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immune reconstitution syndrome

Thursday 25 October 2007

immune restoration disease, IRD, IRS, immune reconstitution inflammatory syndrome, immune restoration inflammatory syndrome, IRIS

Definition: Host immunity is essential in facilitating the eradication of infection. However, immunological recovery and an imbalance characterised by either suboptimum or excessive expression of immune responses can also be harmful to the host.

Inflammatory responses triggered by rapid resolution of immunosuppression can lead to a series of localised and systemic reactions, termed immune reconstitution syndrome (IRS), or immune restoration inflammatory syndrome (IRIS), that are often misconstrued as failure of specific antifungal therapy to eliminate the offending fungal pathogen.

Recognition of IRS has become increasingly relevant in the context of our current use of potent immunosuppressive agents and immunostimulators that allow rapid manipulation of the immune system.

Whereas the conceptual principles of IRS underscore the adverse effects of an overzealous and dysregulated immune response, they also support a role of immunotherapies to augment immunity if induction of endogenous responses is inadequate for the control of infection. (17521592)

Variants

- fungus-associated immune restoration inflammatory syndrome

References

- Singh N, Perfect JR. Immune reconstitution syndrome associated with opportunistic mycoses. Lancet Infect Dis. 2007 Jun;7(6):395-401. PMID: 17521592

- Surjushe AU, Jindal SR, Kamath RR, Saple DG. Immune reconstitution inflammatory syndrome. Indian J Dermatol Venereol Leprol. 2006 Nov-Dec;72(6):410-4. PMID: 17179614

- Colebunders R, John L, Huyst V, Kambugu A, Scano F, Lynen L. Tuberculosis immune reconstitution inflammatory syndrome in countries with limited resources. Int J Tuberc Lung Dis. 2006 Sep;10(9):946-53. PMID: 16964782

- Lipman M, Breen R. Immune reconstitution inflammatory syndrome in HIV. Curr Opin Infect Dis. 2006 Feb;19(1):20-5. PMID: 16374213

- Shelburne SA, Montes M, Hamill RJ. Immune reconstitution inflammatory syndrome: more answers, more questions. J Antimicrob Chemother. 2006 Feb;57(2):167-70. PMID: 16354748