Cytokinene i en HIV Infeksjon

Det har blitt publisert en studie i PLOS ONE 11 august 2011 hvor det har blitt sett på cytokinene i en akuttfase av en HIV-infeksjon, iallefall fra det punktet hvor infeksjonen er symptomatisk. Cytokiner spiller en sentral rolle i infeksjoner og i denne studien er det også sett på spørsmål og problemstillinger rundt eventuell vaksiner for HIV. Publikasjonen er skrevet av Katsikis PD et al. med tittel «The Cytokine Network of Acute HIV Infection: A Promising Target for Vaccines and Therapy to Reduce Viral Set-Point?»

Abstraktet er som følger:

Cytokines play a central role in the pathogenesis of many diseases, including HIV infection. However, the role of the cytokine network in early HIV infection is only now starting to be elucidated. A number of studies conducted in recent years have indicated that cytokines of the acute/early stages of HIV and SIV infection can impact viral set-point months later, and this is of critical importance since viral set-point during chronic HIV infection affects virus transmission and disease progression. This raises the question whether modulating the cytokine environment during acute/early HIV infection can be a target for novel approaches to develop a vaccine and therapeutics. In this review we focus on the kinetics and function of cytokines during acute HIV and SIV infection and how these may impact viral set-point. We also discuss unresolved questions that are essential for our understanding of the role of acute infection cytokines in HIV infection and that, if answered, may suggest novel therapeutic and vaccine strategies to control the worldwide HIV pandemic.

Figuren viser hvordan cytokiner er bestemmende for patogenesen i en HIV infeksjon. For ett større bilde se HER

«The complexity of the role of the cytokine milieu in acute HIV and SIV infection has only partially been addressed. The first reports examining cytokines in acute HIV infection were conducted in patients with symptomatic acute infection. However, very early events during the first days and weeks could not be assessed since the exact time of infection was unknown and the symptomatic phase can occur several weeks after initial viral exposure.

A more recent study analyzed plasma cytokines in HIV infection after the eclipse phase in patients with detectable viral load (at least 100 HIV RNA copies/ml) . This examination of systemic plasma cytokines revealed that IFNα and IL-15 were the first cytokines elevated within 5 days after detection of viremia, followed by TNFα, CXCL10, and IFNγ, and then by IL-12.

As expected for the anti-inflammatory cytokine IL-10, increased IL-10 mRNA and protein levels are detected rather late in HIV infection, after the increased expression of proinflammatory cytokines . Another well-known inhibitory cytokine upregulated in the majority of acutely HIV infected individuals is IL-1R antagonist (IL-1Rα) . In vitro, IL-1Rα inhibits IL-1-mediated HIV replication, suggesting that IL-1Rα would suppress viral replication during acute infection. Similar to IL-10, however, IL-1Rα may also affect anti-viral immunity. A major caveat in all of these human studies is the estimated time point of infection.»

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