References

mimmun

Медицинская иммунология

Medical Immunology (Russia)

1563-06252313-741X

SPb RAACI

10.15789/1563-0625-2017-5-489-504

mimmun-1348

Research Article

ОБЗОРЫ

REVIEWS

АКТИВАЦИЯ ИММУНИТЕТА ПРИ ВИЧ-ИНФЕКЦИИ

IMMUNITY ACTIVATION IN HIV INFECTION

Шмагель

К. В.

Shmagel

K. V.

Шмагель К.В. – доктор медицинских наук, заведующий лабораторией экологической иммунологии ГБУН «Институт экологии и генетики микроорганизмов» УрО РАН; ФГБОУ ВПО «Пермский государственный национальный исследовательский университет».

614081, г.Пермь, ул.Голева, 13.

Shmagel K.V., PhD, MD (Medicine), Head, Laboratory of Ecological Immunology, Institute of Ecology and Genetics of Microorganisms, Ural Branch, Russian Academy of Sciences; Perm State University.

614081, Russian Federation, Perm, Goleva str., 13.

shmagel@iegm.ru

Шмагель

Н. Г.

Shmagel

N. G.

Шмагель Н.Г. – кандидат медицинских наук, врач-иммунолог ГКУЗ «Пермский краевой центр по борьбе со СПИД и инфекционными заболеваниями»; ФГБОУ ВПО «Пермский государственный национальный исследовательский университет».

г. Пермь.

Shmagel N.G., PhD (Medicine), Clinical Immunologist, Perm Regional Center for Protection against AIDS and Infectious Diseases; Perm State University.

Perm.

Черешнев

В. А.

Chereshnev

V. A.

Черешнев В.А. – доктор математических наук, академик РАН, директор ФГБУН «Институт иммунологии и физиологии» УрО РАН, г. Екатеринбург; ФГБОУ ВПО «Пермский государственный национальный исследовательский университет», г. Пермь.

Chereshnev V.A., PhD, MD (Medicine), Full Member, Russian Academy of Sciences, Director, Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences; Perm State University.

Perm.

ФГБУН «Институт экологии и генетики микроорганизмов» УрО РАН; ФГБОУ ВПО «Пермский государственный национальный исследовательский университет».РоссияInstitute of Ecology and Genetics of Microorganisms, Ural Branch, Russian Academy of Sciences; Perm State University.Russian Federation

ФГБОУ ВПО «Пермский государственный национальный исследовательский университет»; ГКУЗ «Пермский краевой центр по борьбе со СПИД и инфекционными заболеваниями».РоссияPerm State University; Perm Regional Center for Protection against AIDS and Infectious.Russian Federation

ФГБОУ ВПО «Пермский государственный национальный исследовательский университет»; ФГБУН «Институт иммунологии и физиологии» УрО РАН.РоссияPerm State University; Institute of Immunology and Physiology, Ural Branch, Russian Academy of Science.Russian Federation

2017

18102017

195489504

2017

Шмагель К.В., Шмагель Н.Г., Черешнев В.А.

Shmagel K.V., Shmagel N.G., Chereshnev V.A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.mimmun.ru/mimmun/article/view/1348

Данный литературный обзор посвящен актуальной проблеме ВИЧ-инфекции – актива-ции иммунитета. Иммунная активация в значительной мере определяет утрату CD4+T-лимфоцитов, приводит к развитию СПИД-ассоциированных и СПИД-неассоциированных заболеваний, а ее по-казатели являются весомыми прогностическими факторами исхода болезни. Активация при ВИЧ-инфекции захватывает клетки как врожденного, так и адаптивного иммунитета, ведет к усилению продукции провоспалительных цитокинов и повышению коагуляции крови. Причиной развития иммунной активации могут быть инфекционные агенты (ВИЧ, цитомегаловирус, вирус Эпштейна– Барр, вирус гепатита C), лимфопения и индуцированный ею процесс гомеостатической пролифе-рации лимфоцитов, транслокация микробов и их продуктов из кишечника, что связано с глубоким дефицитом CD4+T-клеток в lamina propria и нарушением проницаемости кишечного барьера. Други-ми факторами, поддерживающими процесс активации иммунитета, являются «сторонняя» актива-ция T-лимфоцитов, усиление оборота T-клеток, развитие системного воспаления. В работе не только рассмотрены патогенетические механизмы развития ВИЧ-инфекции, связанные с синдромом им-мунной активации, но также приведены различные лабораторные параметры, характеризующие ее проявление у инфицированных пациентов. Представлены значение и прогностическая роль этих па-раметров в оценке эффективности антиретровирусной терапии, формировании осложнений и нега-тивного исхода инфекции.

This review article concerns a challenging problem of HIV infection, immune activation. The processes of immune activation largely determine CD4+T cell depletion, leading to development of AIDS-associated and non-AIDS-related diseases. Immune activation indices are also strong predictors of the clinical outcome. Activation in HIV-infection affects both innate and adaptive immune cells, leads to increased proinflammatory cytokine production and blood coagulation. The reasons for immune activation may include different pathogens (HIV, cytomegalovirus, Epstein–Barr virus, hepatitis C virus), lymphopenia and lymphopenia-induced T lymphocyte homeostatic proliferation, transfer of microbial products from the gut, due to profound CD4+T cell deficiency in lamina propria and altered permeability of intestinal barrier. Other factors that promote the process of immune activation are as follows: T lymphocyte "bystander" activation, increased T cell turnover, and systemic inflammation development. The review covers pathogenic mechanisms HIV-infection associated with immune activation, like as description of different laboratory parameters characterizing its manifestations in HIV-infected patients. Significance and prognostic role of these parameters in assessing efficiency of antiretroviral therapy, development of complications, and adverse outcomes of infection are presented as well.

ВИЧ-инфекцияиммунная активациявоспалениелимфопенияцитокинымикробная транслокация

HIV infectionimmune activationinflammationlymphopeniacytokinesmicrobial translocation

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The authors declare that there are no conflicts of interest present.