Immune Reconstitution Disorders

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (20 August 2021) | Viewed by 23540

Special Issue Editor


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Guest Editor
Division of Infectious Diseases and International Medicine, The University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, USA
Interests: clinical immunology; laboratory pathology; cellular and molecular biology; genomics; transcriptomics; proteomics

Special Issue Information

Dear colleagues,

This Special Issue focuses on the molecular pathogenesis of immune reconstitution inflammatory syndrome, and post-hematopoietic stem cell transplantation immune restoration disorders (IRD). We overview the molecular biology of interferon and interleukin networks, assessments of diagnostic biomarkers for IRD, and tested targeted immunomodulatory treatments.

Dr. Irina St. Louis
Guest Editor

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Keywords

  • immune restoration disorders
  • immune reconstitution
  • inflammatory syndrome
  • Cytokines, interferons
  • interleukins
  • immunomodulatory treatments
  • stem cell transplantation

Published Papers (5 papers)

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Research

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15 pages, 2680 KiB  
Article
Anti-Cancer and Immunomodulatory Activity of a Polyethylene Glycol-Betulinic Acid Conjugate on Pancreatic Cancer Cells
by Pascaline Nanga Fru, Ekene Emmanuel Nweke, Nompumelelo Mthimkhulu, Sindisiwe Mvango, Marietha Nel, Lynne Alison Pilcher and Mohammed Balogun
Life 2021, 11(6), 462; https://doi.org/10.3390/life11060462 - 21 May 2021
Cited by 4 | Viewed by 2176
Abstract
Drug delivery systems involving polymer therapeutics enhance drug potency by improved solubility and specificity and may assist in circumventing chemoresistance in pancreatic cancer (PC). We compared the effectiveness of the naturally occurring drug, betulinic acid (BA), alone and in a polymer conjugate construct [...] Read more.
Drug delivery systems involving polymer therapeutics enhance drug potency by improved solubility and specificity and may assist in circumventing chemoresistance in pancreatic cancer (PC). We compared the effectiveness of the naturally occurring drug, betulinic acid (BA), alone and in a polymer conjugate construct of polyethylene glycol (PEG), (PEG–BA), on PC cells (MIA PaCa-2), a normal cell line (Vero) and on peripheral blood mononuclear cells (PBMCs). PEG–BA, was tested for its effect on cell death, immunomodulation and chemoresistance-linked signalling pathways. The conjugate was significantly more toxic to PC cells (p < 0.001, IC50 of 1.35 ± 0.11 µM) compared to BA (IC50 of 12.70 ± 0.34 µM), with a selectivity index (SI) of 7.28 compared to 1.4 in Vero cells. Cytotoxicity was confirmed by increased apoptotic cell death. PEG–BA inhibited the production of IL-6 by 4–5.5 fold compared to BA-treated cells. Furthermore, PEG–BA treatment of MIA PaCa-2 cells resulted in the dysregulation of crucial chemoresistance genes such as WNT3A, TXNRD1, SLC2A1 and GATA3. The dysregulation of chemoresistance-associated genes and the inhibition of cytokines such as IL-6 by the model polymer construct, PEG–BA, holds promise for further exploration in PC treatment. Full article
(This article belongs to the Special Issue Immune Reconstitution Disorders)
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Review

