艾滋病免疫重建治疗策略的研究进展.pdf

·30·微生物与感染2009年3月第4卷第1期JournalofMicrobesandInfection,March2009,Vol.4,No.1

·综述·

艾滋病免疫重建治疗策略的研究进展

孙富艳1,卢洪洲1,2,3
1.上海市(复旦大学附属)公共卫生中心感染科,上海201508;2.复旦大学附属华山医院感染科,上海200040;
3.复旦大学上海医学院内科学系,上海200032

摘要:获得性免疫缺陷综合征(AIDS)是由人类免疫缺陷病毒(HIV)侵犯并破坏机体免疫系统引起的疾病。
20世纪90年代前,人们普遍认为免疫系统的破坏是不可逆转的,但自高效抗反转录病毒疗法出现以后,发现
受损的免疫功能可以获得重建并成为研究的热点。免疫功能重建是指患者受损的免疫功能恢复到正常水平
或接近正常水平,从而降低机会性感染和肿瘤的发生,降低发病率和病死率。随着各项技术的发展和改进,
AIDS的发病机制和免疫重建机制得到进一步研究,改善调节患者CD4+细胞的数量和免疫功能及细胞毒性T
细胞(CTL)的杀伤功能是最重要的保护性免疫机制。目前一些治疗新策略和手段,如细胞因子治疗、HIV特
异性疫苗的研制已进入试验或临床阶段,以期进一步改善患者的免疫功能。

关键词:获得性免疫缺陷综合征;治疗性疫苗;免疫重建

Therapeuticstrategiesforimmunereconstitutioninacquired
immunodeficiencysyndrome

SUNFu-Yan1,LUHong-Zhou1,2,3
1.DepartmentofInfectiousDisease,ShanghaiPublicHealthClinicalCenterAffiliatedtoFudanUniversity,Shanghai
201508,China;2.DepartmentofInfectiousDisease,HuashanHospital,FudanUniversity,Shanghai200040,China;
3.DepartmentofMedicalScience,ShanghaiMedicalCollege,FudanUniversity,Shanghai200032,China

Abstract:Acquiredimmunodeficiencysyndrome(AIDS)iscausedbythehumanimmunodeficiencyvirus(HIV),an
infectionthatdestroysthebody’simmunesystem.Itwasthoughtthattheimmunodeficiencyobservedinthisdisease
wasirreversible,despiteantiretroviraltherapy.Sincethe1990s,however,highlyactiveantiretroviraltherapy
(HAART)hasbeenusedforclinicaltreatment.IthassincebeenrealizedthatHAARTnotonlysuppressesHIV
replicationbutalsoreconstitutestheimmunefunctioninAIDSpatients.Recentresearchhasaskedhowtoeffectively
reconstitutetheimmunefunctioninAIDSpatients,whichinvolvesfacilitatingtheabilityoftheimmunesystemto
normalornearnormallevelsthroughanti-viralstrategiesandadoptiveimmunotherapyamongotherapproaches.The
goalofimmunereconstitutionisdissipationoftheclinicalsymptomsofAIDS,asevidencedbyadecreaseinthe
incidenceofAIDS-relatedopportunisticinfectionsandtumorsandadeclineinratesofmortality.Through
technologicaldevelopmentsandbetterunderstandingoftheimmunopathogenesisandmechanismsofimmune
reconstitution,itispossibletoimprovethelevelandfunctionofCD4+Tcellsandtoe