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Effects of viremia and CD4 recovery on gut“microbiome-immunity”axis in treatment-na?ve HIV-1-infected patients undergoing antiretroviral therapy

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World Journal of Gastroenterology 2022年第6期28卷 635-652页

作者： Edda Russo Giulia Nannini Gaetana Sterrantino Seble Tekle Kiros Vincenzo Di Pilato Marco Coppi Simone Baldi Elena Niccolai Federica Ricci Matteo Ramazzotti Marco Pallecchi Filippo Lagi gian maria rossolini Alessandro Bartoloni gianluca Bartolucci Amedeo Amedei Department of Clinical and Experimental Medicine University of FlorenceFlorence 50134Italy Department of Surgical Sciences and Integrated Diagnostics University of GenoaGenoa 16126Italy Department of Biomedical Experimental and Clinical"Mario Serio"University of FlorenceFlorence 50134Italy Microbiology and Virology Unit Florence Careggi University HospitalUniversity of FlorenceFlorence 50134Italy Department of Neurosciences PsychologyDrug Research and Child HealthUniversity of FlorenceFlorence 50019Italy

BACKGROUND Human immunodeficiency virus type 1(HIV-1)infection is characterized by persistent systemic inflammation and immune activation,even in patients receiving effective antiretroviral therapy(ART).Converging data from many cross-sectional studies suggest that gut microbiota(GM)changes can occur throughout including human immunodeficiency virus(HIV)infection,treated by ART;however,the results are contrasting.For the first time,we compared the fecal microbial composition,serum and fecal microbial metabolites,and serum cytokine profile of treatment-na?ve patients before starting ART and after reaching virological suppression,after 24 wk of ART therapy.In addition,we compared the microbiota composition,microbial metabolites,and cytokine profile of patients with CD4/CD8 ratio1(immunological responders[IRs]),after 24 wk of ART therapy.AIM To compare for the first time the fecal microbial composition,serum and fecal microbial metabolites,and serum cytokine profile of treatment-na?ve patients before starting ART and after reaching virological suppression(HIV RNA<50 copies/m L)after 24 wk of ART.METHODS We enrolled 12 treatment-na?ve HIV-infected patients receiving ART(mainly based on integrase inhibitors).Fecal microbiota composition was assessed through next generation sequencing.In addition,a comprehensive analysis of a blood broad-spectrum cytokine panel was performed through a multiplex approach.At the same time,serum free fatty acid(FFA)and fecal short chain fatty acid levels were obtained through gas chromatography-mass spectrometry.RESULTS We first compared microbiota signatures,FFA levels,and cytokine profile before starting ART and after reaching virological suppression.Modest alterations were observed in microbiota composition,in particular in the viral suppression condition,we detected an increase of Ruminococcus and Succinivibrio and a decrease of Intestinibacter.Moreover,in the same condition,we also observed augmented levels of serum propionic and buty

关键词： HIV Antiretroviral therapy Microbiome-immunity axis Microbiota Cytokines Short chain fatty acid Inflammation Immunological responders Viremia

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