ALTERATIONS IN SKELETAL MUSCLE STRUCTURE AND FUNCTION IN HIV INFECTION

以前的研究记录了严重的， 进行性营养不良 我们的长期目标是 研究的目的是提供一个了解的发病机制， 艾滋病中的营养不良， 治疗，以及对这种结果的现实期望 疗法 本提案的具体目的是界定 身体变化的代谢机制 作为获得性免疫的结果出现的组合物 缺乏综合征，它们与活动性艾滋病毒感染的关系， 以及它们与细胞因子释放改变的关系。 的 这些研究的核心将是精确测量人体 这将允许精确测定消耗的组合物 或饱食。 将采取两种方法来研究这个问题。 将对一组无症状、HIV血清阳性的男性进行研究 并纵向跟踪。 估计是一个子群 将经历临床进展，并且这些变化将 包括体重减少。 能源利用研究和 将执行衬底通量以确定什么类型的 改变发生在疾病的哪个阶段。 相关性 将与血清细胞因子水平进行比较。 另一种方法 将研究营养不良的艾滋病患者， 营养或抗病毒治疗。 最近的研究 证明了向儿童提供营养支持的可行性， 这些患者，并已显示出身体质量的饱食， 有效的抗病毒治疗。 营养研究将 在饱食期间进行，结果 与血清细胞因子水平相关。 在后来的几年里， 调节细胞因子释放的营养和代谢作用 将被研究。 减轻营养不良的能力 艾滋病慢性感染的后果可能是重要的， 降低了这种并发症的发病率。

Previous studies documented the frequent occurrence of severe, progressive malnutrition in AIDS. The long-term goal of our studies is to provide an understanding of the pathogenesis of malnutrition in AIDS, a scientific rationale for nutritional therapy, and realistic expectations for the results of such therapy. The specific aims of this proposal are to define the metabolic mechanisms underlying the alterations in body composition that occur as a result of the acquired immune deficiency syndrome, their association with active HIV infection, and their relationship to altered release of cytokines. The centerpiece of these studies will be precise measurements of body composition which will allow precise determination of depletion or repletion. Two approaches will be taken to study the problem. A cohort of asymptomatic, HIV-seropositive men will be studied and followed longitudinally. Estimations are that a subgroup will undergo clinical progression, and that the changes will include body mass depletion. Studies of energy utilization and substrate flux will be performed to determine what type of alterations occur and at what point in the disease. Correlations will be made with serum levels of cytokines. The other approach will be to study malnourished AIDS patients who are undergoing nutritional or antiviral therapy. Recent studies have demonstrated the feasibility of providing nutritional support to these patients and have shown body mass repletion as a result of effective antiviral therapy. Nutritional studies will be performed during the period of repletion and the results correlated with serum levels of cytokines. In later years, the nutritional and metabolic effects of modulating cytokine release will be studied. The ability to mitigate the nutritional consequences of chronic infections in AIDS may be important in reducing the morbidity of such complications.