艾滋病患者肠道免疫细胞和肠道菌群的变化及其临床意义

cART能够有效抑制艾滋病患者体内(HIV-1)复制,提高感染者外周血CD4细胞数量,显著降低HIV-1相关疾病的发病率和病死率。不过,目前仍然有约20%的患者接受cART后并不能实现免疫重建。虽然后者发生的确切机制尚不完全清楚,但是慢性HIV-1感染对肠道组织和黏膜免疫微环境的破坏可能是一个重要原因。肠道组织富含免疫细胞,容易受HIV-1攻击,造成肠道黏膜组织损伤和通透性增加,继而发生肠道菌群紊乱和肠道菌群移位。这些变化不仅可以造成患者体内整体的免疫激活和系统性慢性炎症,而且还影响病毒潜伏和cART后的免疫重建。因此,解析HIV-1慢性感染、肠道免疫损伤和肠道菌群失调之间存在的复杂关系,对于阐明艾滋病患者免疫重建失败的机制、发现新型的治疗靶点以及创建新型的治疗策略,都具有重要的参考价值。为此,本文针对慢性HIV-1感染者肠道免疫细胞和肠道菌群改变的特点及其临床意义进行综述。

儿童慢性乙型肝炎免疫耐受期的特点和抗病毒治疗研究进展

免疫耐受期慢性乙型肝炎(CHB)患儿是否需要治疗是尚未明确的临床热点问题之一。充分了解HBV感染的自然史、与疾病进展的关系以及及时治疗能否改变自然史和预后,对免疫耐受期患儿临床抗病毒治疗的决策非常重要。为此,现对近10年来临床抗病毒治疗免疫耐受期CHB患儿的相关研究进展进行综述。同时,对治疗的安全性、有效性和相关的免疫学机制进行探讨,以期明确下一步的重点研究方向、为肝病专家更好地诊治免疫耐受期儿童CHB患者,提供直接的循证医学证据,最终提高临床治愈率。

Polymorphisms of chemokine receptors and its ligand alleles influencing genetic suscepti-bity to HIV-1 infection in eight ethnic groups in Chinese mainland

Limited genetic information is available concerning the polymorphisms of HIV-1 resistant genes in indigenous Chinese populations. The aim of this study is to identify the allelic frequencies of the chemokine and chemokine receptor genes in the Chinese mainland. Genomic DNA samples extracted from whole blood of 2318 subjects were analyzed by using PCR or PCR/restriction fragment length polymorphism (RFLP) assays, and further confirmed by direct DNA sequencing. Higher frequencies of mutant CCR2-64I (19.15%-28.79%) and SDF1-3’A (19.10% -29.86%) alleles were found in subjects of 8 ethnic groups in the Chinese mainland. In contrast, the △32 mutation in CCRS gene occurs at a very low frequency (0.0016, n=1287) in Han population. A relatively high frequency of CCR5-wt/△32 heterozygotes was observed in Uygurian and Mongolian populations. No A32 mutation allele was detected in Tibetan and other 4 ethnic groups in Yunnan Province. There was no CCR5-m303 mutation in subjects of any ethnic group in the Chinese