Instituto Gonçalo Moniz, Salvador, Bahia, Brazil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Fundação José Silveira, Salvador, Bahia, Brazil.
Sci Rep. 2019 Feb 6;9(1):1502. doi: 10.1038/s41598-018-37846-3.
Immune reconstitution inflammatory syndrome (IRIS) occurs in up to 40% of individuals co-infected with pulmonary tuberculosis (PTB) and HIV, primarily upon antiretroviral therapy (ART) initiation. Phenotypic changes in T-cells during TB-IRIS and their relationship with systemic inflammation are not fully understood. In this prospective cohort study, we followed 48 HIV-positive patients with PTB from South India before and after ART initiation, examining T-lymphocyte subsets and inflammatory biomarkers in peripheral blood. Quantification of naïve (CD27CD45RO) as well as effector memory CD4 T cells (CD27CD45RO) at weeks 2-6 after ART initiation could distinguish TB-IRIS from non-IRIS individuals. Additional analyses revealed that ART reconstituted different quantities of CD4 T lymphocyte subsets with preferential expansion of CXCR3 CCR6 cells in TB-IRIS patients. Moreover, there was an expansion and functional restoration of central memory (CD27CD45RO) CXCR3CCR6 CD4 lymphocytes and corresponding cytokines, with reduction in CXCR3CCR6 cells after ART initiation only in those who developed TB-IRIS. Together, these observations trace a detailed picture of CD4 T cell subsets tightly associated with IRIS, which may serve as targets for prophylactic and/or therapeutic interventions in the future.
免疫重建炎症综合征 (IRIS) 可发生于高达 40%的合并肺结核 (PTB) 和 HIV 感染的个体中,主要发生在抗逆转录病毒治疗 (ART) 开始时。在 TB-IRIS 期间 T 细胞的表型变化及其与全身炎症的关系尚未完全阐明。在这项前瞻性队列研究中,我们在 ART 开始前后随访了来自印度南部的 48 名 HIV 阳性合并肺结核患者,检测外周血中的 T 淋巴细胞亚群和炎症生物标志物。在 ART 开始后 2-6 周定量检测 naïve(CD27CD45RO)和效应记忆 CD4 T 细胞(CD27CD45RO)可以区分 TB-IRIS 与非 IRIS 个体。进一步的分析表明,ART 重建了不同数量的 CD4 T 淋巴细胞亚群,TB-IRIS 患者中 CXCR3 CCR6 细胞优先扩增。此外,在那些发生 TB-IRIS 的患者中,中央记忆(CD27CD45RO)CXCR3CCR6 CD4 淋巴细胞及其相应细胞因子扩增和功能恢复,而仅在那些发生 TB-IRIS 的患者中,CXCR3CCR6 细胞在 ART 开始后减少。总之,这些观察结果描绘了与 IRIS 密切相关的 CD4 T 细胞亚群的详细情况,这些亚群可能成为未来预防和/或治疗干预的靶点。
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