RESUMO
BACKGROUND: Endothelial-to-mesenchymal transition (EndMT) has been identified as a critical driver of vascular inflammation and atherosclerosis, and TGF-ß (transforming growth factor ß) is a key mediator of EndMT. Both EndMT and atherosclerosis are promoted by disturbed flow, whereas unidirectional laminar flow limits EndMT and is atheroprotective. How EndMT and endothelial TGF-ß signaling are regulated by different flow patterns is, however, still poorly understood. METHODS: Flow chamber experiments in vitro and endothelium-specific knockout mice were used to study the role of tenascin-X in the regulation of EndMT and atherosclerosis as well as the underlying mechanisms. RESULTS: In human endothelial cells as well as in human and mouse aortae, unidirectional laminar flow but not disturbed flow strongly increased endothelial expression of the extracellular matrix protein TN-X (tenascin-X) in a KLF4 (Krüppel-like factor 4) dependent manner. Mice with endothelium-specific loss of TN-X (EC-Tnxb-KO) showed increased endothelial TGF-ß signaling as well as increased endothelial expression of EndMT and inflammatory marker genes. When EC-Tnxb-KO mice were subjected to partial carotid artery ligation, we observed increased vascular remodeling. EC-Tnxb-KO mice crossed to low-density lipoprotein receptor-deficient mice showed advanced atherosclerotic lesions after being fed a high-fat diet. Treatment of EC-Tnxb-KO mice with an anti-TGF-beta antibody or additional endothelial loss of TGF-beta receptors 1 and 2 normalized endothelial TGF-beta signaling and prevented EndMT. In in vitro studies, we found that TN-X through its fibrinogen-like domain directly interacts with TGF-ß and thereby interferes with its binding to the TGF-ß receptor. CONCLUSIONS: In summary, we show that TN-X is a central mediator of flow-induced inhibition of EndMT, endothelial inflammation and atherogenesis, which functions by binding to and by blocking the activity of TGF-ß. Our data identify a novel mechanism of flow-dependent regulation of vascular TGF-ß, which holds promise for generating new strategies to prevent vascular inflammation and atherosclerosis.
Assuntos
Aterosclerose , Células Endoteliais , Animais , Aterosclerose/genética , Aterosclerose/metabolismo , Aterosclerose/prevenção & controle , Células Cultivadas , Células Endoteliais/metabolismo , Endotélio/metabolismo , Transição Epitelial-Mesenquimal/fisiologia , Inflamação/metabolismo , Camundongos , Transdução de Sinais , Tenascina , Fator de Crescimento Transformador beta/metabolismoRESUMO
Acquired Immune Deficiency Syndrome (AIDS) is a highly dangerous infectious disease caused by the Human Immunodeficiency Virus (HIV), a virus that attacks the human immune system. To explore the correlation between intestinal fungal community and immune function (Immune cells and inflammatory factors) in people living with HIV/AIDS (PLWHA). The feces and blood samples were collected from two groups of subjects: PLWHA and healthy controls. High-throughput sequencing of the internal transcribed spacer 1, flow cytometry, and ELISA were performed to analyze the differences and correlations between fungal microbiota, cellular immune status and serum inflammatory factors in the two groups. There were significant differences in the composition of fungal microbiota between the two groups. The relative abundance of Candida, Bjerkandera, and Xeromyces in PLWHA was significantly higher than that of healthy volunteers (P < 0.01), while the relative abundance of Mycospaerella, Xeroxysium, Penicillium, and Glomerella in PLWHA was significantly lower than that of healthy volunteers. The correlation analysis results show that Mycospaerella and Xeromyces are significantly positively correlated with CD4+/CD8+ T cells and the anti-inflammatory cytokine IL-4. On the other hand, Candida was positively correlated with pro-inflammatory factors negatively correlated with CD4+/CD8+ T cells and the anti-inflammatory cytokine IL-4, while it is positively correlated with pro-inflammatory cytokines. The significant increase in the relative abundance of Candida may be one of the important causes of intestinal damage in PLWHA. The results of this study contribute to the understanding of the relationship between fungal microbiota structure and immune function in the gut ecology of PLWHA.
Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Micobioma , Humanos , Linfócitos T CD8-Positivos , Interleucina-4 , Citocinas , Anti-InflamatóriosRESUMO
OBJECTIVE: To estimate the prevalence and risk factors associated with tuberculosis (TB) among people living with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) in China. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. After the literature was screened based on the inclusion and exclusion criteria, STATA® version 17.0 software was used for the meta-analysis. The heterogeneity among study data was assessed using I2 statistics. Subgroup analysis and meta-regressions were performed to further explore the source of heterogeneity. RESULTS: A total of 5241 studies were retrieved. Of these, 44 studies were found to be eligible. The pooled prevalence of HIV/TB co-infection was 6.0%. The risk factors for HIV/TB co-infection included a low CD4+ T cell count, smoking, intravenous drug use and several other sociodemographic and clinical factors. Bacillus Calmette-Guérin (BCG) vaccination history was a protective factor. CONCLUSION: A high prevalence of TB was observed among people living with HIV/AIDS in China. Low CD4+ T cell count, smoking, and intravenous drug use were the primary risk factors for HIV/TB co-infection, whereas BCG vaccination history was a protective factor. Checking for TB should be prioritized in HIV screening and healthcare access. SYSTEMATIC REVIEW REGISTRATION: Registered on PROSPERO, Identifier: CRD42022297754.
Assuntos
Síndrome da Imunodeficiência Adquirida , Coinfecção , Tuberculose , Humanos , Vacina BCG , Coinfecção/epidemiologia , Prevalência , Fatores de Risco , Tuberculose/epidemiologia , China/epidemiologiaRESUMO
Accumulated evidence shows that elevated urotensin II (UII) levels are associated with cardiovascular diseases. However, the role of UII in the initiation, progression, and regression of atherosclerosis remains to be verified. Different stages of atherosclerosis were induced in rabbits by a 0.3% high cholesterol diet (HCD) feeding, and either UII (5.4 µg/kg/h) or saline was chronically infused via osmotic mini-pumps. UII promoted atherosclerotic fatty streak formation in ovariectomized female rabbits (34% increase in gross lesion and 93% increase in microscopic lesion), and in male rabbits (39% increase in gross lesion). UII infusion significantly increased the plaque size of the carotid and subclavian arteries (69% increase over the control). In addition, UII infusion significantly enhanced the development of coronary lesions by increasing plaque size and lumen stenosis. Histopathological analysis revealed that aortic lesions in the UII group were characterized by increasing lesional macrophages, lipid deposition, and intra-plaque neovessel formation. UII infusion also significantly delayed the regression of atherosclerosis in rabbits by increasing the intra-plaque macrophage ratio. Furthermore, UII treatment led to a significant increase in NOX2 and HIF-1α/VEGF-A expression accompanied by increased reactive oxygen species levels in cultured macrophages. Tubule formation assays showed that UII exerted a pro-angiogenic effect in cultured endothelial cell lines and this effect was partly inhibited by urantide, a UII receptor antagonist. These findings suggest that UII can accelerate aortic and coronary plaque formation and enhance aortic plaque vulnerability, but delay the regression of atherosclerosis. The role of UII on angiogenesis in the lesion may be involved in complex plaque development.
Assuntos
Aterosclerose , Hipercolesterolemia , Placa Aterosclerótica , Urotensinas , Animais , Coelhos , Masculino , Feminino , Placa Aterosclerótica/metabolismo , Aterosclerose/metabolismo , Urotensinas/metabolismo , Urotensinas/farmacologia , Macrófagos/metabolismo , Aorta/metabolismo , Hipercolesterolemia/metabolismoRESUMO
Increasing levels of plasma urotensin II (UII) are positively associated with atherosclerosis. In this study we investigated the role of macrophage-secreted UII in atherosclerosis progression, and evaluated the therapeutic value of urantide, a potent competitive UII receptor antagonist, in atherosclerosis treatment. Macrophage-specific human UII-transgenic rabbits and their nontransgenic littermates were fed a high cholesterol diet for 16 weeks to induce atherosclerosis. Immunohistochemical staining of the cellular components (macrophages and smooth muscle cells) of aortic atherosclerotic lesions revealed a significant increase (52%) in the macrophage-positive area in only male transgenic rabbits compared with that in the nontransgenic littermates. However, both male and female transgenic rabbits showed a significant decrease (45% in males and 31% in females) in the smooth muscle cell-positive area compared with that of their control littermates. The effects of macrophage-secreted UII on the plaque cellular components were independent of plasma lipid level. Meanwhile the wild-type rabbits were continuously subcutaneously infused with urantide (5.4 µg· kg-1· h-1) using osmotic mini-pumps. Infusion of urantide exerted effects opposite to those caused by UII, as it significantly decreased the macrophage-positive area in male wild-type rabbits compared with that of control rabbits. In cultured human umbilical vein endothelial cells, treatment with UII dose-dependently increased the expression of the adhesion molecules VCAM-1 and ICAM-1, and this effect was partially reversed by urantide. The current study provides direct evidence that macrophage-secreted UII plays a key role in atherogenesis. Targeting UII with urantide may promote plaque stability by decreasing macrophage-derived foam cell formation, which is an indicator of unstable plaque.
