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抗逆转录病毒治疗时代的 HIV 感染中的 CD8 T 细胞反应。

CD8 T-Cell Response to HIV Infection in the Era of Antiretroviral Therapy.

机构信息

Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia.

Grupo de Investigaciones Biomédicas Uniremington, Programa de Medicina, Facultad de Ciencias de la Salud, Corporación Universitaria Remington, Medellin, Colombia.

出版信息

Front Immunol. 2019 Aug 9;10:1896. doi: 10.3389/fimmu.2019.01896. eCollection 2019.

Abstract

Although the combined antiretroviral therapy (cART) has decreased the deaths associated with the immune deficiency acquired syndrome (AIDS), non-AIDS conditions have emerged as an important cause of morbidity and mortality in HIV-infected patients under suppressive cART. Since these conditions are associated with a persistent inflammatory and immune activation state, major efforts are currently made to improve the immune reconstitution. CD8 T-cells are critical in the natural and cART-induced control of viral replication; however, CD8 T-cells are highly affected by the persistent immune activation and exhaustion state driven by the increased antigenic and inflammatory burden during HIV infection, inducing phenotypic and functional alterations, and hampering their antiviral response. Several CD8 T-cell subsets, such as interleukin-17-producing and follicular CXCR5 CD8 T-cells, could play a particular role during HIV infection by promoting the gut barrier integrity, and exerting viral control in lymphoid follicles, respectively. Here, we discuss the role of CD8 T-cells and some of their subpopulations during HIV infection in the context of cART-induced viral suppression, focusing on current challenges and alternatives for reaching complete reconstitution of CD8 T-cells antiviral function. We also address the potential usefulness of CD8 T-cell features to identify patients who will reach immune reconstitution or have a higher risk for developing non-AIDS conditions. Finally, we examine the therapeutic potential of CD8 T-cells for HIV cure strategies.

摘要

尽管联合抗逆转录病毒疗法(cART)降低了与获得性免疫缺陷综合征(AIDS)相关的死亡率,但在接受抑制性 cART 的 HIV 感染患者中,非艾滋病疾病已成为发病率和死亡率的一个重要原因。由于这些疾病与持续的炎症和免疫激活状态有关,目前正在努力改善免疫重建。CD8 T 细胞在自然和 cART 诱导的病毒复制控制中起着至关重要的作用;然而,CD8 T 细胞受到 HIV 感染期间抗原和炎症负担增加驱动的持续免疫激活和衰竭状态的严重影响,导致表型和功能改变,并阻碍其抗病毒反应。一些 CD8 T 细胞亚群,如产生白细胞介素 17 和滤泡 CXCR5 CD8 T 细胞,在 HIV 感染期间通过促进肠道屏障完整性和分别在淋巴滤泡中发挥病毒控制作用,可能发挥特定作用。在这里,我们讨论了 CD8 T 细胞及其在 cART 诱导的病毒抑制背景下的一些亚群在 HIV 感染期间的作用,重点关注当前的挑战和替代方案,以实现 CD8 T 细胞抗病毒功能的完全重建。我们还探讨了 CD8 T 细胞特征在识别能够实现免疫重建或发生非艾滋病疾病风险较高的患者方面的潜在用途。最后,我们研究了 CD8 T 细胞在 HIV 治愈策略中的治疗潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/656b/6697065/cf30185d0ff4/fimmu-10-01896-g0001.jpg

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