PMID- 21441488
OWN - NLM
STAT- MEDLINE
DCOM- 20110803
LR  - 20110328
IS  - 1544-0737 (Electronic)
IS  - 0895-9374 (Linking)
VI  - 23
IP  - 1
DP  - 2011 Apr
TI  - Immune reconstitution inflammatory syndrome.
PG  - 90-6
LID - 10.1177/0022034511399915 [doi]
AB  - Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon observed in 
      patients recovering from immunodeficiency. The clinical presentation of IRIS 
      involves the unmasking of covert infections or the worsening of overt conditions. 
      Several causes and pathways have been suggested, most recognizing an inflammatory 
      flare component occurring in the context of rapid immune reconstitution. In 
      HIV-infected patients, IRIS inadvertently occurs as the consequence of successful 
      antiretroviral therapy, and it is affiliated with improvement of the immune 
      function, complicating the course of the disease and presenting treatment 
      challenges to clinicians. The pathogenesis of IRIS is poorly understood, but in 
      recovering HIV patients, its initiation and progression seem to be primarily 
      linked to an increase in CD4+ T-helper and CD8+ T-suppressor cell count and a 
      reduction in T-regulatory cells, all endorsed by exaggerated cytokine release and 
      activity. The clinical presentation of IRIS is usually atypical. The 
      manifestations depend on the trigger antigen, which can be an infective agent 
      (viable or nonviable), a host antigen, or a tumor antigen. Most IRIS cases are 
      self-limiting, but a few cases can be overwhelming and life-threatening; hence, 
      early recognition is important. In most cases, there is no need to discontinue 
      the antiretroviral therapy, although in the more severe cases, other clinical 
      intervention may be necessary.
FAU - Tappuni, A R
AU  - Tappuni AR
AD  - Institute of Dentistry, Barts and the London School of Medicine and Dentistry, 
      Queen Mary, University of London, UK. a.r.tappuni@qmul.ac.uk
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Adv Dent Res
JT  - Advances in dental research
JID - 8802131
RN  - 0 (Cytokines)
RN  - 0 (Inflammation Mediators)
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - CD8-Positive T-Lymphocytes/physiology
MH  - Cytokines/metabolism
MH  - HIV Infections/drug therapy
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/etiology/pathology/physiopathology
MH  - Inflammation Mediators/metabolism
MH  - Lymphocyte Count
MH  - Mouth Neoplasms/*etiology
MH  - T-Lymphocytes, Helper-Inducer/physiology
MH  - Virus Diseases/*etiology
EDAT- 2011/03/29 06:00
MHDA- 2011/08/04 06:00
CRDT- 2011/03/29 06:00
PHST- 2011/03/29 06:00 [entrez]
PHST- 2011/03/29 06:00 [pubmed]
PHST- 2011/08/04 06:00 [medline]
AID - 23/1/90 [pii]
AID - 10.1177/0022034511399915 [doi]
PST - ppublish
SO  - Adv Dent Res. 2011 Apr;23(1):90-6. doi: 10.1177/0022034511399915.