Circulating β-d-Glucan as a Marker of Subclinical Coronary Plaque in Antiretroviral Therapy-Treated People With Human Immunodeficiency Virus.
Circulating β-d-Glucan as a Marker of Subclinical Coronary Plaque in Antiretroviral Therapy-Treated People With Human Immunodeficiency Virus.
复制标题
循环β-d-葡聚糖作为抗逆转录病毒治疗的人类免疫缺陷病毒患者亚临床冠状动脉斑块的标志物
DOI：
10.1093/ofid/ofab109
复制
发表时间：
2021-06
影响因子：
4.2
通讯作者：
Routy JP
中科院分区：
文献类型：
--
作者：
Isnard S;Fombuena B;Sadouni M;Lin J;Richard C;Routy B;Ouyang J;Ramendra R;Peng X;Zhang Y;Finkelman M;Tremblay-Sher D;Tremblay C;Chartrand-Lefebvre C;Durand M;Routy JP
尽管抗逆转录病毒治疗（ART），人类免疫缺陷病毒（PWH）患者患炎性共病的风险增加，包括心血管疾病。肠上皮损伤和细菌脂多糖（LPS）或真菌β-d-葡聚糖（BDG）的移位驱动ART治疗的PWH中的炎症。在这项研究中，我们调查了肠道损伤和微生物易位的标志物是否与无症状ART治疗的PWH的心血管风险相关。我们横断面分析了93名ART治疗的PWH和52名年龄超过40岁的未感染对照的血浆，这些对照来自加拿大HIV和老龄化队列。参与者无心血管疾病，并接受了心脏计算机断层扫描（CT），以测量总冠状动脉粥样硬化斑块体积（TPV）。采用酶联免疫吸附法检测细菌内毒素（LPS）水平及肠损伤标志物REG 3 α和I-FABP。使用Fungitell测定法分析真菌BDG水平。ART治疗的PWH伴冠状动脉斑块患者中β-d-葡聚糖水平显著升高，但LPS水平未显著升高（P =.0007）。 此外，BDG而不是LPS水平与TPV相关（r = 0.26，P =.01）。 肠脂肪酸结合蛋白（I-FABP）而不是REG 3 α水平与TPV相关（r = 0.23，P = 0.03）。 然而，BDG和LPS水平没有升高，在未感染的对照斑块。在多变量模型中，BDG水平升高与PWH中冠状动脉粥样硬化的存在独立相关，但在未感染的对照组中则无关。在ART治疗的PWH患者中，通过CT扫描成像评估，真菌BDG易位与冠状动脉粥样硬化相关，提示人类免疫缺陷病毒特异性途径导致心血管疾病。需要进一步研究来评估这种关联的因果关系。真菌产物的易位可能代表ART治疗PWH中预防心血管疾病的治疗靶点。在接受抗逆转录病毒治疗的HIV感染者中，真菌产物β-D-葡聚糖（而非细菌产物脂多糖）的血浆水平与亚临床冠状动脉粥样硬化斑块的存在和大小相关，与经典的心血管风险因素无关。
Despite antiretroviral therapy (ART), people with human immunodeficiency virus (PWH) have increased risk of inflammatory comorbidities, including cardiovascular diseases. Gut epithelial damage, and translocation of bacterial lipopolysaccharide (LPS) or fungal β-d-glucan (BDG) drive inflammation in ART-treated PWH. In this study, we investigated whether markers of gut damage and microbial translocation were associated with cardiovascular risk in asymptomatic ART-treated PWH. We cross-sectionally analyzed plasma from 93 ART-treated PWH and 52 uninfected controls older than 40 years of age from the Canadian HIV and Aging Cohort. Participants were cardiovascular disease free and underwent a cardiac computed tomography (CT) to measure total coronary atherosclerotic plaque volume (TPV). Levels of bacterial LPS and gut damage markers REG3α and I-FABP were measured by enzyme-linked immunosorbent assay. Fungal BDG levels were analyzed using the Fungitell assay. β-d-glucan levels but not LPS were significantly elevated in ART-treated PWH with coronary artery plaque (P = .0007). Moreover, BDG but not LPS levels correlated with TPV (r = 0.26, P = .01). Intestinal fatty acid binding protein (I-FABP) but not REG3α levels correlated with TPV (r = 0.23, P = .03). However, BDG and LPS levels were not elevated in uninfected controls with plaque. In multivariable models, elevated BDG levels were independently associated with the presence of coronary atherosclerosis in PWH but not in uninfected controls. Translocation of fungal BDG was associated with coronary atherosclerosis assessed by CT-scan imaging in ART-treated PWH, suggesting a human immunodeficiency virus-specific pathway leading to cardiovascular disease. Further investigation is needed to appraise causality of this association. Translocation of fungal products may represent a therapeutic target to prevent cardiovascular disease in ART-treated PWH. Plasma levels of the fungal product β-D-Glucan, but not the bacterial product lipopolysaccharide, are associated with the presence and the size of subclinical coronary atherosclerosis plaque in people living with HIV taking antiretroviral therapy, independently of classical cardiovascular risk factors.
登录
查看更多内容
影响因子：
4.9
作者：
Farhour Z;Mehraj V;Chen J;Ramendra R;Lu H;Routy JP
通讯作者：
Routy JP
DOI：
10.1097/qad.0000000000000243
发表时间：
2014-05-15
期刊：
AIDS (London, England)
影响因子：
--
作者：
May MT;Gompels M;Delpech V;Porter K;Orkin C;Kegg S;Hay P;Johnson M;Palfreeman A;Gilson R;Chadwick D;Martin F;Hill T;Walsh J;Post F;Fisher M;Ainsworth J;Jose S;Leen C;Nelson M;Anderson J;Sabin C;UK Collaborative HIV Cohort (UK CHIC) Study
通讯作者：
UK Collaborative HIV Cohort (UK CHIC) Study
影响因子：
8
作者：
Deleage, Claire;Schuetz, Alexandra;Estes, Jacob D.
通讯作者：
Estes, Jacob D.
DOI：
10.1615/forumimmundisther.2016014177
发表时间：
2015-01-01
期刊：
Forum on immunopathological diseases and therapeutics
影响因子：
--
作者：
Epeldegui, Marta;Martinez-Maza, Otoniel
通讯作者：
Martinez-Maza, Otoniel
DOI：
10.1097/qai.0b013e318271799b
发表时间：
2012-12-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Morris A;Hillenbrand M;Finkelman M;George MP;Singh V;Kessinger C;Lucht L;Busch M;McMahon D;Weinman R;Steele C;Norris KA;Gingo MR
通讯作者：
Gingo MR