Section Review Biologicals & Immunologicals: Deregulation of cytokine production in AIDS: implication for therapy

HIV infection is associated with both a hyperactivity of the immune system and decreased immune responses against specific antigens. A similar pattern is observed when considering cytokine production in HIV-infected patients. Several cytokines are spontaneously produced at an increased level, whereas other cytokines, playing an important role during cell-mediated immune responses, are produced at a low level following stimulation. This deregulation of cytokine production may participate in the immune deficiency, both by impairing immune responses and by accelerating CD4+ T-lymphocyte destruction. In addition to contributing to the immune disequilibrium of the disease, impaired cytokine production in HIV-infected patients may contribute to the emergence and to the clinical symptoms of several complications of the disease, such as opportunistic infections, Kaposi's sarcoma and lymphomas. Better understanding of the role of cytokines in HIV infection may suggest new therapeutic approaches in which administration of cytokines or cytokine antagonists may allow the immune system to function more effectively and may stimulate antiviral and anti-infectious immune defences.