Oxidative Stress Mediated Activation Of NLRP3 Inflammas On IRIS In Patients With Aids And Tuberculosis

Objective:To investigate the effect of NLRP3 mRNA expression and oxidative stress index(SOD,MDA)on IRIS in peripheral blood lymphocytes of patients with AIDS and tuberculosis.In this study,60 patients with AIDS and tuberculosis who were hospitalized in changsha first hospital from August 2018 to October 2019 were selected and followed up regularly for 12 weeks.After the initiation of highly active antiretroviral therapy(HAART),plasma was extracted before and 12 weeks after treatment.Those infected with immune reconstitution inflammatory syndrome(IRIS)were included in the IRIS group.At the end of the observation,no IRIS had occurred in the non-iris group.At the same time,60 patients with simple AIDS and 60 healthy physical examiners were selected.Serum SOD and MDA levels were detected by ELISA,and the expression of NLRP3 mRNA in peripheral venous blood was determined by PCR.Results:(1)the expression levels of MDA and NLRP3 mRNA in patients with HIV/TB and HIV/AIDS were higher than those in the normal group,andSOD was lower than those in the normal group,with statistically significant differences(P<0.05).The expression levels of MDA and NLRP3 mRNA in the AIDS combined with pulmonary tuberculosis group were higher than those in the AIDS alone group and SOD was lower than those in the AIDS alone group,and the difference was statistically significant(P<0.05).(2)the expression level of NLRP3 mRNA and MDA in the IRIS group were higher than that in the non-iris group,and the SOD level in the IRIS group was lower than that in the non-iris group,with statistically significant differences(P<0.05).(3)Pearson correlation analysis results showed that the expression of NLRP3 mRNA was positively correlated with MDA in patients with HIV/TB at IRIS(r=0.816,P<0.05).When IRIS occurred in patients with HIV/TB,the expression of NLRP3 mRNA was negatively correlated with SOD(r=-0.848,P<0.05).Conclusion:1.Oxidative stress and NLRP3 inflammas are involved in the pathogenesis of AIDS,AIDS and tuberculosis.2.Oxidative stress-mediated NLRP3 inflammatosomes may be involved in the development of IRIS in patients with AIDS and tuberculosis.