改善胸腺功能或是艾滋病治疗新思路
2011-11-18 15:08:36 来源: 北京晚报(北京)
本报讯 （通讯员段文利 ）为什么经过长期正规“鸡尾酒”治疗的艾滋病患者中，仍有少数患者的病情得不到理想控制，免疫功能无法重建？北京协和医院李太生教授等经过五年多时间完成的一项研究显示，艾滋病患者免疫功能能否重建，主要取决于“CD4+T”细胞群中胸腺新生亚群的数量，这一发现解释了艾滋病“免疫学无应答”的发生机制，提示改善胸腺功能有可能为艾滋病治疗新思路。相关论文上周发表在国际著名的《Clinical Infectious Diseases》（临床传染病杂志）上，是艾滋病研究领域的又一重要突破。
上世纪90年代，“鸡尾酒疗法”使降低艾滋病发生率、病死率成为可能。但随着研究深入和治疗时间延长，人们发现，在保证良好依从性的前提下接受“鸡尾酒治疗”后，仍有约5%至30%的患者“CD4+T”免疫细胞数量未出现显著增长，研究者们将这类艾滋病患者定义为“免疫功能重建不全”或“免疫学无应答”，其机会性感染发生率、艾滋病相关疾病发病率及病死率等均高于“免疫学应答良好”的患者。
协和医院研究组从病例库中筛选出抗病毒治疗后免疫学无应答者17例和免疫学应答良好者13例，观察3年持续治疗过程中“CD4+T”细胞的纯真亚群、记忆亚群、胸腺新生亚群、凋亡亚群及激活亚群等五个细胞亚群的改变趋势。结果发现，经过三年有效抗病毒治疗，免疫应答好的患者血浆中该免疫细胞的个数从开始的每微升164±78个增加到444±100个，接近于正常值500。相比之下，免疫应答不好的患者增幅远低于前者。同时，无论是免疫应答好的患者，还是免疫无应答的患者，经典的“鸡尾酒疗法”对增加胸腺新生细胞亚群所起作用不大，而胸腺新生细胞在艾滋病患者免疫功能重建中起决定作用。
李太生教授介绍说，针对免疫功能重建不全患者，新治疗策略要在持续“鸡尾酒”治疗的同时，努力提高其胸腺功能。他建议中药研发可沿着提高胸腺功能的方向展开。
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| 图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 |
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艾滋病新鸡尾酒疗法 附 HIV感染者，早吃药早受益
AIDS treatment to improve thymic function or new ideas
2011-11-18 15:08:36 Source: Beijing Evening News (Beijing)
WASHINGTON (Correspondent segments Manley) Why after a long informal "cocktail" treatment of AIDS patients, the patient's condition is still not ideal for a small number of control, immune function can not be rebuilt? Beijing Union Medical College Hospital, Professor Li Taisheng more than five years after completion of such a study, AIDS patients can rebuild the immune function, depending on "CD4 + T" cells in the thymus new group the number of subsets, this finding explains the AIDS "No immunological response" of the mechanism, suggesting that thymic function may improve treatment for AIDS new ideas. Last week, the relevant papers published in international famous "Clinical Infectious Diseases" (Clinical Infectious Diseases), is another important field of AIDS research breakthrough.
In the 1990s, "cocktail therapy" to reduce HIV incidence, mortality is possible. But with the study in-depth and prolonged treatment, it was found to ensure good adherence to accept the premise of "cocktail treatment", there are still about 5% to 30% of patients "CD4 + T" immune cells does not appear significant growth , researchers have defined this type of AIDS as "incomplete immune reconstitution" or "no immunological response", the incidence of opportunistic infections, AIDS-related morbidity and mortality are higher than the "good immunological response." of patients.
Concord Hospital research team from the case library was screened out anti-viral treatment immunological response in 17 cases no immunological response and good in 13 cases, 3 years of continuous observation during the treatment "CD4 + T" cell subsets innocence, memory sub- group, the thymus new subsets, apoptosis and activation of subsets of subsets of five cell subsets change in trend. The results showed that after three years of effective antiretroviral therapy, the immune response in patients with a good number of immune cells from the beginning of each rose 164 ± 78 to 444 ± 100 个 个, close to the normal 500. In contrast, patients with poor immune response increases well below the former. At the same time, whether it is a good immune response in patients with or without the immune response in patients with the classic "cocktail" of the thymus increased the role of new small-cell subsets, and newborn thymus cell immune reconstitution in HIV patients play a decisive role in .
Professor Li Taisheng said failure for patients with immune reconstitution, new treatment strategies continue to be in the "cocktail" treatment at the same time, strive to improve their thymus function. He suggested that traditional Chinese medicine research and development can enhance thymus function along the direction of swing.
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