College of Pharmacy, University of Tennessee Health Science Center, 881 Madison Ave, Memphis, TN 38163, USA.
Cells. 2020 Apr 2;9(4):864. doi: 10.3390/cells9040864.
In the last two decades, the mortality rate in people living with HIV/AIDS (PLWHA) has decreased significantly, resulting in an almost normal longevity in this population. However, a large portion of this population still endures a poor quality of life, mostly due to an increased inclination for substance abuse, including tobacco smoking. The prevalence of smoking in PLWHA is consistently higher than in HIV negative persons. A predisposition to cigarette smoking in the setting of HIV potentially leads to exacerbated HIV replication and a higher risk for developing neurocognitive and other CNS disorders. Oxidative stress and inflammation have been identified as mechanistic pathways in smoking-mediated HIV pathogenesis and HIV-associated neuropathogenesis. Extracellular vesicles (EVs), packaged with oxidative stress and inflammatory agents, show promise in understanding the underlying mechanisms of smoking-induced HIV pathogenesis via cell-cell interactions. This review focuses on recent advances in the field of EVs with an emphasis on smoking-mediated HIV pathogenesis and HIV-associated neuropathogenesis. This review also provides an overview of the potential applications of EVs in developing novel therapeutic carriers for the treatment of HIV-infected individuals who smoke, and in the discovery of novel biomarkers that are associated with HIV-smoking interactions in the CNS.
在过去的二十年中，艾滋病毒/艾滋病（PLWHA）感染者的死亡率显著下降，导致该人群的预期寿命几乎正常。然而，这部分人群的大部分人仍然生活质量较差，主要是因为滥用药物的倾向增加，包括吸烟。PLWHA 中的吸烟率始终高于 HIV 阴性者。在 HIV 环境中对香烟的偏好可能导致 HIV 复制加剧，以及发生神经认知和其他中枢神经系统疾病的风险增加。氧化应激和炎症已被确定为吸烟介导的 HIV 发病机制和与 HIV 相关的神经发病机制中的机制途径。包含氧化应激和炎症因子的细胞外囊泡（EVs）在通过细胞间相互作用理解吸烟诱导的 HIV 发病机制的潜在机制方面显示出希望。本综述重点介绍了 EVs 领域的最新进展，重点介绍了吸烟介导的 HIV 发病机制和与 HIV 相关的神经发病机制。本综述还概述了 EVs 在开发用于治疗吸烟的 HIV 感染者的新型治疗性载体以及发现与 CNS 中 HIV-吸烟相互作用相关的新型生物标志物方面的潜在应用。
