Chiappini Elena, Bianconi Martina, Dalzini Annalisa, Petrara Maria Raffaella, Galli Luisa, Giaquinto Carlo, De Rossi Anita
Infectious Disease Unit, Meyer Children's Hospital, Department of Science Health, University of Florence, Florence, Italy.
Section of Oncology and Immunology, Department of Surgery, Oncology and Gastroenterology, Unit of viral Oncology and AIDS Reference Center, University of Padova, Padova, Italy.
Aging (Albany NY). 2018 Nov 11;10(11):3610-3625. doi: 10.18632/aging.101622.
Premature aging and related diseases have been documented in HIV-infected adults. Data are now emerging also regarding accelerated aging process in HIV-infected children.
A narrative review was performed searching studies on PubMed published in English language in 2004-2017, using appropriate key words, including "aging", "children", "HIV", "AIDS", "immunosenescence", "pathogenesis", "clinical conditions".
Premature immunosenescence phenotype of B and T cells in HIV-infected children is mediated through immune system activation and chronic inflammation. Ongoing inflammation processes have been documented by increased levels of pathogen-associated molecular patterns (PAMPS), increased mitochondrial damage, higher levels of pro-inflammatory cytokines, and a positive correlation between sCD14 levels and percentages of activated CD8 cells. Other reported features of premature aging include cellular replicative senescence, linked to an accelerated telomeres shortening. Finally, acceleration of age-associated methylation pattern and other epigenetic modifications have been described in HIV-infected children. All these features may favor the clinical manifestations related to premature aging. Lipid and bone metabolism, cancers, cardiovascular, renal, and neurological systems should be carefully monitored, particularly in children with detectable viremia and/or with CD4/CD8 ratio inversion.
Aging processes in children with HIV infection impact their quality and length of life. Further studies regarding the mechanisms involved in premature aging are needed to search for potential targets of treatment.
在感染HIV的成年人中已记录到过早衰老及相关疾病。现在也有关于感染HIV儿童加速衰老过程的数据出现。
进行了一项叙述性综述，使用适当的关键词，在2004 - 2017年以英文发表在PubMed上搜索相关研究，关键词包括“衰老”“儿童”“HIV”“艾滋病”“免疫衰老”“发病机制”“临床病症”。
感染HIV儿童中B细胞和T细胞的过早免疫衰老表型是通过免疫系统激活和慢性炎症介导的。病原体相关分子模式（PAMPS）水平升高、线粒体损伤增加、促炎细胞因子水平升高以及sCD14水平与活化CD8细胞百分比之间的正相关，都证明了持续的炎症过程。其他报道的过早衰老特征包括细胞复制性衰老，这与端粒加速缩短有关。最后，在感染HIV的儿童中描述了年龄相关甲基化模式和其他表观遗传修饰的加速。所有这些特征可能有利于与过早衰老相关的临床表现。脂质和骨代谢、癌症、心血管、肾脏和神经系统应受到仔细监测，特别是在病毒血症可检测到和/或CD4/CD8比值倒置的儿童中。
感染HIV儿童的衰老过程会影响他们的生活质量和寿命。需要进一步研究过早衰老所涉及的机制，以寻找潜在的治疗靶点。
