Decreased bone formative and enhanced resorptive markers in human immunodeficiency virus infection:: Indication of normalization of the bone-remodeling process during highly active antiretroviral therapy
Decreased bone formative and enhanced resorptive markers in human immunodeficiency virus infection:: Indication of normalization of the bone-remodeling process during highly active antiretroviral therapy
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DOI：
10.1210/jc.84.1.145
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发表时间：
1999-01-01
影响因子：
5.8
通讯作者：
Froland, SS
中科院分区：
文献类型：
--
作者：
Aukrust, P;Haug, CJ;Froland, SS
由于细胞因子和1,25-二羟基维生素D [1,25-(OH)(2)D]似乎在骨稳态中起重要作用，我们通过分析73例HIV感染患者的血清骨形成标志物（骨钙素）和骨吸收（c -端肽），研究了以促炎细胞因子水平升高和1,25-(OH)(2)D缺乏为特征的人类免疫缺陷病毒（HIV）感染患者扰乱骨代谢的可能性。具有晚期临床和免疫疾病和高病毒载量的hiv感染患者的特征是c端肽升高，特别是骨钙素水平明显降低。hiv感染患者的TNF系统活化增强。血清p55和p75-TNF受体浓度与骨钙素呈负相关，p75-TNF受体与c -末端肽呈正相关。hiv感染的晚期患者血清中125 -(OH)(2)D的浓度也降低，但该参数与骨钙素或c -末端肽无关。在接受高效抗逆转录病毒治疗的24个月期间，血清骨钙素水平显著上升，病毒载量和TNF成分显著下降，CD4(+) T细胞计数显著上升。此外，还有一个转变。骨钙素和c端肽水平在治疗期间从无相关性到显著相关性。目前的研究表明，在HIV感染期间，骨形成和骨吸收受到干扰。我们的研究结果表明，在高活性抗逆转录病毒治疗期间骨重塑的同步可能代表了这种治疗以前未被认识到的有益效果，并扩展了我们对骨重塑过程中细胞因子和毒素之间相互作用的认识。
As cytokines and 1,25-dihydroxyvitamin D [1,25-(OH)(2)D] appear to have an important role in bone homeostasis, we examined the possibility that human immunodeficiency virus (HIV)-infected patients, characterized by enhanced levels of proinflammatory cytokines and 1,25-(OH)(2)D deficiency, have disturbed bone metabolism by analyzing serum markers of bone formation (osteocalcin) and bone resorption (C-telopeptide) in 73 HIV-infected patients. HIV-infected patients with advanced clinical and immunological disease and high viral load were characterized by increased C-telopeptide and particularly by markedly depressed osteocalcin levels. HIV-infected patients had enhanced activation of the TNF system. Serum concentrations of p55 and p75-TNF receptors were negatively correlated with osteocalcin, and p75-TNF receptor was positively correlated with C-telopeptide. HIV-infected patients with advanced disease also had decreased serum concentrations of 1,25-(OH)(2)D, but this parameter was not correlated with osteocalcin or C-telopeptide. During 24 months with highly active antiretroviral therapy there was a marked rise in serum osteolcalcin levels together with a profound fall in viral load and TNF components and a marked rise in CD4(+) T cell counts. Also, there was a shift. from no correlation to a significant correlation between osteocalcin and C-telopeptide levels during such therapy. The present study suggests disturbed bone formation and resorption during HIV infection. Our findings indicating synchronization of bone remodeling during highly active antiretroviral therapy may represent a previously unrecognized beneficial effect of such therapy and expand our knowledge of the interactions between cytokines and bane in the bone-remodeling process.