NCLEX : Identifying Viruses
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Example Question #297 : Nclex
Human immunodeficiency virus, or HIV, is an enveloped human retrovirus of the lentivirus family. There is also a significant number of HIV-infected individuals who never become sick, never experience a decline in their CD4 counts, and never develop high plasma loads of viral RNA. The reasons that these individuals never become sick include host factors such as the presence of mutations provide resistance to HIV, such as which of the following mutations?
IL-8
CCR5
SDF-1
Mac-1
CXCR4
CCR5
CCR5 is necessary for HIV entry into the host cell. CCR5 is expressed by macrophages, dendritic cells, and CD4 T cells. It is thought to be the major co-receptor for establishing primary infection, since individuals who are homozygous for a mutation in CCR5 appear to be resistant to infection by HIV. For example, the CCR5-Delta32 deletion mutation seems to confer resistance against HIV-1 by blocking its attachment to CCR5 so that HIV cannot gain entry to the cell. Development of drugs directed at chemokine receptors is thus an active area of research.
On the other hand, CXCR4 is the other major co-receptor for HIV. Lymphotropic HIV uses CXCR4 found on T cells and requires a high density of CD4 on the cell surface. CXCR4 also binds the CXC-chemokine stromal-derived factor-1 (SDF-1) as a co-receptor. Both co-receptors are G-coupled proteins with 7 transmembrane spanning domains. Mac-1, also called CD11b/CD18, is stored in specific granules that are shuttled to the granulocyte surface. It exists as a chemoattractant activation-dependent molecule that undergoes a conformational change upon stimulation. Until stimulation occurs, it remains in a resting, non-adhesive state. Mac-1 is a β2 integrin. SDF-1 is a small chemokine of the CXC subfamily that is produced constitutively by bone marrow stromal cells and has an important role in early stages of B cell development. It is a growth factor for B cell progenitors and a chemotactic factor for T cells, monocytes, CD34+ hematopoietic progenitor cells, mature megakaryocytes, and dendritic cells. Interleukin-8 or IL-8, a CXC chemokine, is an 11-kDa homodimer of 99 amino acids that is also known as monocyte-derived neutrophil chemotactic factor (MDNCF). It is an important mediator of neutrophil, lymphocyte, and basophil chemotaxis and activation. It is released from several cell types in response to an inflammatory response.
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