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.
MeSH terms
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Bacteria / immunology
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Bacteria / isolation & purification
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Bacteria / pathogenicity
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Fungi / immunology
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Fungi / isolation & purification
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Fungi / pathogenicity
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Humans
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Immune Reconstitution Inflammatory Syndrome / diagnosis*
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Immune Reconstitution Inflammatory Syndrome / microbiology
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Immune Reconstitution Inflammatory Syndrome / pathology*
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Immune Reconstitution Inflammatory Syndrome / virology
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Immunocompromised Host
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Immunosuppressive Agents / administration & dosage*
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Immunosuppressive Agents / adverse effects
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Opportunistic Infections / diagnosis*
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Opportunistic Infections / microbiology
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Opportunistic Infections / pathology*
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Opportunistic Infections / virology
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Transplantation*
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Viruses / immunology
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Viruses / isolation & purification
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Viruses / pathogenicity
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Withholding Treatment