Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
Front Immunol. 2022 Aug 12;13:899559. doi: 10.3389/fimmu.2022.899559. eCollection 2022.
The lumen of the gastrointestinal (GI) tract contains an incredibly diverse and extensive collection of microorganisms that can directly stimulate the immune system. There are significant data to demonstrate that the spatial localization of the microbiome can impact viral disease pathogenesis. Here we discuss recent studies that have investigated causes and consequences of GI tract pathologies in HIV, SIV, and SARS-CoV-2 infections with HIV and SIV initiating GI pathology from the basal side and SARS-CoV-2 from the luminal side. Both these infections result in alterations of the intestinal barrier, leading to microbial translocation, persistent inflammation, and T-cell immune activation. GI tract damage is one of the major contributors to multisystem inflammatory syndrome in SARS-CoV-2-infected individuals and to the incomplete immune restoration in HIV-infected subjects, even in those with robust viral control with antiretroviral therapy. While the causes of GI tract pathologies differ between these virus families, therapeutic interventions to reduce microbial translocation-induced inflammation and improve the integrity of the GI tract may improve the prognoses of infected individuals.
胃肠道(GI)腔含有数量惊人且多样的微生物群体,这些微生物可以直接刺激免疫系统。有大量数据表明,微生物组的空间定位可以影响病毒疾病的发病机制。在这里,我们讨论了最近的研究,这些研究调查了 HIV、SIV 和 SARS-CoV-2 感染中胃肠道病理学的原因和后果,其中 HIV 和 SIV 从基底侧引发胃肠道病理学,而 SARS-CoV-2 则从腔侧引发。这两种感染都导致肠道屏障的改变,导致微生物易位、持续炎症和 T 细胞免疫激活。胃肠道损伤是 SARS-CoV-2 感染个体中多系统炎症综合征和 HIV 感染个体中不完全免疫恢复的主要原因之一,即使在那些通过抗逆转录病毒疗法实现强大病毒控制的个体中也是如此。虽然这些病毒家族的胃肠道病理学的原因不同,但减少微生物易位诱导的炎症和改善胃肠道完整性的治疗干预措施可能会改善感染个体的预后。