Le manifestazioni ematologiche della sindrome da ... - Salute per tutti
Le manifestazioni ematologiche della sindrome da ... - Salute per tutti
Le manifestazioni ematologiche della sindrome da ... - Salute per tutti
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Scripta MEDICA<br />
<strong>Le</strong> <strong>manifestazioni</strong> <strong>ematologiche</strong> <strong>della</strong> <strong>sindrome</strong> <strong>da</strong> immunodeficienza acquisita<br />
113<br />
A questo proposito sembra che in vivo l’interazione<br />
delle MVEC, infettate <strong>da</strong>l HIV, con<br />
altre cellule stromali può indurre l’espressione<br />
<strong>della</strong> molecola di adesione VCAM-1 e<br />
creare quindi un microambiente che favorisce<br />
l’adesione e proliferazione delle cellule B<br />
maligne.<br />
In conclusione si ritiene che nel soggetto<br />
infettato <strong>da</strong>l virus HIV, a seguito di vari eventi<br />
combinati, come la immunodeficienza<br />
generalizzata, la stimolazione cronica B cellulare,<br />
la diminuita sorveglianza immunologica<br />
nei confronti delle neoplasie e la coinfezione<br />
con virus oncogeni, si instaura una<br />
condizione favorevole alla trasformazione<br />
maligna e proliferazione delle cellule B, che<br />
non sono direttamente infettate <strong>da</strong>l virus<br />
HIV, e che questo meccanismo multifattoriale<br />
sia responsabile dell’elevata incidenza dei<br />
LNH-AIDS associati nell’ambito di una<br />
popolazione HIV-1 infettata.<br />
Inoltre si prospetta la possibilità che l’infezione<br />
<strong>da</strong> HIV delle cellule stromali non maligne,<br />
in particolare delle celule endoteliali<br />
microvascolari (MEVC), abbia un ruolo<br />
determinante nel favorire lo sviluppo e proliferazione<br />
di questi linfomi non-Hodgkin<br />
nelle sedi extrano<strong>da</strong>li attraverso alterazioni<br />
del microambiente e una disregolazione di<br />
citochine.<br />
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