Assuntos
Aterosclerose/tratamento farmacológico , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Macrófagos/efeitos dos fármacos , Fragmentos de Peptídeos/farmacologia , Placa Aterosclerótica/tratamento farmacológico , Urotensinas/farmacologia , Animais , Aterosclerose/metabolismo , Aterosclerose/patologia , Células Cultivadas , Dieta Hiperlipídica/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Infusões Subcutâneas , Macrófagos/metabolismo , Masculino , Fragmentos de Peptídeos/administração & dosagem , Fragmentos de Peptídeos/sangue , Placa Aterosclerótica/metabolismo , Placa Aterosclerótica/patologia , Coelhos , Urotensinas/administração & dosagem , Urotensinas/sangueRESUMO
Progastrin-releasing peptide (ProGRP), which is known to be highly specific and sensitive to small cell lung cancer (SCLC), has been proven to be a valuable substitute for neuron-specific enolase in SCLC diagnostics and monitoring, especially in its early stages. The detection of ProGRP levels also facilitates a selection of therapeutic treatments. For the fabrication of our proposed biosensor, titanium (IV) oxide microparticles were first used, followed by dispersing gold nanoparticles into chitosan and immobilizing them onto a carbon paste electrode (CPE) surface. The developed immunosensor exhibits a much higher biosensing performance in comparison with current methods, when it comes to the detection of ProGRP. Therefore, the proposed CPE/TiO2/(CS+AuNPs)/anti-ProGRP/BSA/ProGRP is excellent for the development of a compact diagnostics apparatus.
Assuntos
Biomarcadores Tumorais/sangue , Técnicas Biossensoriais , Fragmentos de Peptídeos/sangue , Carcinoma de Pequenas Células do Pulmão/sangue , Ouro/química , Humanos , Nanocompostos/química , Fosfopiruvato Hidratase/genética , Proteínas Recombinantes/sangue , Carcinoma de Pequenas Células do Pulmão/genética , Carcinoma de Pequenas Células do Pulmão/patologia , Titânio/químicaRESUMO
BACKGROUND/AIMS: The proliferation and migration of vascular smooth muscle cells (VSMCs) are key steps in the progression of atherosclerosis. The aim of the present study was to investigate the potential roles of salusin-α in the functions of VSMCs during the development of atherosclerosis. METHODS: In vivo, the effects of salusin-α on atherogenesis were examined in rabbits fed a cholesterol diet. The aortas were en face stained with Sudan IV to evaluate the gross atherosclerotic lesion size. The cellular components of atherosclerotic plaques were analyzed by immunohistochemical methods. In vitro, Cell Counting Kit-8 and wound-healing assays were used to assess the effects of salusin-α on VSMC proliferation and migration. In addition, western blotting was used to evaluate the total and phosphorylated levels of Akt (also known as protein kinase B) and mammalian target of rapamycin (mTOR) in VSMCs. RESULTS: Salusin-α infusion significantly reduced the aortic lesion areas of atherosclerosis, with a 39% reduction in the aortic arch, a 71% reduction in the thoracic aorta, and a 71% reduction in the abdominal aorta; plasma lipid levels were unaffected. Immunohistochemical staining showed that salusin-α decreased both macrophage- and VSMC-positively stained areas in atherosclerotic lesions by 54% and 69%, cell proliferative activity in the intima and media of arteriosclerotic lesions, and matrix metalloproteinase 2 (MMP-2) and MMP-9 expression in plaques. Studies using cultured VSMCs showed that salusin-α decreased VSMC migration and proliferation via reduced phosphorylation of Akt and mTOR. CONCLUSION: Our data indicate that salusin-α suppresses the development of atherosclerosis by inhibiting VSMC proliferation and migration through the Akt/mTOR pathway.
