HIV感染者先天免疫系统因素与神经认知功能参数结果之间的关系:研究的中期结果

S. Knysh, L. F. Sklyar, Yu.S. Cherkasova, A. A. Chernikova, A. A. Knysh, T. Nevezhkina, E. Chagina
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引用次数: 0

摘要

即使使用抗逆转录病毒治疗,艾滋病毒感染仍与神经系统损伤密切相关。因此,患者出现神经系统并发症的风险很高。由于血脑屏障的渗透性有限,其损伤的机会,直接由HIV感染细胞的蛋白质或间接由免疫系统,如诱导炎症介质的产生,中枢神经系统参与HIV感染的发病机制似乎只是一个时间问题。HIV相关神经认知障碍(HAND)包括与HIV感染中神经元直接和间接损伤相关的多病因病理状况。先天免疫系统和神经系统介质之间的相互作用在病毒感染中的作用表明,亲炎性和抗炎性细胞因子的含量和比例的特定变化是最多能的免疫调节介质之一,可以在HIV感染中容易发生HAND的人群中检测到。本研究的目的是了解HIV感染者血清含量的特点以及先天免疫因子指标与神经认知测试结果的关系。123人参与了这项研究,其中93人感染了艾滋病毒。根据俄罗斯艾滋病毒感染分类,他们根据感染阶段分为三组。30人代表一组健康的志愿者,年龄和性别与主要群体成员相当,并作为对照组。采用固相酶免疫法测定血清中IL-1和IL-10的含量。流式细胞术检测CD4+T淋巴细胞水平。神经认知测试使用舒尔特表,明斯特伯格测试由医学心理学家根据普遍接受的方法进行。与对照组相比,主要组受试者血清IL-10含量显著升高,III组受试者血清IL-10含量较I组和II组显著升高。与其他各组相比,III组IL- 1、CD4+T淋巴细胞水平明显降低。与对照组相比,通过舒尔特表测试确定的个人绩效指数在所有组中都有所降低,其中I组和II组的结果明显优于III组参与者的结果。与对照组相比,所有主要组的明斯特伯格测验得分均有相同的下降。当评估斯皮尔曼系数时,根据疾病的分期,建立了各种相关概况。
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Relationships between the factors of innate immune system and results of neurocognitive function parameters in the persons living with HIV infection: interim results of the study
HIV infection is closely associated with damage to the nervous system, even despite usage of antiretroviral therapy. Thus, the patients are at a high risk for neurological complications. Due to limited permeability of the blood-brain barrier, the opportunity of its damage, both directly by the proteins of HIV-infected cells and indirectly, by immune system, e.g., inducing the production of inflammatory mediators, the involvement of the central nervous system in pathogenesis of HIV infection seems to be only a matter of time. HIV-associated neurocognitive disorders (HAND) comprise a poly-etiological pathological condition associated with direct and indirect damage to neurons in HIV infection. The role of interaction between the innate immune system and nervous system mediators in viral infections suggests that the specific changes in content and ratios of pro- and anti-inflammatory cytokines that are among the most polypotent mediators of immune regulation can be detectable in the persons prone to the development of HAND in HIV infection. The purpose of the present study was to characterize the features of serum content and the relationship between the indexes of innate immunity factors with the results of neurocognitive testing in the persons living with HIV. 123 persons were included in the study, of which 93 subjects live with HIV infection. They were divided into 3 groups according to the stages of HIV infection, according to the Russian Classification of HIV infection. 30 persons represented a group of healthy volunteers, comparable in age and gender with the members of main groups, and served as a control group. Determination of IL-1 and IL-10 contents in blood serum was carried out by solid-phase enzyme immunoassay. The level of CD4+T lymphocytes was determined by flow cytometry. Neurocognitive testing using Schulte tables, the Munsterberg test was conducted by a medical psychologist, according to generally accepted methods. A significant increase in the serum IL-10 content in subjects from the main groups was revealed as compared with the control group, as well as in group III compared with the values groups I and II. The levels of IL- 1, CD4+T lymphocytes were significantly lower in group III, compared with all other groups. The personal performance index determined by testing with Schulte tables was reduced in all groups, relative to the controls, with a significant predominance of the results in groups I and II over the results of the participants from group III. The scores in Munsterberg test were equally diminished in all the main groups compared to the control values. When assessing the Spearman coefficient, the presence of various correlation profiles was established, depending on the stage of the disease.
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