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ВИЧ-инфекция и иммуносупрессии

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ДИСКОРДАНТНЫЙ ОТВЕТ CD4+ T-ЛИМФОЦИТОВ НА АНТИРЕТРОВИРУСНУЮ ТЕРАПИЮ

https://doi.org/10.22328/2077-9828-2019-11-1-

Аннотация

Стандартным результатом проведения антиретровирусной терапии (АРТ) у ВИЧ-инфицированных пациентов является подавление репликации вируса и восстановление численности CD4+ T-лимфоцитов. Однако у части больных (приблизительно у 20%) на фоне низкой вирусной нагрузки отмечается нарушение регенерации иммунокомпетентных клеток. В литературе для них был введен термин “immunological nonresponders” (англ.) – «иммунологические неответчики» (ИН). Причиной развития дискордантного иммунологического ответа на терапию может быть, как усиление гибели, так и уменьшение образования CD4+ T-клеток. Однако механизмы формирования низкого восстановительного потенциала иммунитета остаются недостаточно изученными. Известно, что у ИН по сравнению с пациентами, которые демонстрируют конкордантный ответ на лечение, наблюдается усиленная пролиферация лимфоцитов, повышенная иммунная активация, сокращение времени жизни CD4+ T-лимфоцитов. Состояние их иммунной системы характеризуется более яркими проявлениями истощения и старения. Это приводит к раннему и частому появлению СПИД-ассоциированных заболеваний. Кроме того, ИН подвержены высокому риску возникновения неассоциированных со СПИДом болезней, что обусловлено развитием выраженного системного воспаления. Представленный обзор направлен на освещение важной проблемы, возникающей при назначении АРТ, и привлечению к ее решению внимания специалистов.

Об авторе

Константин Владимирович Шмагель
http://www.iegm.ru
Федеральное государственное бюджетное учреждение науки Пермский федеральный исследовательский центр Уральского отделения Российской академии наук; Федеральное государственное бюджетное образовательное учреждение высшего образования «Пермский государственный национальный исследовательский университет»
Россия

Заведующий лабораторией экологической иммунологии Института экологии и генетики микроорганизмов УрО РАН, профессор кафедры микробиологии и иммунологии Пермского государственного национального исследовательского университета

SPIN-код: 9181-7603; Scopus Author ID: 24081205900; 

ResearcherID: J-8454-2018

 



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Шмагель К.В. ДИСКОРДАНТНЫЙ ОТВЕТ CD4+ T-ЛИМФОЦИТОВ НА АНТИРЕТРОВИРУСНУЮ ТЕРАПИЮ. ВИЧ-инфекция и иммуносупрессии. 2019;11(1). https://doi.org/10.22328/2077-9828-2019-11-1-

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