Change And Clinical Significance Of Group 3 Innate Lymphoid Cells During HIV-1 Infection & Clinical Management Of Ebola Virus Disease

Part 1 Change and clinical significance of group 3 innate lymphoid cells during HIV-1 infectionAbnormal immune activation(hyperactivation) following HIV-1 infection might lead to immunologic nonresponse(INR) after highly active antiretroviral therapy (HAART) and increased incidence of non-AIDS-related events. Intestinal microbial translocation resulting from intestinal mucosal barrier damage is one of the probable causes. Considering the important role of group 3 innate lymphoid cells (ILC3s) in maintaining the function of the intestinal mucosal barrier, we investigated the changes and significance of ILC3s in HIV-1 infected patients(HIV-1 patients), flow cytometry (FCM) was used to detect the frequency of ILC3s. Data showed that the frequency of ILC3s in the peripheral blood of the HIV-1 patients decreased and was associated with viral load, CD4+T cells counts and CD4/CD8 ratio; immunochemistry stain in situ also found that the number of ILC3s in the intestinal mucosal tissue of HIV-1 patients decreased compared with those not infected with HIV-1; further studies found that CD95 and activated caspase-3 expression elevated after HIV-1 infection, suggesting that CD95/FasL-mediated apoptosis is one of the causes of ILC3s deletion; in order to investigate the clinical significance of ILC3s deletion, we detected the plasma levels of lipopolysaccharides (LPS) and soluble CD 14 (sCD14) that reflect microbial translocation, finding that the frequency of ILC3s in the peripheral blood of the HIV-1 patients was negatively correlated with LPS and sCD14, indicating that decreased ILC3s frequency results in intestinal microbial translocation. In Part 1, we concluded that HIV-1 infection causes intestinal mucosal barrier damage, microbial translocation and subsequent immune activation through CD95/FasL-mediated cell apoptosis that leads to decreased ILC3s frequency in the peripheral blood and intestinal mucosa.Part 2 Clinical management of Ebola virus diseaseThe outbreak of Ebola virus disease since December 2013 in West Africa was the most serious pandemic in history, especially in Sierra Leone.The 302 Military Hospital of China has organized and dispatched five medical teams to Freetown, the capital of Sierra Leone on the Africa-aiding mission.By retrospectively summarized the clinical data of the patients confirmed with EVD, we found that the patients were mainly aged between 18 and 40 years old, and the mortality increased with age and viral load while the survival time decreased accordingly. The common symptoms were fever, abdominal pain, diarrhea, and the death group had a significantly higher incidence of such symptoms as diarrhea, fatigue and swallowing difficulty than the survival group. Cox proportional hazard model showed that the survival time was associated with age, viral load and the presence of diarrhea:patients who were at a higher age, had a higher viral load and presented diarrhea were at a higher risk, with a shorter survival. In circumstance where there is a shortage of medical resources and lack of specific antiviral drugs, administering supportive treatments such as intravenous infusion to these patients first may reduce the mortality.