1
|
Pavone P, Giustini N, Fimiani C, Paoletti F, Falciano M, Salotti A, Di Sora F, Al Moghazi S, Mezzaroma I, Vullo V, d'Ettorre G. Long-Term Treatment With Raltegravir is Associated with Lower Triglycerides and Platelets Count in the Older HIV+ Population: Results from the Ral-Age Study. Curr HIV Res 2018; 15:355-360. [PMID: 28969567 DOI: 10.2174/1570162x15666170927124558] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/03/2017] [Accepted: 09/21/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Raltegravir (RAL) is considered one of the better-tolerated antiretroviral medications, due to limited side effects and minimal drug-drug interactions. Matherials and Methods: We retrospectively evaluated 96 HIV+, over 60 years old, experienced patients who had switched from any antiretroviral drug to raltegravir-based nuc-sparing or standard nucleoside-backbone regimens. A control group with patients aged under 60 years old was included. RESULTS The median age of the patients was 66 years (IQR 10.5) (77 M, 19 F); the median time horizon of follow-up was 4 years (IQR 5). HIV-RNA at baseline was undetectable for more than 6 months in most of the patients. Median CD4+ count was 453 cells/mmc (IQR 379). 49 patients had AIDS history. All the patients were assuming concomitant medications. No adverse effect attributed to the use of raltegravir was reported in the medical records. Only 2 patients presented virological failure, whereas viremic blips were observed in 10 patients. After switching to RAL-containing regimens triglycerides values showed a statistically significant reduction from a median value of 172 (IQR 105.5) mg/dl to 129 mg/dl (IQR 73) (p=0,0001). Switching to a standard regimens was associated with a marked reduction of triglycerides. Cholesterol levels were reduced at the time of follow-up (T2) but no significant modifications were observed when patients which had introduced drugs to treat dislypidemia were removed from the analysis; in contrast, triglycerides reduction was also confirmed in this sub-group. Patients presented higher levels of CD4+ at T2 and reduced platelet count [from 230 300/mmc (SD 123 527) to 197 125/mmc (SD 66 377), p=0,04]. Similar trends were observed in younger patients. CONCLUSION RAL-containing regimens are safe and highly effective in the older population. RALtreatment is associated with the reduction of triglycerides and platelets count in the older population.
Collapse
Affiliation(s)
| | | | - Caterina Fimiani
- Azienda Ospedaliera Universitaria Policlinico Umberto I, Rome, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Pepe J, Mezzaroma I, Fantauzzi A, Falciano M, Salotti A, Di Traglia M, Diacinti D, Biondi P, Cipriani C, Cilli M, Minisola S. An oral high dose of cholecalciferol restores vitamin D status in deficient postmenopausal HIV-1-infected women independently of protease inhibitors therapy: a pilot study. Endocrine 2016; 53:299-304. [PMID: 26254790 DOI: 10.1007/s12020-015-0693-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 07/15/2015] [Indexed: 02/07/2023]
Abstract
The best repletion and maintenance dosing regimens with cholecalciferol in vitamin D-deficient HIV-1 patients remain unknown. Protease inhibitors (PIs) have been shown to inhibit vitamin D 1α- and 25α-hydroxylation in hepatocyte and monocyte cultures. We therefore evaluated the effect of a single high dose of cholecalciferol in vitamin D-deficient HIV-1 postmenopausal women undergoing treatment with highly active anti-retroviral therapy (cART), with and without PIs. Forty HIV-1 postmenopausal women treated with cART, with hypovitaminosis D (<20 ng/ml), were enrolled. We measured serum changes of 25-hydroxyvitamin D [25(OH)D]; 1,25-dihydroxyvitamin D [1,25(OH)2D], parathyroid hormone (PTH), serum calcium, and urinary calcium excretion following a loading dose of 600,000 IU of cholecalciferol after 3, 30, 60, 90, and 120 days. Patients were divided into two groups, whether or not they were taking PI. A significant increase in mean 25(OH)D and 1,25(OH)2D levels at day 3 and throughout the entire observation period was found in both groups (p < 0.001). PTH levels concomitantly decreased in both groups (p < 0.001). Mean albumin-adjusted serum calcium increases with respect to baseline were significant only at day 3 and day 30 for both groups (p < 0.01). Considering remaining parameters, there were no significant differences between the groups at any time, by two-way RM ANOVA. An oral dose of 600,000 IU of cholecalciferol in HIV-1 postmenopausal women rapidly increases 25(OH)D and 1,25(OH)2D levels reducing PTH levels, regardless of the presence of PIs in the cART scheme.
