Gougeon Marie-Lise, Pénicaud Luc, Fromenty Bernard, Leclercq Pascale, Viard Jean-Paul, Capeau Jacqueline
Unité d'Immunité Anti-virale, Biothérapie et Vaccins, Département de Medecine Moleculaire, Institut Pasteur, Paris, France.
Antivir Ther. 2004 Apr;9(2):161-77.
The recent clinical use of potent HIV-1 drugs, including nucleoside reverse transcriptase inhibitors (NRTIs) and non-peptidic viral protease inhibitors (PIs), and their combinations, termed highly active antiretroviral therapy (HAART), has dramatically reduced the infection-related mortality of AIDS patients, but it is associated with severe metabolic adverse events such as lipodystrophy syndrome, dyslipidaemia, insulin resistance and diabetes mellitus. The aetiology of this syndrome and metabolic alterations appear to be multifactorial, including HIV drug inhibitory effects on adipocyte differentiation, alteration of mitochondrial functions in adipocytes and altered leptin, adiponectin and cytokine expression in adipose tissue of patients. Adipose tissue may thus be a central regulator in disorganized lipid metabolism and insulin resistance associated with antiretroviral therapy, and we propose in this review to explore how adipose tissue may be a target, but also an actor, in the aetiopathogenesis of the lipodystrophy syndrome.
近期，强效抗HIV-1药物（包括核苷类逆转录酶抑制剂（NRTIs）和非肽类病毒蛋白酶抑制剂（PIs））及其联合使用（即高效抗逆转录病毒疗法（HAART））在临床上的应用，显著降低了艾滋病患者因感染导致的死亡率，但却伴有严重的代谢不良事件，如脂肪代谢障碍综合征、血脂异常、胰岛素抵抗和糖尿病。该综合征及代谢改变的病因似乎是多因素的，包括HIV药物对脂肪细胞分化的抑制作用、脂肪细胞线粒体功能的改变以及患者脂肪组织中瘦素、脂联素和细胞因子表达的改变。因此，脂肪组织可能是抗逆转录病毒疗法相关的脂质代谢紊乱和胰岛素抵抗的核心调节因子，在本综述中，我们旨在探讨脂肪组织如何可能成为脂肪代谢障碍综合征发病机制中的一个靶点，同时也是一个参与者。
