The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Recent observational studies suggest a role for lipopolysaccharide (LPS) as a marker of immune activation in HIV-infected patients, with potential repercussions on the effectiveness of antiretroviral regimens.</p> <p>Obje...

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Main Authors: Vassallo Matteo, Mercié Patrick, Cottalorda Jacqueline, Ticchioni Michel, Dellamonica Pierre
Format: Article
Language:English
Published: BMC 2012-08-01
Series:Virology Journal
Online Access:http://www.virologyj.com/content/9/1/174
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author Vassallo Matteo
Mercié Patrick
Cottalorda Jacqueline
Ticchioni Michel
Dellamonica Pierre
author_facet Vassallo Matteo
Mercié Patrick
Cottalorda Jacqueline
Ticchioni Michel
Dellamonica Pierre
author_sort Vassallo Matteo
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Recent observational studies suggest a role for lipopolysaccharide (LPS) as a marker of immune activation in HIV-infected patients, with potential repercussions on the effectiveness of antiretroviral regimens.</p> <p>Object</p> <p>A systematic review of LPS as a marker of immune activation in HIV-1 infected patients.</p> <p>Data sources</p> <p>MEDLINE register of articles and international conference proceedings.</p> <p>Review methods</p> <p>Case–control studies comparing the role of plasma LPS as a marker of immune activation in HIV-infected patients versus HIV negative subjects.</p> <p>Data synthesis</p> <p>Two hundred and six articles were selected using MEDLINE, plus 51 studies presented at international conferences. Plasma LPS is a marker of immune activation in HIV-infected patients, determining the entry of central memory CD4+ T cells into the replication cycle and finally generating cell death. Plasma LPS probably results from immune-mediated alterations of the intestinal barrier, which can occur soon after HIV seroconversion. LPS is a likely marker of disease progression, as it drives chronic monocyte activation, and some studies suggest that hyperexpression of CCR5 receptors, related to LPS plasma levels, could be responsible for monocyte trafficking in the brain compartment and for the appearance of HIV-associated neurocognitive disorders. Long-term combination antiretroviral therapy (cART) generally reduces LPS concentrations, but rarely to the same levels as in the control group. This phenomenon probably depends on ongoing but incomplete repair of the mucosal barrier. Only in patients achieving maximal viral suppression (i.e. viral load < 2.5 cp/ml) are LPS levels comparable to healthy donors. In successfully treated patients who did not restore CD4+ T cells, one hypothesis is that the degree of residual microbial translocation, measured by LPS, alters the turnover of CD4+ T cells.</p> <p>Conclusions</p> <p>LPS is a marker of microbial translocation, responsible for chronic immune activation in HIV-infected patients. Even in successfully treated patients, LPS values are rarely normal. Several studies suggest a role for LPS as a negative predictive marker of immune restoration in patients with blunted CD4 T cell gain.</p>
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spelling doaj.art-b838f436837f402fa2e92f19706248472022-12-22T01:51:55ZengBMCVirology Journal1743-422X2012-08-019117410.1186/1743-422X-9-174The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature reviewVassallo MatteoMercié PatrickCottalorda JacquelineTicchioni MichelDellamonica Pierre<p>Abstract</p> <p>Background</p> <p>Recent observational studies suggest a role for lipopolysaccharide (LPS) as a marker of immune activation in HIV-infected patients, with potential repercussions on the effectiveness of antiretroviral regimens.</p> <p>Object</p> <p>A systematic review of LPS as a marker of immune activation in HIV-1 infected patients.</p> <p>Data sources</p> <p>MEDLINE register of articles and international conference proceedings.</p> <p>Review methods</p> <p>Case–control studies comparing the role of plasma LPS as a marker of immune activation in HIV-infected patients versus HIV negative subjects.</p> <p>Data synthesis</p> <p>Two hundred and six articles were selected using MEDLINE, plus 51 studies presented at international conferences. Plasma LPS is a marker of immune activation in HIV-infected patients, determining the entry of central memory CD4+ T cells into the replication cycle and finally generating cell death. Plasma LPS probably results from immune-mediated alterations of the intestinal barrier, which can occur soon after HIV seroconversion. LPS is a likely marker of disease progression, as it drives chronic monocyte activation, and some studies suggest that hyperexpression of CCR5 receptors, related to LPS plasma levels, could be responsible for monocyte trafficking in the brain compartment and for the appearance of HIV-associated neurocognitive disorders. Long-term combination antiretroviral therapy (cART) generally reduces LPS concentrations, but rarely to the same levels as in the control group. This phenomenon probably depends on ongoing but incomplete repair of the mucosal barrier. Only in patients achieving maximal viral suppression (i.e. viral load < 2.5 cp/ml) are LPS levels comparable to healthy donors. In successfully treated patients who did not restore CD4+ T cells, one hypothesis is that the degree of residual microbial translocation, measured by LPS, alters the turnover of CD4+ T cells.</p> <p>Conclusions</p> <p>LPS is a marker of microbial translocation, responsible for chronic immune activation in HIV-infected patients. Even in successfully treated patients, LPS values are rarely normal. Several studies suggest a role for LPS as a negative predictive marker of immune restoration in patients with blunted CD4 T cell gain.</p>http://www.virologyj.com/content/9/1/174
spellingShingle Vassallo Matteo
Mercié Patrick
Cottalorda Jacqueline
Ticchioni Michel
Dellamonica Pierre
The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review
Virology Journal
title The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review
title_full The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review
title_fullStr The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review
title_full_unstemmed The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review
title_short The role of lipopolysaccharide as a marker of immune activation in HIV-1 infected patients: a systematic literature review
title_sort role of lipopolysaccharide as a marker of immune activation in hiv 1 infected patients a systematic literature review
url http://www.virologyj.com/content/9/1/174
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