• 作者：Shruthi Ravimohan^a ; ^c ; ^{shruthiravimohan@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Neo Tamuhla^c ; Shiang-Ju Kung^d ; ^f ; Kebatshabile Nfanyana^c ; Andrew P. Steenhoff^b ; ^c ; ^d ; Robert Gross^a ; ^c ; ^e ; Drew Weissman^a ; ^c ; Gregory P. Bisson^a ; ^c ; ^e
• 关键词：Matrix metalloproteinases ; Immune recovery ; Lung function ; HIV ; TB-IRIS ; ART
• 刊名：EBioMedicine
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：3
• 期：Complete
• 页码：100-107
• 全文大小：502 K

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Matrix metalloproteinases (MMP), capable of degrading lung collagen, can increase rapidly on ART in HIV/TB patients.

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Increases in plasma MMP-8 concentrations after ART initiation are associated with the development of paradoxical TB-IRIS.

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Increases in CD4 T-cells and MMP-8 concentrations after ART initiation are correlated with decreased lung function post-TB cure.

TB-associated pulmonary morbidity can persist after TB cure. However, causal mechanisms for lung damage, which may involve immune mechanisms and tissue proteases, in TB are unclear. Less is known in this regard among patients with HIV/TB, who are at risk for inflammatory reactions following ART initiation, otherwise known as TB-immune reconstitution inflammatory syndrome (IRIS). In this study, rapid ART-induced increases in certain tissue degrading proteins called matrix metalloproteinases (MMP) were associated with TB-IRIS. Furthermore, rapid recovery of CD4 T-cells and MMP-8 concentrations were associated with decreased lung function in an exploratory subset. In HIV/TB, robust increases in cellular immune function and MMPs on ART may underlie lung injury and long-term pulmonary deficits.