MUSCULOSKELETAL PHYSIOLOGY IN HIV INFECTION

瘦体重（LBM），特别是肌肉质量的损失是一个标志， 艾滋病病毒感染和在许多其他疾病和正常衰老中可见。 肌肉减少和免疫能力下降是平行发生的， 这些情况。 肌肉质量是力量的主要决定因素， 功能状态 运动是为数不多的可以增加 力量（以及功能状态）和CD 4计数，以及肌肉 散装。 此外，众所周知，运动会引发同样的 感染后观察到的免疫和代谢急性期反应， 其他生理应激，循环白色血细胞升高 计数，外周血白细胞介素-1 β产生增加 单核细胞，蛋白质合成和分解增加，尿 肌肉蛋白质的排泄。 这些反应发生后，甚至 一次剧烈运动 因此， 免疫系统、身体成分和运动之间的关系。 此外，委员会认为， 已经引起了关注，急性期反应（特别是肿瘤）可能是一种免疫反应。 坏死因子-α分泌）可以诱导HIV的表达。 在 运动导致蛋白质净降解， 增加肌肉蛋白质。 这一过程是否发生在免疫系统中， 疾病，如艾滋病毒感染，以及在何种程度上改变了它的 疾病，仍然未知。 本项目拟研究1） 剧烈运动对急性期反应的影响 （交叉- 分段研究），以及2）为期八周的有氧运动和 抗阻运动干预对LBM，力量，静息能量的影响 消耗、有氧能力、功能状态和免疫状态 （干预研究）。 两项研究将分三组进行 按CD 4计数分类的HIV（+）受试者以及HIV（-）受试者 对照 虽然其中一些研究已经在一些国家进行， 艾滋病毒（+）人群，这是第一个大规模的综合 评估生理应激和运动的影响 所有HIV（+）受试者和适当的对照。

Loss of lean body mass (LBM), and specifically muscle mass, is a hallmark of HIV infection and in seen in many other diseases and in normal aging. Decrease in muscle and fall in immune competence occur in parallel in these situations. Muscle mass is a major determinant of strength and of functional status. Exercise is one of the few ways available to increase strength (and thus functional status), and CD4 counts, as well as muscle bulk. In addition, exercise is known to trigger the same kind of immunologic and metabolic acute phase response seen after infections and other physiologic stresses, with elevated circulating white blood cell counts, increased production of interleukin-1Beta by peripheral blood mononuclear cells, elevated protein synthesis and breakdown, and urinary excretion of muscle protein. These responses occur following even a single bout of strenuous exercise. Thus there is an intimate connection between the immune system, body composition, and exercise. Furthermore, concern has been raised that the acute phase response (especially tumor necrosis factor-alpha secretion) can induce expression of HIV. In health, exercise leads to net protein degradation, with subsequent increase in muscle protein. Whether this process occurs in immunologic illness, such as HIV infection, and to what extent it is altered by the disease, remains unknown. This Project proposes to study 1) the effect of a single bout of heavy exercise on the acute phase response. (Cross- Sectional Study), as well as 2) the effect of an eight-week aerobic and resistive exercise intervention on LBM, strength, resting energy expenditure, aerobic capacity, functional status, and immune status (Intervention Study). Both studies will be carried out in three groups of HIV (+) subjects, classified by CD4 count as well as in HIV (-) controls. While some of these studies have been carried out in some groups of HIV (+) people, this is the first large-scale integrated evaluation of the effect of physiologic stress and exercise involving the entire spectrum of HIV (+) subjects and appropriate controls.