Opportunistic infection-associated immune reconstitution syndrome in transplant recipients
Journal
Clinical Infectious Diseases
Journal Volume
53
Journal Issue
2
Pages
168-176
Date Issued
2011
Author(s)
Singh N.
Abstract
Reversal of pathogen-induced immunosuppression upon employment of effective antimicrobial therapy and withdrawal of iatrogenic immunosuppression has the potential to shift the host immune repertoire towards pathologic inflammatory responses conducive to immune reconstitution syndrome (IRS). Posttransplant IRS has been observed with fungi, M. tuberculosis, cytomegalovirus, and polyoma virus nephropathy. This review discusses the existing state of knowledge regarding IRS and the immune mechanisms that underlie its pathogenesis, with significant implications for developing reliable diagnostic biomarkers and optimal management strategies for post-transplant opportunistic infection-associated IRS. ? 2011 The Author.
SDGs
Other Subjects
amphotericin B; C reactive protein; calcineurin inhibitor; corticosteroid; cyclosporin A; gamma interferon; hydroxymethylglutaryl coenzyme A reductase inhibitor; immunoglobulin; interleukin 10; interleukin 17; interleukin 17F; interleukin 22; interleukin 4; mammalian target of rapamycin inhibitor; mycophenolic acid 2 morpholinoethyl ester; prednisone; rapamycin; tacrolimus; toll like receptor; transforming growth factor beta; voriconazole; allogeneic hematopoietic stem cell transplantation; antiinflammatory activity; antimicrobial therapy; arachnoiditis; artificial ventilation; aseptic meningitis; autologous hematopoietic stem cell transplantation; backache; Candida parapsilosis; candidiasis; CD4+ T lymphocyte; cellulitis; cerebrospinal fluid; chorioretinitis; cryptococcosis; Cryptococcus; cytokine production; Cytomegalovirus; Dipodascus capitatus; disease association; dyspnea; graft failure; graft recipient; hemoptysis; Histoplasma capsulatum; histoplasmosis; hypercalcemia; immune deficiency; immune reconstitution inflammatory syndrome; immunocompromised patient; immunomodulation; immunopathology; kidney disease; kidney transplantation; liver transplantation; lung aspergillosis; lung nodule; lymphadenitis; Mycobacterium tuberculosis; natural killer cell; nonhuman; opportunistic infection; outcome assessment; Polyoma virus; priority journal; regulatory T lymphocyte; retina macula edema; review; sensitivity and specificity; Th1 cell; Th17 cell; Th2 cell; thorax pain; uveitis; Bacteria; Fungi; Humans; Immune Reconstitution Inflammatory Syndrome; Immunocompromised Host; Immunosuppressive Agents; Opportunistic Infections; Transplantation; Viruses; Withholding Treatment
Type
review