Collapse
Affiliation(s)
- Jessica Pepe
- Department of Internal Medicine and Medical Disciplines, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Ivano Mezzaroma
- Department of Clinical Medicine, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandra Fantauzzi
- Department of Clinical Medicine, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Mario Falciano
- Department of Public Health and Infectious Diseases, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandra Salotti
- Department of Public Health and Infectious Diseases, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Mario Di Traglia
- Department of Public Health and Infectious Diseases, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Daniele Diacinti
- Department of Radiology, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Piergianni Biondi
- Department of Internal Medicine and Medical Disciplines, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Cristiana Cipriani
- Department of Internal Medicine and Medical Disciplines, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Mirella Cilli
- Department of Internal Medicine and Medical Disciplines, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| |
Collapse
|
3
|
Abstract
PURPOSE To report on clinical features and outcome of severe bacterial keratouveitis. METHODS Twenty patients with severe bacterial keratouveitis treated with topical tobramycin and levofloxacin and oral levofloxacin were included. Main outcome measures were ulcers location, bacterial isolates, risk factors, visual prognosis. RESULTS Centrally located ulcer/abscess was present in 65% of patients. Contact lens (CL) wear was the most common risk factor (70%). Bacterial isolates were observed in 58% of patients, none resistant to tobramycin and levofloxacin. Pseudomonas aeruginosa was found in 47% of positive cases and in 64% of CL wearers. After therapy, the mean visual acuity improved significantly (p < 0.0001), particularly in contact lens wearers (p = 0.04) and in patients younger than 60 years old (p < 0.001). CONCLUSIONS Pseudomonas aeruginosa is the most frequent cause of bacterial keratouveitis and CL wear the most common risk factor. Topical tobramycin and levofloxacin and oral levofloxacin are effective in the treatment of bacterial keratouveitis.
Collapse
Affiliation(s)
- Massimo Accorinti
- a Ocular Immunovirology Service, Department of Ophthalmology, Sapienza University of Rome , Rome , Italy and
| | - Lorena Colao
- a Ocular Immunovirology Service, Department of Ophthalmology, Sapienza University of Rome , Rome , Italy and
| | - Marta Gilardi
- a Ocular Immunovirology Service, Department of Ophthalmology, Sapienza University of Rome , Rome , Italy and
| | - Michela Cecere
- a Ocular Immunovirology Service, Department of Ophthalmology, Sapienza University of Rome , Rome , Italy and
| | - Alessandra Salotti
- b Department of Infectious Disease , Sapienza University of Rome , Rome , Italy
| | - Francesca Romana Pesci
- a Ocular Immunovirology Service, Department of Ophthalmology, Sapienza University of Rome , Rome , Italy and.,b Department of Infectious Disease , Sapienza University of Rome , Rome , Italy
| |
Collapse
|
4
|
Pepe J, Isidori AM, Falciano M, Iaiani G, Salotti A, Diacinti D, Del Fiacco R, Sbardella E, Cipriani C, Piemonte S, Raimo O, Biondi P, Biamonte F, Lenzi A, Minisola S. Effect of risedronate in osteoporotic HIV males, according to gonadal status: a pilot study. Endocrine 2014; 47:456-62. [PMID: 25104272 DOI: 10.1007/s12020-014-0349-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 06/25/2014] [Indexed: 01/22/2023]
Abstract
The aim of the study was to evaluate the effect of risedronate on bone mineral density (BMD) and bone turnover markers in HIV-infected osteoporotic males, according to their gonadal status. HIV patients were followed up for 24 months and divided into two groups: patients with osteoporosis or osteopenia with fractures (group A, n = 20) and those without (group B, n = 21). Group A and B were further divided according to the presence of reduced androgenizations. Both groups were treated with cholecalciferol 800 I.U. and calcium (Ca) 1,000 mg orally every day for the first 12 months. Risedronate 75 mg for two consecutive days a month orally was then added in group A, for another 12 months. Group B continued treatment with Ca and vitamin D. Every 6 months each patient underwent biochemical evaluation, and BMD measurement. A significant increase in lumbar BMD was observed in HIV males with adequate androgenization after 12 months of risedronate treatment in group A together with a reduction of bone turnover markers. BMD remained stable with a concomitant significant slight reduction of bone turnover markers in group B. Risedronate increased BMD and reduced bone turnover markers to a greater extent in patients with adequate androgenization compared to osteoporotic HIV males with symptomatic hypoandrogenization.
