Cellular Immune Activation in Cerebrospinal Fluid From Ugandans With Cryptococcal Meningitis and Immune Reconstitution Inflammatory Syndrome

被引：54

作者：

Meya, David B. ^{[1
,2
,6
]}

Okurut, Samuel ^{[4
]}

Zziwa, Godfrey ^{[4
]}

Rolfes, Melissa A. ^{[6
]}

Kelsey, Melander ^{[7
,8
]}

Cose, Steve ^{[2
,5
,13
]}

Joloba, Moses ^{[3
]}

Naluyima, Prossy

Palmer, Brent E.

Kambugu, Andrew ^{[1
]}

Mayanja-Kizza, Harriet ^{[2
]}

Bohjanen, Paul R.

Eller, Michael A. ^{[10
,11
]}

Wahl, Sharon M. ^{[12
]}

Boulware, David R. ^{[6
]}

Manabe, Yuka C. ^{[1
,9
]}

Janoff, Edward N. ^{[7
,8
]}

机构：

[1] Makerere Univ, Coll Hlth Sci, Infect Dis Inst, Kampala, Uganda

[2] Makerere Univ, Coll Hlth Sci, Sch Med, Kampala, Uganda

[3] Makerere Univ, Dept Microbiol, Sch Biomed Sci, Kampala, Uganda

[4] Makerere Univ Reed Project, Kampala, Uganda

[5] Uganda Virus Res Inst, Med Res Council, Uganda Res Unit AIDS, Entebbe, Uganda

[6] Univ Minnesota, Dept Med, Ctr Infect Dis & Microbiol Translat Res, Minneapolis, MN 55455 USA

[7] Univ Colorado Denver, Mucosal & Vaccine Res Program Colorado, Aurora, CO USA

[8] Denver Vet Affairs Med Ctr, Baltimore, MD USA

[9] Johns Hopkins Univ, Dept Med, Div Infect Dis, Baltimore, MD USA

[10] Walter Reed Army Inst Res, US Mil HIV Res Program, Silver Spring, MD USA

[11] Henry M Jackson Fdn Adv Mil Med, Bethesda, MD USA

[12] Natl Inst Dent & Craniofacial Res, NIH, Bethesda, MD USA

[13] London Sch Hyg & Trop Med, London, England

来源：

JOURNAL OF INFECTIOUS DISEASES | 2015年 / 211卷 / 10期

基金：

英国惠康基金; 美国国家卫生研究院;

关键词：

cryptococcal meningitis; cryptococcus; HIV; cerebrospinal fluid; immune responses; cell activation; CENTRAL-NERVOUS-SYSTEM; CD4(+) T-CELLS; HIV-1-INFECTED PATIENTS; CLINICAL-FEATURES; INFECTED PATIENTS; CHRONIC HIV; TUBERCULOSIS; NEOFORMANS; POLYSACCHARIDE; LYMPHOCYTES;

D O I：

10.1093/infdis/jiu664

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Methods.aEuro integral We characterized the lineage and activation status of mononuclear cells in blood and CSF of HIV-infected patients with noncryptococcal meningitis (NCM) (n = 10), those with CM at day 0 (n = 40) or day 14 (n = 21) of antifungal therapy, and those with CM-IRIS (n = 10). Results.aEuro integral At diagnosis, highly activated CD8(+) T cells predominated in CSF in both CM and NCM. CM-IRIS was associated with an increasing frequency of CSF CD4(+) T cells (increased from 2.2% to 23%; P = .06), a shift in monocyte phenotype from classic to an intermediate/proinflammatory, and increased programmed death ligand 1 expression on natural killer cells (increased from 11.9% to 61.6%, P = .03). CSF cellular responses were distinct from responses in peripheral blood. Conclusions.aEuro integral After CM, T cells in CSF tend to evolve with the development of IRIS, with increasing proportions of activated CD4(+) T cells, migration of intermediate monocytes to the CSF, and declining fungal burden. These changes provide insight into IRIS pathogenesis and could be exploited to more effectively treat CM and prevent CM-IRIS.

引用

页码：1597 / 1606

页数：10

共 46 条

[1] Mycobacterial Antigen Driven Activation of CD14++ CD16- Monocytes Is a Predictor of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome [J].