Assuntos
Proliferação de Células/efeitos dos fármacos , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Transdução de Sinais/efeitos dos fármacos , Animais , Aterosclerose/metabolismo , Aterosclerose/patologia , Becaplermina , Movimento Celular/efeitos dos fármacos , Dieta Hiperlipídica , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Músculo Liso Vascular/citologia , Músculo Liso Vascular/metabolismo , Fosforilação/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-sis/farmacologia , Coelhos , Ratos , Ratos Sprague-Dawley , Serina-Treonina Quinases TOR/metabolismoRESUMO
HIV-1 latency is characterized by reversible silencing of viral transcription driven by the long terminal repeat (LTR) promoter of HIV-1. Cellular and viral factors regulating LTR activity contribute to HIV-1 latency, and certain repressive cellular factors modulate viral transcription silencing. Nef-associated factor 1 (Naf1) is a host nucleocytoplasmic shuttling protein that regulates multiple cellular signaling pathways and HIV-1 production. We recently reported that nuclear Naf1 promoted nuclear export of unspliced HIV-1 gag mRNA, leading to increased Gag production. Here we demonstrate new functions of Naf1 in regulating HIV-1 persistence. We found that Naf1 contributes to the maintenance of HIV-1 latency by inhibiting LTR-driven HIV-1 gene transcription in a nuclear factor kappa B-dependent manner. Interestingly, Naf1 knockdown significantly enhanced viral reactivation in both latently HIV-1-infected Jurkat T cells and primary central memory CD4+ T cells. Furthermore, Naf1 knockdown in resting CD4+ T cells from HIV-1-infected individuals treated with antiretroviral therapy significantly increased viral reactivation upon T-cell activation, suggesting an important role of Naf1 in modulating HIV-1 latency in vivo Our findings provide new insights for a better understanding of HIV-1 latency and suggest that inhibition of Naf1 activity to activate latently HIV-1-infected cells may be a potential therapeutic strategy. IMPORTANCE: HIV-1 latency is characterized mainly by a reversible silencing of LTR promoter-driven transcription of an integrated provirus. Cellular and viral proteins regulating LTR activity contribute to the modulation of HIV-1 latency. In this study, we found that the host protein Naf1 inhibited HIV-1 LTR-driven transcription of HIV genes and contributed to the maintenance of HIV-1 latency. Our findings provide new insights into the effects of host modulation on HIV-1 latency, which may lead to a potential therapeutic strategy for HIV persistence by targeting the Naf1 protein.
Assuntos
Linfócitos T CD4-Positivos/metabolismo , Regulação Viral da Expressão Gênica , Infecções por HIV/genética , HIV-1/genética , Ribonucleoproteínas/genética , Latência Viral/genética , Linfócitos T CD4-Positivos/virologia , Núcleo Celular/metabolismo , Núcleo Celular/virologia , Inativação Gênica , Infecções por HIV/metabolismo , Infecções por HIV/virologia , Repetição Terminal Longa de HIV , HIV-1/crescimento & desenvolvimento , HIV-1/metabolismo , Interações Hospedeiro-Patógeno , Humanos , Células Jurkat , NF-kappa B/genética , NF-kappa B/metabolismo , Cultura Primária de Células , Regiões Promotoras Genéticas , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , RNA Viral/genética , RNA Viral/metabolismo , Ribonucleoproteínas/antagonistas & inibidores , Ribonucleoproteínas/metabolismo , Transdução de Sinais , Transcrição Gênica , Ativação Viral , Produtos do Gene gag do Vírus da Imunodeficiência Humana/genética , Produtos do Gene gag do Vírus da Imunodeficiência Humana/metabolismoRESUMO
Despite many differences between Traditional Chinese Medicine (TCM) and conventional medicine, the use of TCM in the treatment of human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is increasingly recognized and accepted by patients. Recent research findings on the benefits of Chinese herbal medicine on long-term survival in patients with HIV/AIDS are encouraging and hopeful, but inconclusive. More research is needed.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Síndrome da Imunodeficiência Adquirida/mortalidade , Humanos , Taxa de SobrevidaRESUMO
HIV/AIDS is a severe infectious disease with ineffective drug or method found till now. Highly active antiretroviral therapy (HAART) is a treatment method widely internationalized. Its coverage populations are continually expanding due to its definite clinical effect. AIDS prevented and treated by Chinese medicine and pharmacy has ever been reported. Especially early intervention of Chinese medicine syndrome differentiation based treatment can delay the process of HIV-infected subjects' entry into AIDS in AIDS asymptomatic phase. However, it has great significance of clinical and basic researches in the following 4 aspects: (1) attenuating toxic/adverse reactions of HAART; (2) improving clinical effects of HAART; (3) lowering resistance rate of HAART; and (4) treating common opportunistic infections of AIDS in the post-HAART period.