Collapse
Affiliation(s)
- J Pepe
- Department of Internal Medicine and Medical Disciplines, "Sapienza" University, Viale Del Policlinico 155, 00161, Rome, Italy,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Sauzullo I, Mastroianni CM, Mengoni F, Ermocida A, Mascia C, Salotti A, Falciano M, Vullo V. Long-term IFN-γ and IL-2 response for detection of latent tuberculosis infection in healthcare workers with discordant immunologic results. J Immunol Methods 2014; 414:51-7. [PMID: 25111618 DOI: 10.1016/j.jim.2014.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/31/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
Abstract
Discordant results between the interferon-gamma release assays (IGRAs) and tuberculin skin test (TST) are common in latent tuberculosis infection (LTBI). We evaluated whether the measurement of IFN-γ and interleukin (IL)-2T-cell responses, after prolonged Mycobacterium tuberculosis-specific antigen stimulation, can be used as adjunctive biomarker for LTBI detection in subjects with discordant results between TST and QuantiFERON-Gold In-Tube (QFT). 196 healthcare workers were screened for LTBI and in 90 of those participants, the QFT was repeated after 18 h, and IFN-γ/IL-2 immune response was measured after 72 h long-term stimulation. Of the 196 patients, 34 had positive, 155 negative, and 7 indeterminate QFT results. Discordant TST+/QFT- results were found in 29 (14.7%) patients, of whom 6 (20.6%) were Bacillus Calmette-Guerin (BCG) vaccinated. None of 23 non-BCG vaccinated subjects showed a specific IFN-γ immune response after 18 h nor 72 h of incubation, whereas 3/23 (13.04%) discordant subjects produced a specific long-term IL-2 response, which might reflect a LTBI status. In LTBI group (TST+/QFT+) both cytokine levels were increased after long-term in comparison to short-term stimulation. No significant long-term IFN-γ/IL-2 secretion was detected in control group (TST-/QFT-). Taken together, our data showed that the 87% of discordant patients who did not respond to the long-term assay, as controls subjects, were judged LTBI negative. The use of classic QFT and long-term IL-2 response may have a potential role to clarify the LTBI status in individuals in whom the diagnosis of LTBI is uncertain due to the discordance of the available diagnostic tests, such as TST and IGRA.
Collapse
Affiliation(s)
- Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy.
