PMID- 22562000
OWN - NLM
STAT- MEDLINE
DCOM- 20120719
LR  - 20120507
IS  - 1473-6527 (Electronic)
IS  - 0951-7375 (Linking)
VI  - 25
IP  - 3
DP  - 2012 Jun
TI  - Pathogenesis of the immune reconstitution inflammatory syndrome in HIV-infected 
      patients.
PG  - 312-20
LID - 10.1097/QCO.0b013e328352b664 [doi]
AB  - PURPOSE OF REVIEW: The immune reconstitution inflammatory syndrome (IRIS) is an 
      important clinical complication in HIV-infected patients initiating 
      antiretroviral therapy. This review focuses on the latest literature pertaining 
      to the pathogenesis of IRIS. RECENT FINDINGS: The clinical manifestations of IRIS 
      are heterogeneous due to the variety of opportunistic infections that are 
      associated with this inflammatory syndrome. However, the disproportionate 
      inflammation is a defining hallmark for which common mechanisms are suspected. 
      Lymphopenia-induced proliferation in the context of systemic immune activation, 
      presence of high antigenic exposure and a wider availability of interleukin-7 
      contribute to the exacerbated immune response underlying IRIS. Defect in pathogen 
      clearance by phagocytes might favor high pathogen burden, which in turn is 
      thought to activate both innate immune cells and pathogen-specific T cells upon 
      correction of the CD4 T-cell lymphopenia, predisposing to IRIS. This common 
      scenario might be further invigorated by functional impairments among regulatory 
      T cells. SUMMARY: Further insight into the cellular mechanisms driving IRIS is 
      urgently needed. Understanding the relative contribution of distinct effector and 
      regulatory T-cell subsets, and innate immune components to IRIS is required to 
      inspire future therapeutic approaches.
FAU - Martin-Blondel, Guillaume
AU  - Martin-Blondel G
AD  - Department of Infectious and Tropical Diseases, Toulouse University Hospital, 
      Toulouse, France.
FAU - Mars, Lennart T
AU  - Mars LT
FAU - Liblau, Roland S
AU  - Liblau RS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Opin Infect Dis
JT  - Current opinion in infectious diseases
JID - 8809878
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/immunology
MH  - Anti-HIV Agents/adverse effects
MH  - HIV Infections/complications/drug therapy/*immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*immunology
MH  - Immune Tolerance/immunology
MH  - Immunity, Innate/immunology
MH  - Lymphopenia/immunology
EDAT- 2012/05/09 06:00
MHDA- 2012/07/20 06:00
CRDT- 2012/05/08 06:00
PHST- 2012/05/08 06:00 [entrez]
PHST- 2012/05/09 06:00 [pubmed]
PHST- 2012/07/20 06:00 [medline]
AID - 00001432-201206000-00012 [pii]
AID - 10.1097/QCO.0b013e328352b664 [doi]
PST - ppublish
SO  - Curr Opin Infect Dis. 2012 Jun;25(3):312-20. doi: 10.1097/QCO.0b013e328352b664.