Metaorganism Immunity Section, National Institute of Allergy & Infectious Disease, National Institutes of Health, Bethesda, MD, USA.
Division of Gastroenterology, University of California, San Francisco, CA, USA.
Curr HIV/AIDS Rep. 2019 Jun;16(3):204-213. doi: 10.1007/s11904-019-00441-w.
We discuss recent advances in understanding of gut bacterial microbiota composition in HIV-infected subjects and comment on controversies. We discuss the putative effects of microbiota shifts on systemic inflammation and HIV disease progression and potential mechanisms, as well as ongoing strategies being developed to modulate the gut microbiota in humans for amelioration of infectious and inflammatory diseases.
Lifestyle and behavioral factors relevant to HIV infection studies have independent effects on the microbiota. Microbial metabolism of immunomodulatory compounds and direct immune stimulation by translocation of microbes are putative mechanisms contributing to HIV disease. Fecal microbiota transplantation, microbial enzyme inhibition, phage therapy, and rationally selected probiotic cocktails have emerged as promising strategies for microbiota modulation. Numerous surveys of the HIV gut microbiota matched for lifestyle factors suggest consistent shifts in gut microbiota composition among HIV-infected subjects. Evidence exists for a complex pathogenic role of the gut microbiota in HIV disease progression, warranting further study.
我们讨论了目前对于 HIV 感染者肠道细菌微生物群落组成的理解的最新进展，并对争议点进行了评论。我们讨论了微生物群落变化对全身炎症和 HIV 疾病进展的潜在影响及其潜在机制，以及目前正在开发的用于调节人类肠道微生物群以改善传染性和炎症性疾病的策略。
与 HIV 感染研究相关的生活方式和行为因素对微生物群落有独立的影响。免疫调节化合物的微生物代谢和微生物的直接免疫刺激通过微生物易位被认为是导致 HIV 疾病的潜在机制。粪便微生物移植、微生物酶抑制、噬菌体治疗和经过合理选择的益生菌混合物已成为调节微生物群落的有前途的策略。许多针对 HIV 肠道微生物群的研究在匹配生活方式因素后表明，HIV 感染者的肠道微生物群落组成存在一致的变化。有证据表明肠道微生物群在 HIV 疾病进展中具有复杂的致病性作用，值得进一步研究。