| | - Claudio M Mastroianni
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy; Infectious Diseases Unit, Fondazione Eleonora Lorillard Spencer Cenci, Sapienza University, Latina, Italy
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Angela Ermocida
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Claudia Mascia
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Alessandra Salotti
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Mario Falciano
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| |
Collapse
|
6
|
Sauzullo I, Mengoni F, Ermocida A, Massetti AP, D'Agostino C, Russo G, Salotti A, Falciano M, Vullo V, Mastroianni CM. Interferon-γ release assay in HIV-infected patients with active tuberculosis: impact of antituberculous drugs on host immune response. New Microbiol 2014; 37:153-161. [PMID: 24858642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 03/04/2014] [Indexed: 06/03/2023]
Abstract
The objective of the study was to: 1) investigate the performance of QuantiFERON-TB Gold In-Tube (QFT-GIT) in HIV-infected patients with active tuberculosis (TB); 2) evaluate the sequential changes in QFT-GIT assay during the treatment response; 3) investigate the direct in vitro effects of antituberculous drugs on both secretion of IFN-g and apoptosis of T cells. Forty-four HIV-patients with active TB were enrolled and tested with QFT-GIT. Thirteen of them were followed longitudinally by QFT-GIT, performed at baseline and six and nine months after TB-treatment onset. For in vitro experiments, cells from healthy donors and HIV-naive subjects were pretreated with four antituberculous-drugs, and then examined for IFN-g secretion and apoptosis of T-cells. The QFT-GIT was positive in 66%, negative in 11.3% and indeterminate in 22.7%. Longitudinal analysis in 13 HIV-TB subjects showed that at therapy completion a reversion to negative response was found only in 38.4% of patients, but in 30.7% the QFT-GIT remained positive. Overall, during the anti-TB treatment no significant decrease in average IFN-g response was observed in these patients (p<0.001). In vitro experiments showed that the four antituberculous- drugs, within the range of therapeutically achievable concentrations, did not exert any down-regulatory effect on IFN-g production and did not have any effect on apoptosis of T cells from HIV naïve subjects. Despite the high rate of indeterminate results, QFT-GIT assay may represent a good tool in the diagnostic workup for active TB in HIV-patients. Although the antituberculous drugs do not have any direct effect on host immune response to mycobacterial antigen, changes in longitudinal IGRA response have been found during in vivo anti-TB treatment.
Collapse
Affiliation(s)
- Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, "Sapienza" University, Rome, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Pepe J, Isidori AM, Falciano M, Iaiani G, Salotti A, Diacinti D, Del Fiacco R, Sbardella E, Cipriani C, Piemonte S, Romagnoli E, Lenzi A, Minisola S. The combination of FRAX and Ageing Male Symptoms scale better identifies treated HIV males at risk for major fracture. Clin Endocrinol (Oxf) 2012; 77:672-8. [PMID: 22630782 DOI: 10.1111/j.1365-2265.2012.04452.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Osteoporosis and hypogonadism are common in men with HIV infection. Ageing Male Symptoms (AMS) scale measures symptoms related to hypogonadism. FRAX provides 10-year probability of major fractures. We investigated the role of AMS scale combined with FRAX without bone mineral density (BMD), in identifying HIV men with bone fragility. DESIGN Cross-sectional observational study. METHODS Fifty HIV-positive men treated with highly active antiretroviral therapy and 27 controls underwent hormonal evaluation, BMD scan and spine X-ray. The AMS questionnaire was administered. RESULTS Osteoporosis was found in 24·0% of HIV patients and in 3·7% of controls (P = 0·05). In HIV patients, 9 radiological vertebral fractures were found (none in controls, P = 0·04). Calculated free testosterone suggested hypogonadism in 26% of HIV patients vs 4% of controls (P = 0·04); an abnormal AMS score (≥27) was found in 62% HIV patients compared with 41% controls (P = 0·04). ROC curves showed that FRAX for major fracture had a 23% sensitivity and a 100% specificity in identifying HIV patients with bone fragility (P = 0·002, with the threshold of 7% at which bisphosphonate therapy is cost-effective). Considering a value of AMS ≥27, we obtained an 82·6% sensitivity and a 42·9% specificity (P = 0·04). The combination of AMS and FRAX score achieved a 77·3% sensitivity and a 69% specificity (P = 0·02, cut-off 34). CONCLUSION Combination of FRAX (without BMD) and AMS improved sensitivity of FRAX alone in identifying HIV patients at fracture risk, at the expense of reduced specificity.
