Modification of resistance to Streptococcus pneumoniae by dietary ethanol, immunization, and murine retroviral infection

Alcohol use accelerates HIV disease progression

The effects of alcohol abuse on HIV disease progression have not been definitively established. A prospective, 30-month, longitudinal study of 231 HIV(+) adults included history of alcohol and illicit drug use, adherence to antiretroviral therapy (ART), CD4(+) cell count, and HIV viral load every 6 months. Frequent alcohol users (two or more drinks daily) were 2.91 times (95% CI: 1.23-6.85, p = 0.015) more likely to present a decline of CD4 to <or=200 cells/microl, independent of baseline CD4(+) cell count and HIV viral load, antiretroviral use over time, time since HIV diagnosis, age, and gender. Frequent alcohol users who were not on ART also increased their risk for CD4 cell decline to <or=200 cells/mm(3) (HR = 7.76: 95% CI: 1.2-49.2, p = 0.03). Combined frequent alcohol use with crack-cocaine showed a significant risk of CD4(+) cell decline (HR = 3.57: 95% CI: 1.24-10.31, p = 0.018). Frequent alcohol intake was associated with higher viral load over time (beta = 0.259, p = 0.038). This significance was maintained in those receiving ART (beta = 0.384, p = 0.0457), but not in those without ART. Frequent alcohol intake and the combination of frequent alcohol and crack-cocaine accelerate HIV disease progression. The effect of alcohol on CD4(+) cell decline appears to be independent of ART, through a direct action on CD4 cells, although alcohol and substance abuse may lead to unmeasured behaviors that promote HIV disease progression. The effect of alcohol abuse on viral load, however, appears to be through reduced adherence to ART.

Alcohol consumption alters cytokine release during murine AIDS

Acquired immune deficiency syndrome (AIDS) is a clinical disorder caused by a human immunodeficiency virus (HIV), representing the end point in a progressive sequence of immunosuppressive changes. HIV, the key causative agent of AIDS, induces immunosuppression that render the body highly susceptible to opportunistic infections and neoplasm. However, the onset of clinical symptoms of AIDS (e.g., low CD4+ T cells count, opportunistic infections, and tumors) is quite variable among HIV+ individuals with a mean incubation times 3-10 years following seroconversion. Because of the deleterious effects of chronic alcohol (EtOH) consumption on cytokine release, immune response, host defense, nutritional status, and oxidative stress, it has been believed to be a possible cofactor that could enhance the host's susceptibility to HIV infection, and subsequently accelerate the development of AIDS. The purpose of this review is to present evidence of EtOH-induced cytokine dysregulation during murine AIDS. Our results done in murine AIDS indicate the EtOH consumption may accelerate the development of AIDS by disrupting cytokine production. These EtOH-induced abnormalities in cytokine release may promote a more rapid development of AIDS as a cofactor, which exacerbates the immune dysfunctions initiated by retrovirus infection.

Is alcohol consumption a cofactor in the development of acquired immunodeficiency syndrome?

Excessive alcohol (EtOH) consumption and acquired immunodeficiency syndrome (AIDS) are two major public health problems in the United States. Overwhelming evidence is showing that heavy EtOH ingestion broadly suppresses the various arms of immune response, seriously impairing the body's normal host defense to invading microbes and tumorigenesis. The onset of clinical symptoms of AIDS (low CD4+ T cells count, opportunistic infections, and tumors) is quite variable among HIV+ individuals with a mean incubation time 3-10 years following seroconversion. Because of the deleterious effects of chronic EtOH consumption on cytokine release, immune response, host defense, nutritional status, and oxidative stress, it has been believed to be a possible cofactor that could enhance the host's susceptibility to infections, and subsequently increase the rate of AIDS development. The purpose of this review is to present evidence indicating clinical disorders during EtOH ingestion in murine AIDS. These EtOH-induced abnormalities may promote a more rapid development of AIDS in HIV-infected individuals.

