Chew Nicholas S, Doran Peter P, Powderly William G
UCD School of Medicine and Medical Sciences, Mater Misericordiae University Hospital, Dublin 7, Ireland.
Curr Opin HIV AIDS. 2007 Jul;2(4):318-23. doi: 10.1097/COH.0b013e3281a3c092.
Since the introduction of potent antiretroviral therapy, the emphasis in managing HIV patients has changed from treatment and prevention of opportunistic infections to dealing with toxicities of long-term antiretroviral therapy such as bone demineralization. To date, the pathogenic mechanisms underlying the initiation and progression of osteoporosis in HIV patients remain to be elucidated. This review focuses on recent advances in our understanding of the role of both HIV and antiretroviral therapy in driving bone disease and presents an update on current treatment options and new therapeutic agents targeting novel sites.
Recent studies explored the role of HIV and individual antiretroviral therapy drugs in modifying the phenotype of bone cells. Studies have demonstrated effects on cell differentiation, maturation and function in response to both HIV and its treatment - effects mediated via direct alterations in both cell signaling and gene and protein expression.
Evidence from clinical and cell biological investigations has demonstrated the importance of both HIV and antiretroviral therapy in the emergence of osteoporotic bone disease. Continued efforts aimed at deciphering the molecular basis of metabolic bone disease in HIV patients are necessary to ensure optimal treatment of current patients and to create novel therapeutic interventions.
自从强效抗逆转录病毒疗法问世以来，管理HIV患者的重点已从治疗和预防机会性感染转变为应对长期抗逆转录病毒疗法的毒性，如骨质脱矿。迄今为止，HIV患者骨质疏松症发生和进展的致病机制仍有待阐明。本综述重点关注我们对HIV和抗逆转录病毒疗法在引发骨病中作用的最新认识进展，并介绍当前治疗选择以及针对新靶点的新型治疗药物的最新情况。
最近的研究探讨了HIV和个别抗逆转录病毒治疗药物在改变骨细胞表型中的作用。研究表明，HIV及其治疗对细胞分化、成熟和功能均有影响——这些影响是通过细胞信号以及基因和蛋白质表达的直接改变介导的。
临床和细胞生物学研究的证据表明，HIV和抗逆转录病毒疗法在骨质疏松性骨病的发生中都很重要。持续努力破译HIV患者代谢性骨病的分子基础对于确保当前患者的最佳治疗以及开发新的治疗干预措施是必要的。