Assuntos
Síndrome da Imunodeficiência Adquirida , Terapia Antirretroviral de Alta Atividade , Infecções por HIV , Medicina Tradicional Chinesa , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Medicamentos de Ervas Chinesas , HIV , Infecções por HIV/prevenção & controle , HumanosRESUMO
Complementary and alternative medicine, including Chinese medicine (CM), has been used to treat acquired immune deficiency syndrome (AIDS) foralmost 30 years. We aimed to compare the main differences between AIDS treatment and evaluation strategies between CM and Western Medicine (WM), and analyze advantages and disadvantages. The characteristics of integrative medicine (IM), based on CM and WM, include a patient-centered mode of medicine based on evidence. IM focuses on complex intervention and management with systemic and individual treatment. The evaluation indexes of IM might consist of objective indicators and subjective indexes. IM might be a more valuable method for treating AIDS in the future instead of WM or CM alone.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/administração & dosagem , Avaliação de Medicamentos/métodos , Medicamentos de Ervas Chinesas/administração & dosagem , Animais , Humanos , Resultado do TratamentoRESUMO
OBJECTIVE: To provide survival estimates of people living with human immunodeficiency virus (PLHIV) after treatment with Traditional Chinese Medicine (TCM) in rural China, to identify the prognostic factors at enrollment, and to explore the effectiveness ofTCM in treating PLHIV. METHODS: PLHIV who enrolled in national TCM HIV treatment trial program in October 2004 were analyzed in this study and followed up to October 2010. Survival time was estimated by the Kaplan-Meier curve and hazard ratios, and identifying prognostic factors were computed through Cox proportional hazard models. RESULTS: A total of 1666 PLHIV were included with 102 591 person-months of follow-up. Overall, 312 (18.7%) patients died. The total mortality rate over the study period was 3.6 per 100 person-years, which was lower than the worldwide rate. The cumulative survival rate was 95.9% at 1 year [95% confidence interval (CI) (94.8-96.8)] and 80.4% at 6 years [95% CI (78.4-82.3)]. Elevated death risks emerged among males, older individuals, and those with lower CD4+ T-cell counts. CONCLUSION: TCM could increase survival and lengthen the life span of PLHIV in Henan province of China, as shown by our retrospective cohort study. Factors such as sex, age, education, and CD4+ T-cell counts correlated to survival. However, retrospective cohorts bias the data, so more prospective studies should be performed to confirm our primary results.
