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Carrico AW, Cherenack EM, Flentje A, Moskowitz JT, Asam K, Ghanooni D, Chavez JV, Neilands TB, Dilworth SE, Rubin LH, Gouse H, Fuchs D, Paul RH, Aouizerat BE. A positive affect intervention alters leukocyte DNA methylation in sexual minority men with HIV who use methamphetamine. Brain Behav Immun 2024; 120:151-158. [PMID: 38777283 PMCID: PMC11269022 DOI: 10.1016/j.bbi.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/16/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This epigenomics sub-study embedded within a randomized controlled trial examined whether an evidenced-based behavioral intervention model that decreased stimulant use altered leukocyte DNA methylation (DNAm). METHODS Sexual minority men with HIV who use methamphetamine were randomized to a five-session positive affect intervention (n = 32) or an attention-control condition (n = 21), both delivered during three months of contingency management for stimulant abstinence. All participants exhibited sustained HIV virologic control - an HIV viral load less than 40 copies/mL at baseline and six months post-randomization. The Illumina EPIC BeadChip measured leukocyte methylation of cytosine-phosphate-guanosine (CpG) sites mapping onto five a priori candidate genes of interest (i.e., ADRB2, BDNF, FKBP5, NR3C1, OXTR). Functional DNAm pathways and soluble markers of immune dysfunction were secondary outcomes. RESULTS Compared to the attention-control condition, the positive affect intervention significantly decreased methylation of CpG sites on genes that regulate β2 adrenergic and oxytocin receptors. There was an inconsistent pattern for the direction of the intervention effects on methylation of CpG sites on genes for glucocorticoid receptors and brain-derived neurotrophic factor. Pathway analyses adjusting for the false discovery rate (padj < 0.05) revealed significant intervention-related alterations in DNAm of Reactome pathways corresponding to neural function as well as dopamine, glutamate, and serotonin release. Positive affect intervention effects on DNAm were accompanied by significant reductions in the self-reported frequency of stimulant use. CONCLUSIONS There is an epigenetic signature of an evidence-based behavioral intervention model that reduced stimulant use, which will guide the identification of biomarkers for treatment responses.
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Affiliation(s)
- Adam W Carrico
- Robert Stempel College of Public Health & Social Work, Florida International University, United States.
| | | | - Annesa Flentje
- University of California, San Francisco School of Nursing, United States; Alliance Health Project, University of California San Francisco School of Medicine, United States
| | | | - Kesava Asam
- Department of Oral Maxillofacial Surgery, New York University College of Dentistry, United States
| | - Delaram Ghanooni
- Robert Stempel College of Public Health & Social Work, Florida International University, United States
| | - Jennifer V Chavez
- Robert Stempel College of Public Health & Social Work, Florida International University, United States
| | - Torsten B Neilands
- University of California, San Francisco School of Medicine, United States
| | | | - Leah H Rubin
- Johns Hopkins University School of Medicine, United States
| | - Hetta Gouse
- University of Miami Miller School of Medicine, United States
| | | | - Robert H Paul
- Department of Psychological Sciences, University of Missouri Saint Louis, United States
| | - Bradley E Aouizerat
- Department of Oral Maxillofacial Surgery, New York University College of Dentistry, United States
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Ross EJ, Williams RS, Viamonte M, Reynolds JM, Duncan DT, Paul RH, Carrico AW. Overamped: Stimulant Use and HIV Pathogenesis. Curr HIV/AIDS Rep 2023; 20:321-332. [PMID: 37971597 DOI: 10.1007/s11904-023-00672-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW In the era of HIV treatment as prevention (TasP), more clarity is needed regarding whether people with HIV who use stimulants (i.e., methamphetamine, powder cocaine, and crack cocaine) display elevated HIV viral load and greater immune dysregulation. RECENT FINDINGS Although rates of viral suppression have improved in the TasP era, stimulant use was independently associated with elevated viral load in 23 of 28 studies included in our review. In the 12 studies examining other HIV disease markers, there was preliminary evidence for stimulant-associated alterations in gut-immune dysfunction and cellular immunity despite effective HIV treatment. Studies generally focused on documenting the direct associations of stimulant use with biomarkers of HIV pathogenesis without placing these in the context of social determinants of health. Stimulant use is a key barrier to optimizing the effectiveness of TasP. Elucidating the microbiome-gut-brain axis pathways whereby stimulants alter neuroimmune functioning could identify viable targets for pharmacotherapies for stimulant use disorders. Examining interpersonal, neighborhood, and structural determinants that could modify the associations of stimulant use with biomarkers of HIV pathogenesis is critical to guiding the development of comprehensive, multi-level interventions.
