毒载量水平较低，尽管在考虑慢性感染中的病毒载量水平时，与男性相比，她们进展为艾滋病的速度更快。此外，对于相同的病毒载量，与HIV-1感染的男性相比，女性往往具有更高水平的免疫激活和干扰素刺激基因表达，这与Toll样受体7对HIV-1的固有感知以及浆细胞样树突状细胞随后产生的干扰素-α有关。
总结
在设计针对HIV-1感染人群的实验和临床研究时，更好地理解与HIV-1介导的免疫病理学中的性别差异相关的机制对于考虑性别差异至关重要。
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