Assuntos
Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Adulto , Contagem de Linfócito CD4 , China , Medicamentos de Ervas Chinesas , Feminino , Infecções por HIV/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Taxa de Sobrevida , Adulto JovemRESUMO
OBJECTIVE: To observe the effect of Qingfei Peiyuan Micro-pill (QPM) on HIV/AIDS patients with pulmonary infection of phlegm heat obstructing lung syndrome (PHOLS). METHODS: Totally 141 HIV/AIDS patients with pulmonary infection of PHOLS were randomly assigned to the treatment group (94 cases) and the control group (47cases). On the basis of Western medicine, patients in the treatment group took QPM. The therapeutic course for all was 28 days. The improvement of symptoms and signs was observed. The body temperature (BT), chest X ray, and white blood cells (WBCs) were detected. RESULTS: The Chinese medical syndrome score was lower in the treatment group than in the control group at the 7th, 21st, and 28th day of treatment, showing statistical difference (P < 0.05). The efficacy was better in the treatment group than in the control group at the 7th, 21st, and 28th day of treatment, showing statistical difference (P < 0.05). The BT was lower in the treatment group than in the control group on the 7th day. There was no statistical difference in the patient number with normal WBCs on the 7th day (P > 0.05). But there was statistical difference in the patient number with normal WBCs on the 14th, 21st, and 28th day of treatment (P < 0.05). There was no statistical difference in the patient number with normal chest X ray on the 7th and 28th day of treatment (P > 0.05). But there was statistical difference in the patient number with normal chest X ray on the 14th and 21 st day of treatment (P < 0.05). CONCLUSION: QPM had certain complementary effect on HIV/AIDS patients with pulmonary infection of PHOLS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Medicamentos de Ervas Chinesas/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/complicações , Resultado do TratamentoRESUMO
Aging and aging-related diseases present a global public health problem. Therefore, the development of efficient anti-aging drugs has become an important area of research. Traditional Chinese medicine is an important complementary and alternative branch of aging-related diseases therapy. Recently, a growing number of studies have revealed that traditional Chinese medicine has a certain delaying effect on the progression of aging and aging-related diseases. Here, we review the progress in research into using traditional Chinese medicine for aging and aging-related diseases (including neurodegenerative diseases, cardiovascular diseases, diabetes, and cancer). Furthermore, we summarize the potential mechanisms of action of traditional Chinese medicine and provide references for further studies on aging and aging-related diseases.
Assuntos
Envelhecimento , Medicamentos de Ervas Chinesas , Medicina Tradicional Chinesa , Neoplasias , Doenças Neurodegenerativas , Humanos , Envelhecimento/efeitos dos fármacos , Medicina Tradicional Chinesa/métodos , Doenças Neurodegenerativas/tratamento farmacológico , Neoplasias/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/farmacologia , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/tratamento farmacológicoRESUMO
Diarrheal acquired immune deficiency syndrome (AIDS) seriously affects the quality of life of patients. In this study, we analyzed the differences in the intestinal microbiota among healthy individuals, AIDS patients without diarrhea and AIDS patients with diarrhea through high-throughput sequencing. The microbial diversity in the intestines of patients in the AIDS diarrhea group was significantly increased, and after treatment with Xielikang, the intestinal microbial diversity returned to the baseline level. At the phylum level, compared those in to the healthy (ZC) and AIDS non diarrhea (FN) groups, the relative abundances of Bacteroidetes and Verrucomirobia in the AIDS diarrhea (FA) group before treatment were significantly increased, while the relative abundance of Firmicutes was significantly decreased. Similarly, compared with those in the FA group, the relative abundances of Bacteroidea and Firmicutes in the AIDS diarrhea (FB) group after treatment were significantly increased, while the relative abundance of Firmicutes was significantly decreased after treatment. Additionally, there was no significant difference between the ZC and FN groups. At the genus level, compared with those in the ZC group, the relative abundance of Prevotella and Escherichia_Shigella in the FA group was significantly increased, while the relative abundances of Megamonas and Bifidobacterium was significantly decreased compared to that in the ZC group. After treatment with Xielikang, the relative abundance of Prevotella and Escherichia_Shigella in the FB group were significantly decreased, while the relative abundances of Megamonas and Bifidobacteria were significantly increased than those in the FA group; moreover, there was no significant difference between the ZC and FN groups. The functional prediction results showed that the ketodeoxyoctonate (Kdo) transfer to lipid IVA III and the superpathway of N-acetylglucosamine pathways in the AIDS diarrhea group were significantly altered. The correlation analysis results showed that Dorea was positively correlated with inflammatory factors, while Streptococcus and Lactobacillus were negatively correlated with inflammatory factors. The composition and function of the intestinal microbiota changed significantly in AIDS diarrhea patients, which affected the immune function of the host. The Xielikang capsule modulated the composition of the intestinal microbiota in AIDS diarrhea patients and thus improved immune function and reduced diarrheal symptoms.
