Mocchegiani E, Muzzioli M, Gaetti R, Veccia S, Viticchi C, Scalise G
Immunology Centre, Gerontol, Res. Dept., N. Masera, Italian National Research Centres on Aging, Ancona.
Int J Immunopharmacol. 1999 Apr;21(4):271-81. doi: 10.1016/s0192-0561(99)00009-0.
Aging and HIV have parallelism in immunodeficiency status because of the appearance of infections or relapse leading to death in both conditions. HIV-RNA is predictor for HIV progression correlated with CD4+ depletion. CD4+ and plasma zinc levels (zincaemia) may be predictors for infections relapse in aging because of zinc relevance for normal immune efficiency against infections and for CD4+ growth. Moreover, zincaemia decreases in aging and infection. A total of 67 elderly subjects affected by infections resistant to antibiotic therapy were recruited. A total of 28 HIV+ subjects with HAART therapy were also used. CD4+ depletion (507 mm3) and zincaemia deficiency (76 microg/dl), as compared to CD4+ (700-1100 mm3) and zincaemia (85-100 microg/dl; age 40-75 years) normal ranges, are possible limits (Cox hazard regression) for severe infections relapse, such as chronic obstructive bronchitis and bronchopneumonia by bacteria or Candida complication, in aging. CD4+ and zincaemia values are within the lower limits of normal range in urinary tract infections. Zincaemia and HIV-RNA or CD4+ are inversely correlated (r = 0.57 and r = 0.72, respectively) in HIV+ HAART treated subjects. Consequently there is no appearance of opportunistic infections. Parallelism between aging and HIV may exist because of the resemblance in marked zinc deficiency and CD4+ depletion with high scores in relative risks for severe infections relapse. Supplementing zinc (12 mg Zn++/day) for one month in infected elderly subjects and HAART therapy in HIV+ subjects reduces risk scores in CD4+ and zincaemia deficiencies for infections relapse, suggesting that the zinc beneficial effect may be independent either by HIV-virus or pathogen agents involved. While HAART may reduce the occurrence of opportunistic infections in HIV by means of also major zinc bioavailability, supplementing zinc can be recommended in elderly people as resistance to infections. Since zinc deficiency is correlated with CD4+ depletion, this latter may also be good diagnostic marker to detect 'clear immunodeficiency' in aging, as in HIV condition.
衰老和艾滋病毒在免疫缺陷状态方面具有相似性，因为在这两种情况下都会出现感染或复发并导致死亡。HIV-RNA是与CD4+细胞耗竭相关的HIV病情进展的预测指标。由于锌对于抵抗感染的正常免疫效率以及CD4+细胞生长具有重要意义，CD4+细胞水平和血浆锌水平（血锌浓度）可能是衰老过程中感染复发的预测指标。此外，血锌浓度在衰老和感染过程中会降低。总共招募了67名对抗生素治疗耐药的感染老年受试者。还使用了28名接受高效抗逆转录病毒治疗（HAART）的HIV阳性受试者。与正常范围的CD4+细胞水平（700 - 1100 mm³）和血锌浓度（85 - 100 μg/dl；年龄40 - 75岁）相比，CD4+细胞耗竭（507 mm³）和血锌浓度缺乏（76 μg/dl）可能是衰老过程中严重感染复发的限制因素（Cox风险回归），如慢性阻塞性支气管炎、细菌性或念珠菌性并发症引起的支气管肺炎。在尿路感染中，CD4+细胞水平和血锌浓度值处于正常范围的下限。在接受HAART治疗的HIV阳性受试者中，血锌浓度与HIV-RNA或CD4+细胞水平呈负相关（分别为r = 0.57和r = 0.72）。因此，没有机会性感染的出现。衰老和艾滋病毒之间可能存在相似性，因为在明显的锌缺乏和CD4+细胞耗竭方面存在相似之处，且严重感染复发的相对风险得分较高。在感染的老年受试者中补充锌（每天12毫克锌离子）一个月，以及对HIV阳性受试者进行HAART治疗，可降低CD4+细胞水平和血锌浓度缺乏导致感染复发的风险评分，这表明锌的有益作用可能独立于HIV病毒或所涉及的病原体。虽然HAART可能通过提高锌的生物利用度来减少HIV感染者中机会性感染的发生，但对于老年人，建议补充锌以增强抗感染能力。由于锌缺乏与CD4+细胞耗竭相关，后者也可能是检测衰老过程中“明显免疫缺陷”的良好诊断标志物，如同在艾滋病毒感染情况中一样。
