AUTONOMIC NERVOUS SYSTEM ACTIVITY IN HIV

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。高效抗逆转录病毒疗法（HAART）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bb0 25mg /dl， HDL < 45mg /dl; HIV-DL）的发生所缓和。50%的治疗患者（5;6）。虽然HAART的使用是血脂异常的一个危险因素，但在抗逆转录病毒药物可用之前，有报道称HIV感染患者血浆甘油三酯较高。未经治疗的HIV感染通常伴随着高脂溶酶率，这是不受HAART影响的。可能是由于溶脂率升高导致的FFA供应增加导致了HIV感染患者的血脂异常。交感神经系统（SNS）在生理应激期间模拟脂肪分解，我们发现hiv血脂异常患者血浆儿茶酚胺升高。几项小型研究表明，HIV感染患者SNS活动升高。在一些研究中观察到，副交感神经系统活动的减少也可能导致脂肪分解区域的升高。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活性与脂质代谢的关系。在这项研究中，我们建议系统地测量自主神经系统活动，并评估在基础条件下，在输注丙泊洛尔期间，未经治疗的HIV感染患者和健康志愿者的脂溶率。

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.