HIV and inflammation

What is inflammation?

Inflammation is the onset of a response to infection or injury. It is a "nonspecific immune response". They do not vary depending on the type of injury or infection.

Most body repair tools circulate in the blood. These include antibodies, T cells and other white blood cells, clotting factors, chemicals that can kill the germs and nutrients to fuel the damaged cells.

Chemicals that go through a process of releasing the damaged cells that communicate with the immune system. They attract healing cells and chemicals. Helps these healing factors and inflammation leave the bloodstream and work on damaged tissue. Enlarge blood vessels, increasing blood flow to the damaged area. Inflammation causes changes in the structures of blood vessels, making it easier for the plasma to pass into adjacent tissues. This causes a "swelling" to appear. The inflammation also causes redness, heat and pain. In addition, it reduces tissue function.

Coagulation (the formation of blood clots) is part of the inflammation. This can occur on the skin (eg stopping bleeding from a cut) or inside the body (for example, building a barrier around germs or protecting a damaged area in the lining of a blood vessel.)

Coagulation must remain in balance with the breakage and removal of clots. This process is called fibrinolysis. Fibrin is the protein that forms clots. The suffix "lise" means reduction or destruction. Editor's note: because the word is of little use and I myself did not know it, to better understand what I translate, I went to my wonderful source of information, which is the Wikipedia :

"From Wikipedia, the free encyclopedia.

A fibrinolysis is the process by which a clot de fibrin (product of coagulation do blood) is destroyed. Fibrin is degraded by plasmin leading to the production of circulating fragments which are then destroyed by other proteinases or the kidneys eliver.

It is the process that is related to activation of coagulation. It is the breakdown of fibrin soluble fragments to the vessel recanalization, it is important in the injured vessel reconstruction. There is an inactive protein of hepatic origin (plasminogen) which when activated to plasmin is able to break down the fibrin degradation products (PDF). The plasminogen activators are active factor XII, urokinase and tissue plasminogen factor (TPA) present in the vascular endothelium. Plasmin is a proteolytic enzyme which breaks down fibrin and fibrinogen. "

Editor's note: I just discovered what saved me in two lung embolisms 🙂 🙂

acute and chronic inflammation

Acute inflammation usually occurs in response to physical injuries such as a cut or sprain, or a localized infection. Acute inflammation ends when specific chemicals circulate to "turn off" the inflammation.

However, inflammation can also be chronic. Chronic inflammation causes tissue damage and scarring. The blood vessels remain permeable. White blood cells continue to leave the blood and accumulate in the tissue. Immune cells can "wear out" and stop working properly. Chronic inflammation eventually destroys the surrounding tissue and creates scar tissue. It can also contribute to allergies, asthma or "autoimmune diseases" diseases like arthritis and multiple sclerosis. In autoimmune diseases, the body sometimes makes antibodies that attack healthy cells.

The ongoing inflammation is associated with many chronic diseases. These include heart failure, kidney problems, metabolic syndrome, diabetes, dementia, and frailty.

HIV causes inflammation

HIV is a chronic infection. Even patients with undetectable viral load create new viruses. This may contribute to the continuation of inflammation. Antiretroviral drugs reduce inflammatory conditions, but do not reduce them to normal levels.

Over time, HIV (if not treated) weakens the immune system. Old infections can come back (do you know that mumps?). Almost all patients infected with HIV are also infected with cytomegalovirus (CMV, see Sheet of fact 504) latent. However, with the CD4 count dropping, CMV may become active in people with HIV, causing further inflammation.

Other infections or diseases (comorbidities) are important in understanding the health of people with HIV. Infections such as hepatitis or herpes (see Sheet of fact 507) are also common.

gut

Leaky gut syndrome

The mouth and digestive tract, like skin, keeps the body free of threats. The "start point" of the digestive tract is the mouth. Bad dental health can lead to infection and general inflammation (see Sheet of fact 653.) (Read also the importance of oral health)

Lymphoid tissue associated with the gut usually contains about 70% of immune cells in the body. Intestines have a surface roughly equal to the size of a football field! The immune system in the gut is called intestinal-associated lymphoid tissue or GALT (Untranslatable English). It protects the body from microorganisms in food. Damage is caused very early by HIV to the lymphoid tissue associated with the gut in the infection.

Inflammation in the intestine makes it easier for germs to pass out of the intestine and "escape" into the body's circulation. This leakage contributes to global systemic inflammation (). Inflammation in the intestine also contributes to malabsorption of nutrients.

Lipopolysaccharides (LPS) are molecules that form part of the coating of some bacteria normally found in the intestine. LPS produces a strong immune response. High levels of LPS in the blood are a sign of "fecal mass leak syndrome."


The measurement of inflammation

Inflammation in people with HIV shows in high levels of some elements in the blood:

  • Interleukin 6 is involved both in terms of increase and reduction of inflammation. It increases rapidly after exercise.
  • C-reactive protein is thought to bind to damaged cells, attracting substances that will remove them. It is a general measure of inflammation. It rises quickly and dramatically during infections.
  • D-dimer is produced when the formation of blood clots break. It is a general measure of inflammation. It is also used to diagnose the formation of blood clots, especially blood clots in the deep veins or lungs
  • Cystatin C is mainly used as an indicator of renal health. However, high levels of cystatin C have been linked to heart disease, nervous problems and increased death rates.

Treatment of inflammation HIV

Researchers are studying anti-inflammatories that have been used in other diseases such as rheumatoid arthritis and trying to learn from other studies of immune activation, inflammation and aging.

Another area of ​​HIV research involves the bacterial environment of the gut. These bacteria can affect the results of various diseases. Interventions that affect these bacteria may be helpful and this includes "probiotics" such as acidophilus and other live cultures that stimulate the growth of bacteria in the gut.

Summary

Inflammation is a complex process. Acute inflammation is a normal part of the healing process of the body. Chronic inflammation can damage the body and is associated with many chronic health problems and with normal aging.

HIV is an inflammatory disease and causes chronic inflammation. This can accelerate physical changes normally associated with aging.

Several possible treatments for chronic inflammation are being studied.

It would be interesting if you could follow the next post

Translated by Claudio Souza the original HIV and Inflammation reviewed by Mara Macedo on 14 April 2016

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International Association of Providers of AIDS Care

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