Cocaine and HIV-mediated disruptions of hypothalamic signaling in hypothyroidism

描述（由申请人提供）：低社会经济背景，失业和萧条的环境对前景和行为起重要作用。同样，一些患有情绪障碍的人可能会推迟寻求医疗保健，或者可能没有医疗保健福利，转而求助于药物滥用（SA）作为替代方案。与SA和/或HIV感染相关的一些合并症直接影响行为和认知，并显著影响生活质量、抗逆转录病毒治疗的依从性和成功的药物成瘾治疗方案。在这种情况下，甲状腺激素水平的改变已经成为一些SA疾病和/或HIV感染个体的并发症，尽管这种联系的分子基础尚不清楚。我们的广泛假设是SA和HIV CNS疾病导致下丘脑-垂体-甲状腺（HPT）反馈回路的破坏，并可能导致或加剧甲状腺功能减退。我们认为，这些干扰部分发生在下丘脑信号水平，并可能部分促成在许多滥用可卡因和HIV阳性的个体中观察到的HPT综合征。我们提出的探索性研究的结果将为设计更详细的研究提供有价值的信息，以解决：

DESCRIPTION (provided by applicant): Low socio-economic background, unemployment and depressed environmental surroundings play significant roles in outlook and behavior. Likewise, some individuals suffering from mood disorders may delay seeking healthcare or may not have healthcare benefits and turn to substance abuse (SA) as an alternative. Some comorbidities associated with SA and/or HIV infection directly affect behavior and cognition, and impact significantly on quality of life, adherence to anti-retroviral therapy and successful drug addiction treatment programs. In this context, alterations in thyroid hormone levels have emerged as a complication among some individuals with SA disorders and/or HIV infection, although the molecular basis for the connection is unknown. Our broad hypothesis is that SA and HIV CNS disease contribute to disruptions in the hypothalamic pituitary thyroid (HPT) feedback loop and may lead to or exacerbate hypothyroidism. We propose that these disruptions occur, in part, at the level of hypothalamic signaling and may contribute, in part, to HPT syndrome observed in many individuals who abuse cocaine and are HIV positive. Results from our proposed exploratory study will provide valuable information needed to design more detailed studies addressing: molecular interactions among cocaine, HIV, HAART and CNS HPT signaling impact on cognitive dysfunction, behavior and disease progression treatment strategies for HIV patients with SA disorder at risk for thyroid disease. Our studies are designed to address if cocaine and/or HIV affect pre-existing subclinical or overt hypothyroidism to provide increased awareness among healthcare providers treating substance abuser and/or HIV patients. Left unchecked, the combination of these disorders could lead to increased SA and more rapid disease progression. Results from the proposed studies will increase our understanding of how altered hypothalamic signaling in patients suffering from SA disorders and/or HIV infection may contribute to declining cognition and disease progression, and/or treatment failure. PUBLIC HEALTH RELEVANCE: Alterations in thyroid hormone levels have emerged as a complication among some individuals with SA disorders and/or HIV infection, although the molecular basis for the connection is unknown. Left unchecked, the combination of these disorders could lead to increased SA and more rapid disease progression. Our study will provide information to address molecular interactions among cocaine, HIV, and CNS thyroid signaling.