University of Athens Medical School, Athens, Greece.
J Infect. 2010 Jul;61(2):101-13. doi: 10.1016/j.jinf.2010.06.002. Epub 2010 Jun 12.
The use of highly active anti-retroviral therapy has been associated with effects on various metabolic and morphological parameters that are underlied by significant hormonal and cytokine changes. Novel adipokines may have a role in the pathogenesis of these changes. In fact, leptin deficiency and hypoadiponectinemia correlate with lipoatrophy and central fat accumulation respectively whereas hypoadiponectinemia also appears to be associated with insulin resistance and lipid disorders. Preliminary evidence from proof-of-concept studies suggests that administration of recombinant leptin in replacement doses and/or administration of medications that increase adiponectin levels may improve the HIV-1/HAART associated metabolic syndrome (HAMS). Immune effects of hypoleptinemia and hypoadiponectinemia might have a role in the evolution of the HAMS that need to be further elucidated. The role for resistin in relation to HAMS is controversial and further investigation is necessary. A potential role of other novel cytokines like visfatin, retinol-binding protein-4, apelin, acylation stimulating protein, omentin and vaspin needs to be further elucidated.
高效抗逆转录病毒疗法的应用与各种代谢和形态参数有关，这些参数是由显著的激素和细胞因子变化引起的。新型脂肪因子可能在这些变化的发病机制中起作用。事实上，瘦素缺乏和脂联素水平降低分别与脂肪萎缩和中心性脂肪堆积相关，而脂联素水平降低似乎也与胰岛素抵抗和脂质紊乱有关。来自概念验证研究的初步证据表明，给予重组瘦素替代剂量和/或给予增加脂联素水平的药物可能改善 HIV-1/HAART 相关代谢综合征（HAMS）。低瘦素血症和低脂联素血症的免疫作用可能在 HAMS 的演变中起作用，需要进一步阐明。抵抗素在 HAMS 中的作用存在争议，需要进一步研究。其他新型细胞因子（如内脂素、视黄醇结合蛋白-4、apelin、酰化刺激蛋白、网膜素和vaspin）的潜在作用需要进一步阐明。
