Title

Hypothalamus-Pituitary-Adrenal cell mediated Immunity Regulation in the Immune Restoration Inflammatory Syndrome (IRIS)
 

Authors

Allen Khakshooy^1,2& Francesco Chiappelli ^1,3*

Affiliation

1Oral Biology & Medicine, Center for the health Sciences, School of Dentistry University of California LosAngels, USA; 2Health Sciences, California State University, Northridge, USA; 3Evidence-Based Decisions Practice-Based Research Network, USA

Email

fchiappelli@dentistry.ucla.edu; *Corresponding author

Article Type

Hypothesis

Date

Received January 31, 2016; Accepted January 31, 2016; Published January 31, 2016

Over one third of the patients seropositive for the human immunodeficiency virus (HIV) with signs of the acquired immune deficiency syndrome (AIDS), and under treatment with anti-retroviral therapy (ART), develop the immune reconstitution inflammatory syndrome (IRIS).  It is not clear what variables are that determine whether a patient with HIV/AIDS will develop ART-related IRIS, but the best evidence base thus far indicates that HIV/AIDS patients with low CD4 cell count, and HIV/AIDS patients whose CD4 count recovery shows a sharp slope, suggesting a particularly fast "immune reconstitution", are at greater risk of developing IRIS. Here, we propose the hypothesis that one important variable that can contribute to low CD4 cell count number and function in ART-treated HIV/AIDS patients is altered   hypothalamic-pituitary-adrenal (HPA) cell-mediated immune (CMI) regulation. We discuss HPA-CMI deregulation in IRIS as the new frontier in comparative effectiveness research (CRE) for obtaining and utilizing the best evidence base for treatment of patients with HIV/AIDS in specific clinical settings.  We propose that our hypothesis about altered HPA-CMI may extend to the pathologies observed in related viral infection, including Zika.

Keywords

Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), Anti-Retro viral Therapy (ART), Immune Reconstitution Inflammatory Syndrome (IRIS), Hypothalamic Pituitary Adrenal axis (HPA), Cell Mediated Immunity (CMI), Corticotropin Releasing Hormone (CRH), Adeno Cortico Tropin Hormone (ACTH), Glucocorticoids (GC), Comparative Effectiveness Research (CER)

Citation

Khakshooy & Chiappelli, Bioinformation 12(1): 28-31 (2016)

Edited by

P Kangueane

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.