ABSTRACT
HIV-1 infection is enhanced by adhesive structures that form between infected and uninfected T cells called virological synapses (VSs). This mode of transmission results in the frequent co-transmission of multiple copies of HIV-1 across the VS, which can reduce sensitivity to antiretroviral drugs. Studying HIV-1 infection of humanized mice, we measured the frequency of co-transmission and the spatiotemporal organization of infected cells as indicators of cell-to-cell transmission in vivo. When inoculating mice with cells co-infected with two viral genotypes, we observed high levels of co-transmission to target cells. Additionally, micro-anatomical clustering of viral genotypes within lymphoid tissue indicates that viral spread is driven by local processes and not a diffuse viral cloud. Intravital splenic imaging reveals that anchored HIV-infected cells induce arrest of interacting, uninfected CD4(+) T cells to form Env-dependent cell-cell conjugates. These findings suggest that HIV-1 spread between immune cells can be anatomically localized into infectious clusters.
Subject(s)
CD4-Positive T-Lymphocytes/virology , Gene Dosage , HIV Infections/virology , HIV-1/physiology , Tropism/physiology , Animals , CD4-Positive T-Lymphocytes/immunology , Cell Movement , Cell-Free System , Cells, Cultured , HIV Infections/blood , Humans , Immunological Synapses/metabolism , Mice , Receptors, CCR5 , Spleen/pathology , Spleen/virology , env Gene Products, Human Immunodeficiency Virus/metabolismABSTRACT
En este artículo se presenta un breve análisis de los cambios que ha habido a través del tiempo con respecto al paciente quirúrgico que presenta que presenta patología médica concomitante, y las razones por las que se ha desarrollado lo que se denomina Medicina Perioperatoria; como asimismo de qué forma se puede avanzar en este tema sobre las bases de un accionar multidisciplinario, bien coordinado y con consensos, lo que arroja positivos resultados tanto para los pacientes como para los centros hospitalarios