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Affiliation(s)
- Emily J Ross
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Renessa S Williams
- University of Miami School of Nursing and Health Sciences, Coral Gables, FL, USA
| | | | - John M Reynolds
- Calder Memorial Library, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Dustin T Duncan
- Columbia University Mailman School of Public Health, New York City, NY, USA
| | - Robert H Paul
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Adam W Carrico
- Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, AHC5, #407, Miami, FL, 33199, USA.
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Anderson AM, Bhondoekhan F, Curanovic D, Connelly MA, Otvos JD, Post WS, Michos ED, Stosor V, Levine A, Seaberg E, Weinstein AM, Becker JT. Higher Soluble CD163 in Blood Is Associated With Significant Depression Symptoms in Men With HIV. J Acquir Immune Defic Syndr 2022; 91:325-333. [PMID: 35969468 PMCID: PMC9588493 DOI: 10.1097/qai.0000000000003063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND People with HIV (PWH) are more likely to experience depression, a highly morbid disease. More evidence is needed to better understand mechanisms of depression in PWH. We evaluated a panel of blood biomarkers in relation to depression symptoms in the Multicenter AIDS Cohort Study (MACS). SETTING Four sites in the United States. METHODS A cross-sectional analysis was performed within the MACS, a prospective study of cisgender men with and without HIV. Depression was assessed with the Center for Epidemiological Studies-Depression Scale, and six blood biomarkers were measured: GlycA, high sensitivity C-reactive protein (CRP), interleukin-6, CCL2, soluble CD14 (sCD14), and soluble CD163 (sCD163). Using univariable and multivariable logistic regression, the biomarkers and other factors were evaluated in relation to significant depression symptoms (SDS) by Center for Epidemiological Studies-Depression score ≥16. RESULTS 784 men were analyzed; most of whom (63%) were PWH. PWH were more likely to have SDS (32% vs. 21%). In univariable analysis, higher GlycA, CRP, and sCD163 concentrations were associated with SDS. In multivariable analysis, however, only higher sCD163 concentration was associated with SDS (odds ratio = 2.30, 95% CI = 1.11 to 4.76). This relationship was driven by the PWH group (odds ratio = 2.72, 95% CI = 1.12 to 6.58) and remained significant when controlling for antidepressant use. Lack of college education was also associated with SDS. CONCLUSIONS Higher sCD163, a marker of macrophage activation, was significantly associated with significant depression symptoms in the MACS. Further research on this biomarker and macrophage activation in general is warranted to better understand and treat depression in PWH.
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Affiliation(s)
- Albert M Anderson
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Druid Hills, GA
| | - Fiona Bhondoekhan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | | | - Wendy S Post
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valentina Stosor
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Andrew Levine
- Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA; and
| | - Eric Seaberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Andrea M Weinstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Carrico AW, Cherenack EM, Rubin LH, McIntosh R, Ghanooni D, Chavez JV, Klatt NR, Paul RH. Through the Looking-Glass: Psychoneuroimmunology and the Microbiome-Gut-Brain Axis in the Modern Antiretroviral Therapy Era. Psychosom Med 2022; 84:984-994. [PMID: 36044613 PMCID: PMC9553251 DOI: 10.1097/psy.0000000000001133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Depression, substance use disorders, and other neuropsychiatric comorbidities are common in people with HIV (PWH), but the underlying mechanisms are not sufficiently understood. HIV-induced damage to the gastrointestinal tract potentiates residual immune dysregulation in PWH receiving effective antiretroviral therapy. However, few studies among PWH have examined the relevance of microbiome-gut-brain axis: bidirectional crosstalk between the gastrointestinal tract, immune system, and central nervous system. METHODS A narrative review was conducted to integrate findings from 159 articles relevant to psychoneuroimmunology (PNI) and microbiome-gut-brain axis research in PWH. RESULTS Early PNI studies demonstrated that neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis and autonomic nervous system could partially account for the associations of psychological factors with clinical HIV progression. This review highlights the need for PNI studies examining the mechanistic relevance of the gut microbiota for residual immune dysregulation, tryptophan catabolism, and oxytocin release as key biological determinants of neuropsychiatric comorbidities in PWH (i.e., body-to-mind pathways). It also underscores the continued relevance of neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and oxytocin release in modifying microbiome-gut-brain axis functioning (i.e., mind-to-body pathways). CONCLUSIONS Advancing our understanding of PNI and microbiome-gut-brain axis pathways relevant to depression, substance use disorders, and other neuropsychiatric comorbidities in PWH can guide the development of novel biobehavioral interventions to optimize health outcomes. Recommendations are provided for biobehavioral and neurobehavioral research investigating bidirectional PNI and microbiome-gut-brain axis pathways among PWH in the modern antiretroviral therapy era.
