A preliminary study on the characteristics of Th1/Th2 immune response in cerebrospinal fluid of AIDS patients with cryptococcal meningitis.

Background: Cryptococcal Meningitis (CM) is a common opportunistic infection in the late stage of acquired immunodeficiency syndrome (AIDS). Despite the wide use of effective antiretroviral and antifungal therapy in AIDS patients, CM is still a major morbidity and mortality cause. Understanding the...

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Publicado en:BMC Infectious Diseases Vol. 21; no. 1; pp. 1 - 11
Autores principales: Li, Aixin, Zhu, Wenjiao, Yin, Jiming, Huang, Xiaojie, Sun, Lijun, Hua, Wei, Wang, Wen, Zhang, Tong, Dai, Lili, Wu, Hao
Formato: Journal Article
Publicado: BioMed Central 5/29/2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 5/29/2021
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      pub: BioMed Central
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        atl: A preliminary study on the characteristics of Th1/Th2 immune response in cerebrospinal fluid of AIDS patients with cryptococcal meningitis.
      aug:
        au:
          Li, Aixin
          Zhu, Wenjiao
          Yin, Jiming
          Huang, Xiaojie
          Sun, Lijun
          Hua, Wei
          Wang, Wen
          Zhang, Tong
          Dai, Lili
          Wu, Hao
        affil: Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
      sug:
        subj:
          Cytokines Cerebrospinal Fluid
          Acquired Immunodeficiency Syndrome Immunology
          Meningitis, Cryptococcal Immunology
          Meningitis, Cryptococcal Cerebrospinal Fluid
          Female
          Biochemistry
          Immunity, Cellular
          Comorbidity
          Acquired Immunodeficiency Syndrome Microbiology
          Cryptococcus
          Acquired Immunodeficiency Syndrome Complications
          Cytokines Immunology
          Meningitis, Cryptococcal Complications
          Prospective Studies
          Middle Age
          Male
          Adult
          Vascular Endothelial Growth Factor A
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
          Male
      ab: Background: Cryptococcal Meningitis (CM) is a common opportunistic infection in the late stage of acquired immunodeficiency syndrome (AIDS). Despite the wide use of effective antiretroviral and antifungal therapy in AIDS patients, CM is still a major morbidity and mortality cause. Understanding the immune response in cryptococcal infection may help to improve the treatment strategies.Methods: We established a prospective cohort of twelve AIDS patients with CM (HIV + CM+) admitted to the hospital from 2019 to 2020. All patients were examined at the baseline, 2 weeks, and 4 weeks thereafter. The level of 19 cytokines in cerebrospinal fluid (CSF) were recorded to analyze the characteristics and dynamic changes of Th1/Th2 immune response. Meanwhile, six AIDS patients without CM (HIV + CM-) and seventeen healthy subjects (HIV-CM-) were included as control groups for CSF assessment.Results: The HIV+ CM+ group had higher CSF IFN-γ, TNF-α, IL-6, IL-7, IL-8, IL-10, IL-12 (P40), IL-15, IL-18, CCL2 levels but lower IL-4 when compared with the HIV-CM- group at baseline. And they also had a higher level of IL-12 (P40) and IL-17A compared with HIV + CM- patients. Except one patient dropped out of the study, eleven HIV + CM+ patients received induction antifungal therapy and regular CSF testing, and the mortality rate was 9.1% (1/11) and 18.2% (2/11) respectively at week 2 and week 4. Compared with baseline CSF cytokines, IL-2, IL-13, IL-17A, and VEGF-A decreased in week 2, and the VEGF-A levels further decreased in week 4. But there was no difference in the levels of all cytokines between survivors and the dead.Conclusion: No evidence of Th1/Th2 imbalance was found in AIDS patients with CM. However, the CSF cytokine network may provide new clues for the treatment of AIDS patients with CM.Trial Registration: This trial was prospectively registered in 2019.7.16. The registered number is ChiCTR1900024565 .
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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