MUSCULOSKELETAL PHYSIOLOGY IN HIV INFECTION

瘦体重(LBM)，特别是肌肉质量的减少是一个标志 艾滋病毒感染以及在许多其他疾病和正常衰老中可见。 肌肉的减少和免疫能力的下降同时发生在 这些情况。肌肉质量是力量的主要决定因素 功能状态。锻炼是为数不多的增加体重的方法之一 力量(因此是功能状态)和CD4计数，以及肌肉 散装的。此外，众所周知，锻炼也会引发相同类型的 感染和感染后出现的免疫和代谢急性期反应 其他生理应激，循环中的白细胞升高 计数，增加外周血中IL-1β的产生 单个核细胞，蛋白质合成和分解增加，以及尿液 肌肉蛋白质的排泄。这些响应发生在即使在 单轮剧烈运动。因此，有一种亲密的联系 免疫系统、身体成分和运动之间的关系。此外， 人们对急性时相反应(尤其是肿瘤)表示关注 分泌的肿瘤坏死因子)可以诱导HIV的表达。在……里面 健康，运动导致净蛋白质降解，随后 增加肌肉蛋白质。这一过程是否发生在免疫学中 疾病，如艾滋病毒感染，以及在多大程度上由 疾病，仍然是未知的。本项目建议研究1)影响 单次大强度运动对急性期反应的影响。(交叉- 部分研究)，以及2)8周的有氧和 阻力运动干预对LBM、力量、静息能量的影响 支出、有氧能力、机能状态和免疫状态 (干预研究)。这两项研究将分三组进行 HIV(+)受试者中，按CD4计数分类以及在HIV(-)中 控制。虽然这些研究中的一些已经在一些 艾滋病病毒(+)人群，这是第一次大规模整合 评估生理应激和运动的效果 所有艾滋病毒(+)受试者的范围和适当的对照。

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.