AUTONOMIC NERVOUS SYSTEM ACTIVITY IN HIV

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。高效抗逆转录病毒疗法（HAART）已大大降低了艾滋病毒感染患者的死亡率。最初对HAART益处的热情已经被血脂异常（血浆甘油三酯> 250 mg/dl，HDL <45 mg/dl; HIV-DL）的发生所冲淡。50%的治疗患者（5;6）。虽然HAART使用是血脂异常发生的一个风险因素，但在抗逆转录病毒药物可用之前，HIV感染患者报告了高血浆甘油三酯。未经治疗的HIV感染通常伴有不受HAART影响的脂解率升高。很可能是由于脂肪分解率升高导致FFA供应增加导致HIV感染患者血脂异常。交感神经系统（SNS）在生理应激期间模拟脂解，我们发现HIV血脂异常患者血浆儿茶酚胺升高。一些小型研究表明，HIV感染患者的SNS活性升高。在几项研究中观察到的副交感神经系统活动减少也可能导致脂解区域升高。尽管有证据表明未经治疗的HIV感染患者的自主神经功能异常，但没有研究系统地评估未经治疗的HIV感染患者的SNS和PNS活性，以及ANS活性与脂质代谢之间的关系。在这项研究中，我们建议系统地测量自主神经系统的活动，并评估脂解率在基础条件下，在心得安输注过程中，在未经治疗的HIV感染患者，并在健康志愿者。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Highly-active antiretroviral therapy (HAART) has dramatically reduced mortality rates in patients with HIV infection. Initial enthusiasm for the benefits of HAART has been tempered by the occurrence of dyslipidemia (plasma triglyceride >25omg/dl, HDL <45 mg/dl; HIV-DL) in ? 50% of treated patients (5;6). While HAART use is a risk factor for development of dyslipidemia, high plasma triglycerides were reported in patients with HIV infection prior to the availability of antiretroviral medications. Untreated HIV infection is often accompanied by elevated lipolytic rate that is unaffected by HAART. It is likely that increased FFA supply due to elevated lipolytic rate contributes to dyslipidemia in patients with HIV infection. The sympathetic nervous system (SNS) simulates lipolysis during periods of physiologic stress, and we have found that plasma catecholamines are elevated in patients with HIV-dyslipidemia. Several small studies have suggested that patients with HIV infection have elevated SNS activity. Reduced parasympathetic nervous system activity, which has been observed in several studies, could also contribute to elevated areas of lipolysis. Despite evidence of abnormalities in autonomic function in patients with untreated HIV infection, no study has systematically evaluated SNS and PNS activity in patients with untreated HIV infection, and the relationship between ANS activity and lipid metabolism. In this study we propose to systematically measure autonomic nervous system activity and to evaluate lipolytic rate during basal conditions, and during infusion of propanolol, in patients with untreated HIV infection, and in healthy volunteers.