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15 pages, 339 KiB  
Review
Immune Reconstitution after Haploidentical Donor and Umbilical Cord Blood Allogeneic Hematopoietic Cell Transplantation
by Hany Elmariah, Claudio G. Brunstein and Nelli Bejanyan
Life 2021, 11(2), 102; https://doi.org/10.3390/life11020102 - 29 Jan 2021
Cited by 8 | Viewed by 2739
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is the only potentially curative therapy for a variety of hematologic diseases. However, this therapeutic platform is limited by an initial period when patients are profoundly immunocompromised. There is gradual immune recovery over time, that varies by transplant [...] Read more.
Allogeneic hematopoietic cell transplantation (HCT) is the only potentially curative therapy for a variety of hematologic diseases. However, this therapeutic platform is limited by an initial period when patients are profoundly immunocompromised. There is gradual immune recovery over time, that varies by transplant platform. Here, we review immune reconstitution after allogeneic HCT with a specific focus on two alternative donor platforms that have dramatically improved access to allogeneic HCT for patients who lack an HLA-matched related or unrelated donor: haploidentical and umbilical cord blood HCT. Despite challenges, interventions are available to mitigate the risks during the immunocompromised period including antimicrobial prophylaxis, modified immune suppression strategies, graft manipulation, and emerging adoptive cell therapies. Such interventions can improve the potential for long-term overall survival after allogeneic HCT. Full article
(This article belongs to the Special Issue Immune Reconstitution Disorders)
18 pages, 389 KiB  
Review
Cryptococcal Immune Reconstitution Inflammatory Syndrome: From Blood and Cerebrospinal Fluid Biomarkers to Treatment Approaches
by Vânia Maria Sabadoto Brienze, Júlio César André, Elisabete Liso and Irina Vlasova-St. Louis
Life 2021, 11(2), 95; https://doi.org/10.3390/life11020095 - 27 Jan 2021
Cited by 9 | Viewed by 3192
Abstract
Immune reconstitution inflammatory syndrome (IRIS) presents as an exaggerated immune reaction that occurs during dysregulated immune restoration in immunocompromised patients in late-stage human immunodeficiency virus (HIV) infection who have commenced antiretroviral treatments (ART). Virtually any opportunistic pathogen can provoke this type of immune [...] Read more.
Immune reconstitution inflammatory syndrome (IRIS) presents as an exaggerated immune reaction that occurs during dysregulated immune restoration in immunocompromised patients in late-stage human immunodeficiency virus (HIV) infection who have commenced antiretroviral treatments (ART). Virtually any opportunistic pathogen can provoke this type of immune restoration disorder. In this review, we focus on recent developments in the identification of risk factors for Cryptococcal IRIS and on advancements in our understanding of C-IRIS immunopathogenesis. We overview new findings in blood and cerebrospinal fluid which can potentially be useful in the prediction and diagnosis of cryptococcal meningitis IRIS (CM-IRIS). We assess current therapeutic regimens and novel treatment approaches to combat CM-IRIS. We discuss the utility of biomarkers for clinical monitoring and adjusting treatment modalities in acquired immunodeficiency syndrome (AIDS) patients co-infected with Cryptococcus who have initiated ART. Full article
(This article belongs to the Special Issue Immune Reconstitution Disorders)
26 pages, 1398 KiB  
Review
Systemic Inflammation Associated with Immune Reconstitution Inflammatory Syndrome in Persons Living with HIV
by Caian L. Vinhaes, Mariana Araujo-Pereira, Rafael Tibúrcio, Juan M. Cubillos-Angulo, Fernanda O. Demitto, Kevan M. Akrami and Bruno B. Andrade
Life 2021, 11(1), 65; https://doi.org/10.3390/life11010065 - 18 Jan 2021
Cited by 18 | Viewed by 5432
Abstract
Antiretroviral therapy (ART) has represented a major advancement in the care of people living with HIV (PLWHH), resulting in significant reductions in morbidity and mortality through immune reconstitution and attenuation of homeostatic disruption. Importantly, restoration of immune function in PLWH with opportunistic infections [...] Read more.
Antiretroviral therapy (ART) has represented a major advancement in the care of people living with HIV (PLWHH), resulting in significant reductions in morbidity and mortality through immune reconstitution and attenuation of homeostatic disruption. Importantly, restoration of immune function in PLWH with opportunistic infections occasionally leads to an intense and uncontrolled cytokine storm following ART initiation known as immune reconstitution inflammatory syndrome (IRIS). IRIS occurrence is associated with the severe and rapid clinical deterioration that results in significant morbidity and mortality. Here, we detail the determinants underlying IRIS development in PLWH, compiling the available knowledge in the field to highlight details of the inflammatory responses in IRIS associated with the most commonly reported opportunistic pathogens. This review also highlights gaps in the understanding of IRIS pathogenesis and summarizes therapeutic strategies that have been used for IRIS. Full article
(This article belongs to the Special Issue Immune Reconstitution Disorders)
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26 pages, 798 KiB  
Review
Tuberculosis IRIS: Pathogenesis, Presentation, and Management across the Spectrum of Disease
by Carson M. Quinn, Victoria Poplin, John Kasibante, Kyle Yuquimpo, Jane Gakuru, Fiona V. Cresswell and Nathan C. Bahr
Life 2020, 10(11), 262; https://doi.org/10.3390/life10110262 - 29 Oct 2020
Cited by 31 | Viewed by 9064
Abstract
Antiretroviral therapy (ART), while essential in combatting tuberculosis (TB) and HIV coinfection, is often complicated by the TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Depending on the TB disease site and treatment status at ART initiation, this immune-mediated worsening of TB pathology can take [...] Read more.
Antiretroviral therapy (ART), while essential in combatting tuberculosis (TB) and HIV coinfection, is often complicated by the TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Depending on the TB disease site and treatment status at ART initiation, this immune-mediated worsening of TB pathology can take the form of paradoxical TB-IRIS, unmasking TB-IRIS, or CNS TB-IRIS. Each form of TB-IRIS has unique implications for diagnosis and treatment. Recently published studies have emphasized the importance of neutrophils and T cell subtypes in TB-IRIS pathogenesis, alongside the recognized role of CD4 T cells and macrophages. Research has also refined our prognostic understanding, revealing how the disease can impact lung function. While corticosteroids remain the only trial-supported therapy for prevention and management of TB-IRIS, increasing interest has been given to biologic therapies directly targeting the immune pathology. TB-IRIS, especially its unmasking form, remains incompletely described and more data is needed to validate biomarkers for diagnosis. Management strategies remain suboptimal, especially in the highly morbid central nervous system (CNS) form of the disease, and further trials are necessary to refine treatment. In this review we will summarize the current understanding of the immunopathogenesis, the presentation of TB-IRIS and the evidence for management recommendations. Full article
(This article belongs to the Special Issue Immune Reconstitution Disorders)
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