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면역 후천성면역결핍 #
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Introduction #

면역결핍증후군으로 알려진 후천성 면역 결핍증은 영양실조, 노화, 특정 약물 및 수은 등의 중금속, 살충제 등 환경 독소와 같은 다양한 면역 억제제로 인해 발생할 수 있다. 면역 억제제는 일반적으로 면역 체계의 기능을 감소시키는 것으로 면역 결핍이라는 부작용을 초래할 수 있다. 특정 질병에 의해서 직간접적으로 면역 억제가 일어나기도 하는데 암, 특히 골수 및 혈액 세포 (백혈병, 림프종, 다발성 골수종) 및 특정 만성 감염이 이에 포함된다. 후천성 면역 결핍 중 가장 유명한 것이 [후천성 면역 결핍 증후군] ([AIDS])로, HIV (human immunodeficiency virus)로 인해 발병한다. 그 외에도 호르몬 및 대사 장애에 의해서 빈혈, 갑상선 기능 저하증, 당뇨 및 저혈당과 같은 면역 결핍이 일어날 수 있다. (참고 : 위키백과)

Selected causes of secondary immunodeficiencies #

condition Effect of immune funtion
Extremes of age
Newborn period Immature lymphoid organs
Absent memory immunity
Low maternal IgG levels in premature infants
Decreased neutrophil storage pool
Decreased neutrophil function
Decreased natural killer activity
Advanced age Decreased antigen-specific cellular immunity
T-cell oligoclonality
Restricted B-cell repertoire
Malnutrition Decreased cellular immune response
Weakened mucosal barriers
Metabolic diseases
Diabetes mellitus Decreased mitogen-induced lymphoproliferation
Defective phagocytosis
Decreased chemotaxis
Chronic uremia Decreased cellular immune response
Decreased generation of memory antibody responses
Decreased chemotaxis
Genetic syndromes: trisomy 21 Defective phagocytosis
Defective chemotaxis
Variable defects of antigen-specific immune responses
Anti-inflammatory, immunomodulatory, and immunosuppressive drug therapy: corticosteroids, calcineurin inhibitors, cytotoxic agents Lymphopenia
Decreased cellular immune response and anergy
Decreased proinflammatory cytokines
Decreased phagocytosis
Decreased chemotaxis
Neutropenia (cytotoxic agents)
Weakened mucosal barriers (cytotoxic agents)
Surgery and trauma Disruption of epithelial and mucosal barriers
T-cell anergy caused by nonspecific immune activation
Environmental conditions UV light, radiation, hypoxia, space Flight Increased lymphocyte apoptosis
Increased secretion of tolerogenic cytokines
Cytopenias
Decreased cellular immunity and anergy
Stress-induced nonspecific immune activation
Infectious diseases: HIV infection T-cell lymphopenia
Decreased cellular immune response and anergy
Defective antigen-specific antibody responses

출처 : Chinen, Javier, and William T. Shearer. "Secondary immunodeficiencies, including HIV infection." Journal of Allergy and Clinical Immunology 125.2 (2010): S195-S203.

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