PDF(Pubmed)
Abstract：
Immune reconstitution inflammatory syndrome (IRIS) is characterized by exaggerated and dysregulated inflammatory responses that occur as a result of reconstitution of adaptive or innate immunity. A wide range of microorganisms have been found to be associated with IRIS, such as human immunodeficiency virus (HIV), Mycobacterium and actinobacteria. Whipple disease (WD) is an infectious disorder caused by the Gram-positive bacterium Tropheryma whipplei (T. whipplei) and IRIS also serves as a complication during its treament. Although many of these pathological mechanisms are shared with related inflammatory disorders, IRIS in WD exhibits distinct features and is poorly described in the medical literature. Novel investigations of the intestinal mucosal immune system have provided new insights into the pathogenesis of IRIS, elucidating the interplay between systemic and local immune responses. These insights may be used to identify monitoring tools for disease prevention and to develop treatment strategies. Therefore, this review synthesizes these new concepts in WD IRIS to approach the feasibility of manipulating host immunity and immune reconstitution of inflammatory syndromes from a newer, more comprehensive perspective and study hypothetical options for the management of WD IRIS.
摘要：
免疫重建炎症综合征(IRIS)的特征在于由于适应性或先天免疫的重建而发生的过度和失调的炎症反应。已发现多种微生物与IRIS有关,如人类免疫缺陷病毒（HIV），分枝杆菌和放线菌。Whipple病（WD）是由革兰氏阳性细菌Tropherymawhipplei（T.whipplei）和IRIS在治疗过程中也是一种并发症。尽管这些病理机制中的许多与相关的炎性疾病共有，WD中的IRIS表现出明显的特征，在医学文献中描述甚少。对肠道粘膜免疫系统的新研究为IRIS的发病机理提供了新的见解，阐明全身和局部免疫反应之间的相互作用。这些见解可用于确定疾病预防的监测工具并制定治疗策略。因此,这篇综述综合了WDIRIS中的这些新概念，以探讨从较新的炎症综合征中操纵宿主免疫和免疫重建的可行性，更全面的视角和研究WDIRIS管理的假设选择。