Chronic ethanol consumption before retrovirus infection is a cofactor in the development of immune dysfunction during murine AIDS

Chronic ethanol (EtOH) consumption has been presumed to be a cofactor in the development of acquired immune deficiency syndrome (AIDS). AIDS is identified as a major public health priority in the United States, with heavy economic and social impact. In the present study, we tested this hypothesis that EtOH users are more predisposed to immunosuppression because of retrovirus infection in murine AIDS. Adult female C57BL/6 mice were fed 4.5% (v/v) in liquid diet and control diets for 10 weeks. Then all mice were infected with LP-BM5 retrovirus, causing murine AIDS, and were fed control liquid diets without EtOH. Interleukin (IL)-2 production produced by concanavalin A (Con A)-stimulated splenocytes was suppressed during murine AIDS. It was further inhibited in EtOH-fed mice compared with controls at 6 weeks postinfection, whereas decreased level of interferon-gamma during murine AIDS was not further affected in EtOH-fed mice. The levels of IL-5, IL-6, and IL-10 secreted by Con A-induced splenocytes, elevated during murine AIDS, were significantly further enhanced in EtOH-fed mice compared with controls at 6 weeks postinfection, whereas retrovirus-induced elevated release of IL-6 and tumor necrosis factor-alpha, produced by lipopolysaccharide (LPS)-stimulated splenocytes, were further increased in EtOH-fed mice compared with controls at 6 and 9 weeks postinfection, respectively. Con A- and LPS-induced splenocyte proliferation, inhibited by retrovirus infection, was significantly further suppressed in EtOH-fed mice compared with controls. These results suggest that dietary EtOH consumption before retrovirus infection aggravated progression of immune dysfunction, because it modified production of immunological regulatory cytokines and immune functions.

Ethanol consumption and early murine retrovirus infection influence liver, heart, and muscle levels of iron, zinc, and copper in C57BL/6 mice

The relative and combined roles of ethanol and murine acquired immunodeficiency syndrome (MAIDS) on the mineral status (Fe, Zn, and Cu) of liver (storage site), heart, muscle (nutrient mobile sites) were investigated. C57BL/6 mice were randomly assigned to four groups: (a) uninfected mice fed isocaloric, adequate nutrient diet (NRC), (b) uninfected mice fed the NRC diet with 25% of energy derived from ethanol, (c) LP-BM5 retrovirus-infected mice fed the isocaloric NRC diet, and (d) retrovirus-infected mice fed the NRC diet with 25% of its energy derived from ethanol. The levels of Cu and Zn levels in the liver did not significantly change as a result of ethanol consumption. However hepatic Zn concentration was increased significantly in retrovirus-infected mice. This may be correlated to the increase in their liver weight. Ethanol administration significantly increased Fe concentration in the liver, yet significantly decreased concentration of Cu in the heart. Retrovirus infection alone, which had not proceeded to murine AIDS, resulted in a significant increase in heart Cu and Zn concentration as compared with uninfected mice. Retrovirus infection in C57BL/6 mice significantly increased Fe and Zn level/g of muscle. Early retrovirus infection alters tissue micronutrient levels, and may thus contribute to immunological changes.

Ethanol, immune responses, and murine AIDS: the role of vitamin E as an immunostimulant and antioxidant

Excessive alcohol consumption is a major health problem in the United States. Prolonged consumption of alcohol results in alterations of immune responses, ultimately manifested by increasing susceptibility to infectious agents. Such changes can be due to the direct effects of alcohol or its metabolites on immune cells, as well as to nutritional deficiency, oxidative stress, and neutrophil dysfunctions. This ETOH-induced immunosuppression could be a potential cofactor in the progression to AIDS. As vitamin E supplementation has been associated with enhancement of immune response and improvement of host defense, it may provide a useful therapeutic approach for treatment of alcoholics to improve host defense. This article is a review of alcohol-related immunosuppression as a possible cofactor in the development of AIDS, and vitamin E-related immunoenhancing roles in animals and humans, showing why vitamin E supplementation could be used as a useful adjunct agent in alcoholics' treatment. Since there is little information available regarding nutritional therapy with alcohol users, our purpose is to provide evidence from animal models of the potential therapeutic role of vitamin E supplementation in the treatment of alcoholics.