Pugliese A, Gennero L, Pescarmona G P, Beccattini M, Morra E, Orofino G, Torre D
Dept of Medical Surgery, University of Turin, Italy.
Infection. 2002 Apr;30(2):86-9. doi: 10.1007/s15010-002-2088-z.
The progression of HIV-1 infection towards its more advanced stages is accompanied by changes in iron metabolism and increased body iron stores.
Given the ability of HIV to alter iron metabolism, we studied the principal (transferrin system) and alternative (citrate system) iron pathways in a group of 65 HIV-infected patients (symptomatic stage B1-B3) and in a group of 36 healthy seronegative individuals. We determined serum citrate levels, haptoglobin (Hp) haplotypes, expression of transferrin receptor (CD71) on cell lines infected with HIV-1 as well as iron markers including blood iron, transferrin and ferritin.
Our data showed decreased serum citrate levels in the HIV-infected patients compared to controls (92.9 +/- 22.4 microM/l vs 126.2 +/- 29.2 microM/L; p < 0.01). In particular, the serum citrate levels negatively correlated with HIV-1 RNA copy number (mean: 2.53 +/- 1.88 x 10(5)/ml, r(s) = 0.70, p < 0.01) and positively correlated with CD4+ T-lymphocyte count (mean: 241 +/- 168/ml, r(s) = 0.64, p > 0.05). Accordingly, blood iron, transferrin and red cell concentrations were lower in HIV-infected patients compared to the controls, whereas serum ferritin levels were higher in HIV-infected patients. Moreover, the Hp haplotype distribution showed significant differences only in the group of HIV-infected patients (p = 0.02; chi2 test).
Our results show that iron metabolism is altered in patients with HIV-1 infection. The alternative pathway (citrate system) is particularly affected, since when citrate levels are low, both aconitase activity and HIV-1 replication need iron.
HIV-1感染进展至更晚期阶段时，会伴随铁代谢变化及体内铁储存增加。
鉴于HIV改变铁代谢的能力，我们在一组65例HIV感染患者（症状性B1 - B3期）和一组36例健康血清阴性个体中研究了主要（转铁蛋白系统）和替代（柠檬酸盐系统）铁代谢途径。我们测定了血清柠檬酸盐水平、触珠蛋白（Hp）单倍型、HIV-1感染细胞系上转铁蛋白受体（CD71）的表达以及包括血铁、转铁蛋白和铁蛋白在内的铁标志物。
我们的数据显示，与对照组相比，HIV感染患者的血清柠檬酸盐水平降低（92.9±22.4微摩尔/升 vs 126.2±29.2微摩尔/升；p<0.01）。特别是，血清柠檬酸盐水平与HIV-1 RNA拷贝数呈负相关（平均值：2.53±1.88×10⁵/毫升，r(s)=0.70，p<0.01），与CD4⁺T淋巴细胞计数呈正相关（平均值：241±168/毫升，r(s)=0.64，p>0.05）。因此，与对照组相比，HIV感染患者的血铁、转铁蛋白和红细胞浓度较低，而HIV感染患者的血清铁蛋白水平较高。此外，Hp单倍型分布仅在HIV感染患者组中显示出显著差异（p = 0.02；卡方检验）。
我们的结果表明，HIV-1感染患者的铁代谢发生改变。替代途径（柠檬酸盐系统）受到特别影响，因为当柠檬酸盐水平较低时，乌头酸酶活性和HIV-1复制都需要铁。
