Longitudinal study of adrenal steroids in a cohort of HIV-infected patients with hemophilia
Longitudinal study of adrenal steroids in a cohort of HIV-infected patients with hemophilia
复制标题
DOI：
10.1016/s0022-2143(96)90145-6
复制
发表时间：
1996-06-01
期刊：
影响因子：
--
通讯作者：
Hechter, O
中科院分区：
文献类型：
--
作者：
Chatterton, RT;Green, D;Hechter, O
该研究的目的是将血浆硫酸脱氢表雄酮（DHEA-S）浓度与个体HIV感染男性血友病患者的HIV感染进展相关，并获得有关DHEA-S改变原因的信息。从16名血友病男性中获得血液样本;在9名男性中，HIV-1感染后长达11年的连续样本可用。对照样本来自年龄相当的无血友病或HIV感染的男性。测量CD 4（+）细胞计数、血浆促肾上腺皮质激素（ACTH）、皮质醇、脱氢表雄酮（DHEA）、脱氢表雄酮-S和催乳素。在HIV感染前，血友病患者的血浆DHEA-S水平明显低于对照组。在感染后，9名连续研究的受试者中有3名在11年内血浆DHEA-S水平或CD 4（+）细胞计数变化很小或没有变化。在9名艾滋病患者中，有4名患者的血浆DHEA-S浓度呈进行性下降，在某些情况下，这种下降先于CD 4（+）细胞计数的急剧下降。在另外2例患有其他严重疾病的受试者中观察到血浆DHEA-S水平在CD 4（+）计数福尔斯下降之前显著降低。DHEA-S水平的降低与血浆皮质醇、ACTH或催乳素浓度的降低无关。我们的结论是，血浆DHEA-S是一个指标的总体健康，而不是一个具体的指标，艾滋病毒的进展。血浆DHEA-S的减少与肾上腺的ACTH刺激或皮质醇分泌无关，但可能与抑制DHEA-S前体17-羟基化的细胞因子有关。
The objective of the study was to relate plasma dehydroepiandrosterone sulfate (DHEA-S) concentrations to the progression of HIV infection in individual HIV-infected men with hemophilia and to obtain information on the cause of DHEA-S alterations. Blood samples were obtained from 16 men with hemophilia; in 9 men serial samples were available for up to 11 years after HIV-1 infection. Control samples were obtained from men of comparable ages without hemophilia or HIV infection. Measurements were made of CD4(+) cell counts, plasma adrenocorticotropic hormone (ACTH), cortisol, DHEA, DHEA-S, and prolactin. Before HIV infection, men with hemophilia had significantly lower plasma levels of DHEA-S than control men. After infection, 3 of 9 subjects studied serially had little or no change in plasma DHEA-S levels or in CD4(+) cell counts over 11 years. Four of the 9 in whom AIDS developed had progressive decreases in plasma DHEA-S concentrations that, in some cases, preceded a precipitous fall in CD4(+) cell counts. Major decreases in plasma DHEA-S levels before falls in CD4(+) counts were observed in 2 other subjects who had other severe illnesses. None of the decreases in DHEA-S levels were associated with decreased concentrations of plasma cortisol, ACTH, or prolactin. We conclude that plasma DHEA-S is an indicator of general health rather than a specific indicator for progression of HIV. The decrease in plasma DHEA-S is not related to ACTH stimulation of the adrenal gland or to cortisol secretion, but it may be related to cytokines that can inhibit 17-hydroxylation of DHEA-S precursors.