Immune reconstitution inflammatory syndrome: the trouble with immunity when you had none
Open accessAbstract
Some individuals who are infected with HIV rapidly deteriorate shortly after starting antiretroviral therapy, despite effective viral suppression. This reaction, referred to as immune reconstitution inflammatory syndrome (IRIS), is characterized by tissue-destructive inflammation and arises as CD4(+) T cells re-emerge. It has been proposed that IRIS is caused by a dysregulation of the expanding population of CD4(+) T cells specific for a co-infecting opportunistic pathogen. Here, we argue that IRIS instead results from hyper-responsiveness of the innate immune system to T cell help, a mechanism that may be shared by the many manifestations of IRIS that occur following the reversal of other types of immunosuppression in pathogen-infected hosts.
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Co-infections with C. neoformans and other pathogens represent a significant risk factor for the development of immune reconstitution inflammatory syndrome.
“Given that co-infections with C. neoformans and other pathogens represent a significant risk factor for the development of immune reconstitution inflammatory syndrome, this adverse reaction needs to be carefully monitored when advancing novel immunotherapies.”
From Treatment strategies for cryptococcal infection: challenges, advances and future outlook (2021) · cites this paper as [139]
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References 70 · Cited by 169
- Authors
- Barber, D. L., Andrade, B. B., Sereti, I., & Sher, A.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Barber, Daniel L.
- Venue
- Nature Reviews Microbiology
- Published
- 2012-01-09
- Volume
- 10
- Issue
- 2
- Pages
- 150-156
- ISSN
- 1740-1526 (ISSN-L)
- 1740-1534
- PMC
- PMC3507517
- OpenAlex
- W2022250472
- Cited by
- 169
- References
- 70
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 6 · 2023: 6 · 2022: 11 · 2021: 14 · 2020: 11 · 2019: 10 · 2018: 10 · 2017: 10 · 2016: 12 · 2015: 21 · 2014: 19 · 2013: 18 · 2012: 6
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Microbiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases (ZIAAI001171)
- Topics
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Keywords
- immune reconstitution inflammatory syndrome, HIV, opportunistic infections, CD4+ T cells, antiretroviral therapy, T cell help, immunosuppression reversal, co-infection
- MeSH terms
- Natalizumab, Animals, Disease Models, Animal, Humans, Immune Tolerance, Immunity, Innate, Lymphopenia, Multiple Sclerosis, Risk Factors, HIV Infections, AIDS-Related Opportunistic Infections, Models, Immunological, Mice, Immune Reconstitution Inflammatory Syndrome, Antibodies, Monoclonal, Humanized
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