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AIDS Research and Therapy
Published in: AIDS Research and Therapy 1/2007

Open Access 01-12-2007 | Hypothesis

Immune reconstitution inflammatory syndrome in association with HIV/AIDS and tuberculosis: Views over hidden possibilities

Authors: Esaki Muthu Shankar, Ramachandran Vignesh, Kailapuri G Murugavel, Pachamuthu Balakrishnan, Ramalingam Sekar, Charmaine AC Lloyd, Suniti Solomon, Nagalingeswaran Kumarasamy

Published in: AIDS Research and Therapy | Issue 1/2007

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Abstract

Gut immune components are severely compromised among persons with AIDS, which allows increased translocation of bacterial lipopolysaccharides (LPS) into the systemic circulation. These microbial LPS are reportedly increased in chronically HIV-infected individuals and findings have correlated convincingly with measures of immune activation. Immune reconstitution inflammatory syndrome (IRIS) is an adverse consequence of the restoration of pathogen-specific immune responses in a subset of HIV-infected subjects with underlying latent infections during the initial months of highly active antiretroviral treatment (HAART). Whether IRIS is the result of a response to a high antigen burden, an excessive response by the recovering immune system, exacerbated production of pro-inflammatory cytokines or a lack of immune regulation due to inability to produce regulatory cytokines remains to be determined. We theorize that those who develop IRIS have a high burden of proinflammatory cytokines produced also in response to systemic bacterial LPS that nonspecifically act on latent mycobacterial antigens. We also hypothesize that subjects that do not develop IRIS could have developed either tolerance (anergy) to persistent LPS/tubercle antigens or could have normal FOXP3+ gene and that those with defective FOXP3+ gene or those with enormous plasma LPS could be vulnerable to IRIS. The measure of microbial LPS, anti-LPS antibodies and nonspecific plasma cytokines in subjects on HAART shall predict the role of these components in IRIS.
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Metadata
Title
Immune reconstitution inflammatory syndrome in association with HIV/AIDS and tuberculosis: Views over hidden possibilities
Authors
Esaki Muthu Shankar
Ramachandran Vignesh
Kailapuri G Murugavel
Pachamuthu Balakrishnan
Ramalingam Sekar
Charmaine AC Lloyd
Suniti Solomon
Nagalingeswaran Kumarasamy
Publication date
01-12-2007
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2007
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/1742-6405-4-29

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