Serum cortisol and DHEA concentrations during HIV infection

被引:75
作者
Christeff, N
Gherbi, N
Mammes, O
Dalle, MT
Gharakhanian, S
Lortholary, O
Melchior, JC
Nunez, EA
机构
[1] HOP BICHAT, FAC MED, LAB BIOCHIM ENDOCRINIENNE BIOCHIM B, F-75877 PARIS, FRANCE
[2] HOP ROTHSCHILD, SERV MALAD INFECT PR W ROZENBAUM, F-75571 PARIS, FRANCE
[3] HOP AVICENNE, SERV MED INTERNE PR GUILLEVIN, F-93009 BOBIGNY, FRANCE
[4] HOP BICHAT, SERV NUTR, F-75877 PARIS, FRANCE
关键词
cortisol; DHEA; cortisol-DHEA ratio; HIV-infected men; CD4; lymphocytes; cachexia;
D O I
10.1016/S0306-4530(97)00015-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The progression of HIV infection is accompanied by severe immunodepression and cachexia, particularly during advanced stages. The immune depression is due largely to a dramatic drop in the number of CD4 cells. The loss of body weight is mainly due to a reduced fat-free mass with no change in adipose tissue. We determined the serum concentrations of cortisol and DHEA and their correlations with absolute CD4 cell counts and changes in body weight of HIV-positive men. The results of five retrospective and prospective studies indicate that the serum concentrations of cortisol and DHEA in HIV-infected patients were different from those of HIV-negative controls. Serum cortisol was elevated at all stages of infection (+20 to +50%, p<.05 to p<.001) particularly in AIDS patients (stage IV C). In contrast, the serum DHEA concentrations were closely correlated with the stage of HIV-infection, being higher in the early stages (stages II and III or >500 CD4) than in advanced stages (IV C or <500 CD4)-in the latter being below those of HIV-negative men-or in controls (+40 to 100%, p<.01 to p<.001). There was a negative linear correlation between the CD4 cell counts and cortisol (r=-0.4, p<.02) and a positive linear correlation with DHEA (r=+0.36, p<.01). There was no significant correlation between Delta body weight and serum cortisol. In contrast, there was a negative correlation between serum DHEA and Delta body weight (%) (r=-0.69, p<.0001) and a positive correlation with the cortisol/DHEA ratio (r=+0.61, p<.0001). There is thus a link between the circulating concentrations of adrenal steroids and the progression of immunosuppression and cachexia during HIV-infection. This mises the question of whether there is a cause-and-effect relationship between clinical progression and circulating steroid concentrations. Further investigations into the relationship between the ratio cortisol/DHEA and the immune response and cachexia should indicate the contributions of these steroids to the etiology of HIV infection and lead to the development of new therapeutic strategies. (C) 1997 Elsevier Science Ltd.
引用
收藏
页码:S11 / S18
页数:8
相关论文
共 30 条
[1]   CYTOKINES AS MODULATORS OF THE HYPOTHALAMUS PITUITARY-ADRENAL AXIS [J].
BESEDOVSKY, HO ;
DELREY, A ;
KLUSMAN, I ;
FURUKAWA, H ;
ARDITI, GM ;
KABIERSCH, A .
JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, 1991, 40 (4-6) :613-618
[2]   DEHYDROEPIANDROSTERONE ANTAGONIZES THE SUPPRESSIVE EFFECTS OF DEXAMETHASONE ON LYMPHOCYTE-PROLIFERATION [J].
BLAUER, KL ;
POTH, M ;
ROGERS, WM ;
BERNTON, EW .
ENDOCRINOLOGY, 1991, 129 (06) :3174-3179
[3]   DIFFERENCES IN ANDROGENS OF HIV-POSITIVE PATIENTS WITH AND WITHOUT KAPOSI-SARCOMA [J].
CHRISTEFF, N ;
WINTER, C ;
GHARAKHANIAN, S ;
THOBIE, N ;
WIRBEL, E ;
COSTAGLIOLA, D ;
NUNEZ, EA ;
ROZENBAUM, W .
JOURNAL OF CLINICAL PATHOLOGY, 1995, 48 (06) :513-518
[4]   ABNORMAL FREE FATTY-ACIDS AND CORTISOL CONCENTRATIONS IN THE SERUM OF AIDS PATIENTS [J].
CHRISTEFF, N ;
MICHON, C ;
GOERTZ, G ;
HASSID, J ;
MATHERON, S ;
GIRARD, PM ;
COULAUD, JP ;
NUNEZ, EA .
EUROPEAN JOURNAL OF CANCER & CLINICAL ONCOLOGY, 1988, 24 (07) :1179-1183
[5]  
CHRISTEFF N, 1992, J ACQ IMMUN DEF SYND, V5, P841
[6]   Relationship between sex steroid hormone levels and CD4 lymphocytes in HIV infected men [J].
Christeff, N ;
Lortholary, O ;
Casassus, P ;
Thobie, N ;
Veyssier, P ;
Torri, O ;
Guillevin, L ;
Nunez, EA .
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 1996, 104 (02) :130-136
[7]   ENDOTOXIN-INDUCED CHANGES IN SEX STEROID-HORMONE LEVELS IN MALE-RATS [J].
CHRISTEFF, N ;
AUCLAIR, MC ;
BENASSAYAG, C ;
CARLI, A ;
NUNEZ, EA .
JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, 1987, 26 (01) :67-71
[8]  
CHRISTEFF N, 1992, CIRC SHOCK, V36, P249
[9]   ELEVATED ESTROGEN AND REDUCED TESTOSTERONE LEVELS IN THE SERUM OF MALE SEPTIC SHOCK PATIENTS [J].
CHRISTEFF, N ;
BENASSAYAG, C ;
CARLIVIELLE, C ;
CARLI, A ;
NUNEZ, EA .
JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, 1988, 29 (04) :435-440
[10]   REGULATION OF MURINE LYMPHOKINE PRODUCTION INVIVO .2. DEHYDROEPIANDROSTERONE IS A NATURAL ENHANCER OF INTERLEUKIN-2 SYNTHESIS BY HELPER T-CELLS [J].
DAYNES, RA ;
DUDLEY, DJ ;
ARANEO, BA .
EUROPEAN JOURNAL OF IMMUNOLOGY, 1990, 20 (04) :793-802