Collapse
Affiliation(s)
- Jessica Pepe
- Department of Internal Medicine and Medical Disciplines, Sapienza University, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Visco-Comandini U, Yun Z, Paganelli R, Orlandi P, Salotti A, Johansson B, Vahlne A, Sönnerborg A. HIV-1 nef mutations and clinical long-term nonprogression. A molecular epidemiology study. J Hum Virol 1998; 1:320-7. [PMID: 10195259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVES To analyze HIV-1 nef gene mutations in a cohort of Italian and Swedish long-term nonprogressors (LTNP) and to investigate whether particular amino acid substitutions are associated with LTNP. STUDY DESIGN/METHODS nef alleles from 21 LTNP and 8 progressor controls were amplified by polymerase chain reaction (PCR) and sequenced. The amino acid sequences were compared with the previously reported sequences of 16 North American LTNP and of 28 patients with progressive infection. RESULTS An untruncated intact open reading frame was observed as major sequence in all LTNP and controls. None of the amino acid substitutions in known biologically functional sites was linked to LTNP. A valine/isoleucine at the variable position 11 was associated with both European (P = .0001) and American (P = .001) LTNP. The interpatient nef variation was lower among European LTNP (P = .002) than in European progressor controls. CONCLUSIONS Nef amino acid heterogeneity is lower among LTNP, probably reflecting the lower HIV-1 replication rate. Nef gene defects appear uncommon in both Swedish and Italian LTNP, although the presence of a valine/isoleucine at position 11 is statistically associated with a lower probability to progress to disease.
Collapse
Affiliation(s)
- U Visco-Comandini
- Department of Immunology, Microbiology, Pathology and Infectious Diseases, Karolinska Institute, Huddinge Hospital, Sweden.
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Caporossi AP, Bruno G, Salemi S, Mastroianni C, Falciano M, Salotti A, Bergami N, Santilio I, Nisini R, Barnaba V. Autoimmune T-cell response to the CD4 molecule in HIV-infected patients. Viral Immunol 1998; 11:9-17. [PMID: 9586693 DOI: 10.1089/vim.1998.11.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In a previous study, we demonstrated that by downregulating plasma membrane CD4 and increasing its processing, human immunodeficiency (HIV)-1-gp120 unveils hidden CD4 epitopes, inducing an in vitro anti-CD4-specific T-cell response. We report herein that this mechanism may potentially have important implications in HIV immunopathogenesis, because it could take part in the severe depletion of CD4+ cells that characterizes acquired immune deficiency syndrome (AIDS) and be related to disease progression. Freshly isolated peripheral blood lymphocytes (PBMC) from about 1/4 of a conspicuous cohort of HIV-infected patients responded to CD4 and this response was correlated with beta2-microglobulin levels, widely recognized as marker for progression of HIV infection. Moreover, we provide evidence that a CD4-specific T cell priming can occur in vivo, following a gp120 or anti-CD4 monoclonal antibody (mAb)-mediated CD4 molecule downregulation on antigen-presenting cells (APC). To our knowledge, this is the first study indicating that an autoimmune T-cell response is linked to HIV infection and that it could have an important impact on the immunopathogenesis of this disease.
Collapse
Affiliation(s)
- A P Caporossi
- Istituto I Clinica Medica, Università di Roma La Sapienza, Rome, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Ciardi M, Sharief MK, Thompson EJ, Salotti A, Vullo V, Sorice F, Cirelli A. High cerebrospinal fluid and serum levels of tumor necrosis factor-alpha in asymptomatic HIV-1 seropositive individuals. Correlation with interleukin-2 and soluble IL-2 receptor. J Neurol Sci 1994; 125:175-9. [PMID: 7807163 DOI: 10.1016/0022-510x(94)90031-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The relationship between tumour necrosis factor-alpha (TNF-alpha) and the interleukin-2 (ILL-2) system in HIV-1 infection is important in understanding the dynamics of early immune response before the development of acquired immunodeficiency syndrome. Levels of TNF-alpha, IL-2 and soluble IL-2 receptor (sIL-2R) in serum and cerebrospinal fluid (CSF) samples from 31 asymptomatic HIV-1 seropositive individuals were measured. High levels of TNF-alpha were detected in CSF of 17 (55%) and serum of 22 (71%) subjects, 15 (88%) of whom had elevated CSF IL-2 levels and 16 (94%) had high sIL-2R levels. Moreover, CSF levels of TNF-alpha significantly correlated with CSF levels of IL-2 and sIL-2R. TNF-alpha, IL-2 and sIL-2R seem to be released within the intrathecal compartment early in the course of HIV-1 infection. In view of the known cytotoxic effects of TNF-alpha, an early release may contribute to subsequent development of neurological complications.
