艾滋病免疫重建治疗策略的研究进展

Therapeutic strategies for immune reconstitution in acquired immunodeficiency syndrome

获得性免疫缺陷综合征(AIDS)是由人类免疫缺陷病毒(HIV)侵犯并破坏机体免疫系统引起的疾病。20世纪90年代前,人们普遍认为免疫系统的破坏是不可逆转的,但自高效抗反转录病毒疗法出现以后,发现受损的免疫功能可以获得重建并成为研究的热点。免疫功能重建是指患者受损的免疫功能恢复到正常水平或接近正常水平,从而降低机会性感染和肿瘤的发生,降低发病率和病死率。随着各项技术的发展和改进,AIDS的发病机制和免疫重建机制得到进一步研究,改善调节患者CD4+细胞的数量和免疫功能及细胞毒性T细胞(CTL)的杀伤功能是最重要的保护性免疫机制。目前一些治疗新策略和手段,如细胞因子治疗、HIV特异性疫苗的研制已进入试验或临床阶段,以期进一步改善患者的免疫功能。

Acquired immunodeficiency syndrome （AIDS） is caused by the human innnunodeficiency virus （HIV）, an infection that destroys the body＇ s immune system. It was thought that the immunodeficiency observed in this disease was irreversible, despite antiretroviral therapy. Since the 1990s, however, highly active antiretroviral therapy （HAART）has been used for clinical treatment. It has since been realized that HAART not only suppresses HIV replication but also reconstitutes the immune funetion in AIDS patients. Recent research has asked how to effectively reconstitute the immune function in AIDS patients, which involves facilitating the ability of the immune system to normal or near normal levels through anti-viral strategies and adoptive immunotherapy among other approaches. The goal of immune reconstitution is dissipation of the clinical symptoms of AIDS, as evidenced by a decrease in the incidence of AIDS-related opportunistic infectious and tumors and a decline in rates of mortality. Through technological developments and better understanding of the immunopathogenesis and mechanisms of immune reconstitution, it is possible to improve the level and function of CD4^＋ T cells and to enhance HIV-specific cytotoxic T lymphocyte（CTL） immune responses. At present, a number of new therapies and strategies are entering clinical studies, including the use of various cytokines and therapeutic HIV vaccines.