HIV infection and the intestinal mucosal barrier.
HIV infection induces a barrier defect of the intestinal mucosa, which is closely linked to immune activation and CD4 T cell depletion. The HIV-induced barrier defect is initiated in early acute and maintained through chronic infection. In acute infection, increased epithelial permeability is associated with increased epithelial apoptosis possibly caused by perforin-expressing cytotoxic T cells. In chronic infection, mucosal production of inflammatory cytokines is associated with increased epithelial permeability, epithelial apoptosis, and alterations of epithelial tight junctions. In addition to HIV-induced immune-mediated effects, viral proteins have the potential to directly affect epithelial barrier function. After prolonged viral suppression by antiretroviral therapy, there is, at least partial, restoration of the HIV-associated intestinal mucosal barrier defect despite persisting alterations of the mucosal immune system.
Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. hans-joerg.epple@charite.de
Hans-Jörg
HJ
Epple
Martin
M
Zeitz
D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D017209:Apoptosis / Q000187:drug effects; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology*; D019108:Tight Junctions / Q000187:drug effects / Q000502:physiology
D019380:Anti-HIV Agents