Collapse
Affiliation(s)
- M Ciardi
- Institute of Infectious Diseases, University of Rome, La Sapienza, Italy
| | | | | | | | | | | | | |
Collapse
|
11
|
Cirelli A, Ciardi M, Salotti A, Rossi F. An unusual neurological feature of HIV-1 encephalopathy: Gerstmann's syndrome. Acta Neurol (Napoli) 1994; 16:110-113. [PMID: 7992659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The authors describe the first case in literature of Gerstmann's syndrome (agraphia, acalculia, finger agnosia) occurred in HIV correlated encephalopathy developed as the first severe manifestation of HIV infection in a patient with prevalent white matter neuroradiologic alterations. The PDL rapidly extended from the left subcortical parietal-occipital regions to the pre-rolandic one, with subsequent involvement of the corpus calosum splenium and the bilateral temporal lobes white matter. The authors indicate the extent of the lesions and the involvement of the interhemispheric connection fibres as the pathogenetic mechanism of the "Gerstmann syndrome", that until today has not been reported in the literature of the wide variety of AIDS dementia complex. The administration of 1 g of zidovudine for about 9 months did not avoid the establishing of the neurologic damage, but the sudden suspension of the drug could have enhanced the exacerbation of inflammation and the involvement of areas whose lesion is classically believed responsible for cognitive impairment.
Collapse
Affiliation(s)
- A Cirelli
- Department of Infectious Diseases, University of Pisa, Italy
| | | | | | | |
Collapse
|
12
|
Ciardi M, Sharief MK, Noori MA, Thompson EJ, Salotti A, Rossi F, Vullo V, Catania S, Sorice F, Cirelli A. Intrathecal synthesis of interleukin-2 and soluble IL-2 receptor in asymptomatic HIV-1 seropositive individuals. Correlation with local production of specific IgM and IgG antibodies. J Neurol Sci 1993; 115:117-22. [PMID: 8468587 DOI: 10.1016/0022-510x(93)90076-b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The relationship between the interleukin-2 (IL-2) system and the humoral response against human immunodeficiency virus type-I (HIV-1) is important in understanding the immune reaction before the development of AIDS. Levels of IL-2 and soluble IL-2 receptor (sIL-2R) in serum and cerebrospinal fluid (CSF) samples from 31 asymptomatic HIV-1 seropositive individuals were measured and correlated with levels of anti-1 IgG and IgM antibodies. High IL-2 levels were detected in the CSF of 20 (65%) subjects, 18 (90%) of whom had evidence of intrathecal synthesis of HIV-1-specific IgM antibodies. Similarly, IgG antibodies were detected in 10 subjects who had elevated IL-2 levels in the CSF. Moreover, intrathecal levels of IL-2 and sIL-2R correlated with intrathecal synthesis of both IgG and IgM antibodies. Local release of IL-2 seems to play an important role in the initiation of the antibody response against HIV-1 in early stages of infection and may be utilised in devising effective therapeutic strategies.
Collapse
Affiliation(s)
- M Ciardi
- Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, U.K
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Ferrazzi M, De Rinaldis ML, Salotti A, Cirelli A. Serum IgE levels in human immunodeficiency virus (HIV)-1 infected patients: correlation between IgE and CD4+ cells. Riv Eur Sci Med Farmacol 1993; 15:67-70. [PMID: 7909618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Human immunodeficiency virus (HIV) infection is associated, like allergic diseases, with altered T cell regulation. Total serum IgE levels were measured in 65 infected patients. The mean IgE level of subjects with a T lymphocytes number < or = 200/mmc was greater than mean IgE level of subjects with a T cell number > 200/mmc. No prevalence of atopic diseases was noted in the two groups. The elevation of IgE may be related to a difference in IgE regulatory lymphokines produced by T lymphocytes.
Collapse
Affiliation(s)
- M Ferrazzi
- Institute of Infectious Diseases, University La Sapienza, Rome, Italy
| | | | | | | |
Collapse
|