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Affiliation(s)
- Adam W Carrico
- From the Department of Public Health Sciences (Carrico, Cherenack, Ghanooni, Chavez), University of Miami Miller School of Medicine, Miami, Florida; Departments of Neurology (Rubin) and Psychiatry and Behavioral Sciences (Rubin), Johns Hopkins University School of Medicine; Department of Epidemiology (Rubin), Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychology (McIntosh), University of Miami College of Arts and Sciences, Coral Gables, Florida; Department of Surgery (Klatt), University of Minnesota School of Medicine, Minneapolis, Minnesota; and Department of Psychological Sciences (Paul), University of Missouri St. Louis, St. Louis, Missouri
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Kondur HR, Lee TK, McIntosh R, Gouse H, Paul R, Grov C, Fuchs D, Gómez W, Dilworth SE, Neilands TB, Carrico AW. HIV-related drivers of sexual compulsivity and sexuality in sexual minority men who use methamphetamine. J Neurovirol 2022; 28:446-455. [PMID: 35821194 DOI: 10.1007/s13365-022-01085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/22/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
Although co-occurring methamphetamine (meth) use and HIV amplify the risk for neuropsychiatric comorbidities, the underlying neuroimmune mechanisms are not well characterized. We examined whether a detectable viral load and dysregulated metabolism of amino acid precursors for neurotransmitters predicted subsequent levels of sexual compulsivity and sexual sensation seeking. This 15-month longitudinal study enrolled 110 sexual minority men (SMM) living with HIV who had biologically confirmed meth use (i.e., reactive urine or hair toxicology results). Peripheral venous blood samples collected at baseline, 6 months, 12 months, and 15 months were used to measure a detectable viral load (> 40 copies/mL), the kynurenine/tryptophan (K/T) ratio, and the phenylalanine/tyrosine (P/T) ratio. The K/T and P/T ratios index dysregulated serotonin and catecholamine (e.g., dopamine) synthesis, respectively. In a cross-lagged panel model, a detectable viral load at 6 months predicted greater sexual compulsivity at 12 months after adjusting for prior levels of sexual compulsivity and recent stimulant use (β = 0.26, p = 0.046). A greater P/T ratio at baseline predicted decreased sexual sensation seeking at 6 months (β = - 0.25, p = 0.004) after adjusting for baseline sexual sensation seeking and recent stimulant use. Taken together, HIV replication and dysregulated catecholamine synthesis could potentiate sexual compulsivity while decreasing sexual pleasure in SMM who use meth.
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Affiliation(s)
- Hema R Kondur
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Tae K Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, Korea
| | - Roger McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Hetta Gouse
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Robert Paul
- Department of Psychological Sciences, University of Missouri St. Louis, St. Louis, MO, USA
| | - Christian Grov
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | | | - Walter Gómez
- Jane Addams College of Social Work, University of Illinois, Chicago, IL, USA
| | - Samantha E Dilworth
- School of Medicine, Department of Medicine, Division of Prevention Science, San Francisco Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Torsten B Neilands
- School of Medicine, Department of Medicine, Division of Prevention Science, San Francisco Center for AIDS Prevention Studies, University of California, San Francisco, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
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