Biomarkers in immune reconstitution inflammatory syndrome: signals from pathogenesis.

Abstract:

PURPOSE OF REVIEW:Immune reconstitution inflammatory syndrome (IRIS) is the paradoxical worsening or unmasking of an infection or neoplasm in HIV-1-infected patients shortly after antiretroviral therapy (ART) initiation. New insights into the pathogenesis of IRIS may help identify biomarkers that could be useful in predicting or diagnosing IRIS. RECENT FINDINGS:Studies of immunopathogenesis have shown a signification activation of both innate and adaptive immune responses with elevation of plasma or serum chemokines and cytokines. Markers of inflammation such as C-reactive protein, interferon-inducible protein 10 or interferon γ may be helpful as predictors of IRIS events. In addition, tuberculosis (TB)-associated IRIS is associated with a prominent Th1 response that can be heightened even prior to ART initiation in cases of unmasking TB, and may assist in early diagnosis. Large prospective studies are needed to elucidate the predictive and diagnostic value of IRIS biomarkers and advance them to the clinic. SUMMARY:Reversal of immunosuppression by ART leads to exaggerated pathogen-specific immune responses (known as IRIS) that appear to be primed prior to therapy. Inflammatory markers, chemokines and cytokines that signify innate and adaptive immune activation are biomarkers that could prove of clinical value after appropriate validation.

journal_name

Curr Opin HIV AIDS

authors

Sereti I,Rodger AJ,French MA

doi

10.1097/COH.0b013e32833ed774

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

504-10

issue

6

eissn

1746-630X

issn

1746-6318

pii

01222929-201011000-00009

journal_volume

5

pub_type

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