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BACKGROUND: Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing. OBJECTIVE: This study aimed to investigate the survival and factors affecting mortality among this group. METHODS: We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016, using the Kaplan-Meier method and Cox proportional hazards models. RESULTS: We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio (HR), 0.66; 95% confidence interval (CI) 0.55-0.79), > 50 years old (HR, 2.69; 95% CI, 2.03-3.56), single/widowed (HR, 1.26; 95% CI, 1.04-1.52), having > 6 years of education (HR, 0.78; 95% CI, 0.65-0.94), Chinese medicine (HR, 0.75; 95% CI, 0.52-0.96), liver injury (HR, 1.58; 95% CI, 1.19-2.10), and CD4+ T cell count <200 cells/µl (HR, 1.94; 95% CI, 1.47-2.55), or 200-350 cells/µl (HR, 1.37; 95% CI, 1.03-1.82) were associated with mortality risk. CONCLUSIONS: We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.
Assuntos
Infecções por HIV , População Rural , Humanos , Feminino , Masculino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Estudos Retrospectivos , China/epidemiologia , Adulto , Pessoa de Meia-Idade , Fatores de Risco , População Rural/estatística & dados numéricos , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Terapia Antirretroviral de Alta Atividade , Modelos de Riscos Proporcionais , Adulto JovemRESUMO
Background: We aimed to distinguish the different Chinese medicine (CM) syndromes of acquired immune deficiency syndrome (AIDS) patients at the proteomics level. Methods: We collected AIDS patients diagnosed with different CM syndromes from Weishi County, Kaifeng City, Henan Province, China, including Qi-deficiency syndrome (named QD group) and dampness-heat syndrome (named DH group). Healthy people were collected as controls from Weishi County, Kaifeng city, Henan Province, China. The plasma from three groups were labeled with ITRAQ, LC/MC was used for protein quantitative analysis. Finally, sequence search and cluster analysis were performed. Results: Overall, 27 different proteins were found. Three proteins were up-regulated and 2 proteins down-regulated in the QD group, 11 proteins up-regulated and 13 proteins down-regulated in the DH group. Compared with DH group, there were 7 different proteins in QD group, among which 5 proteins were down-regulated and 2 proteins were up-regulated. When the target protein of DH group was up-regulated, the protein of HC group was down-regulated correspondingly. Conclusion: The significance analysis and clustering of protein results showed that DH group was significantly different from QD group and HC group at the protein level (P<0.05). However, the QD group could not be effectively distinguished from the HC group. AAT, PF4, C-reactive protein and c4bp may be used as potential biomarkers in DH group. Mass spectrometry based on feature selection can be used to classify different CM syndromes.
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OBJECTIVE: To explore Chinese medicine syndrome distribution laws of asymptomatic HIV infection patients. METHODS: Using Chi-square test, Chinese medicine syndrome distribution laws were compared and analyzed in 1 156 asymptomatic HIV infection patients from March 2009 to October 2011 from four aspects, i.e., age, possible infection time, disease duration, and different routes of infection. RESULTS: Qi deficiency syndrome (QDS) and internal dampness-heat accumulation syndrome (IDHAS) were dominant in all syndrome types. Along with aging, QDS showed a growing tendency, while IDHAS showed obvious declining tendency. There was no obvious change in other syndrome types. There was statistical difference in the distribution of each syndrome type among each age period (P < 0.01). Within 15 years, along with the increase of infection time, QDS showed a growing tendency, while IDHAS ratio showed an obvious declining tendency. No obvious laws were found in other syndrome types. There was statistical difference in the distribution of each syndrome type (P < 0.01). Along with the prolongation of disease duration, the case number of each syndrome showed a decreasing trend, but QDS and IDHAS still accounted for higher ratios in each stage. There was statistical difference in the distribution of each syndrome type (P < 0.01). As for infection routes, QDS was predominant in paid blood donation, blood transfusion infection, intravenous drugs. IDHAS was predominant in sexual transmit. No obvious laws were found in other syndrome types. There was statistical difference in the distribution of each syndrome type (P < 0.01). CONCLUSIONS: DIS, IDHAS, and no confirmable syndrome typing were dominant in asymptomatic HIV infection patients. Deficiency and dampness were important pathological factors for them.
Assuntos
Infecções por HIV/diagnóstico , Medicina Tradicional Chinesa/métodos , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: To investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection. METHODS: Using cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis. RESULTS: Basic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05). CONCLUSIONS: AIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.