HIV感染与疾病中的下丘脑-垂体-肾上腺轴

Hypothalamic-pituitary-adrenal axis in HIV infection and disease.

作者信息

Chrousos George P, Zapanti Evangelia D

机构信息

First Department of Pediatrics, "Agia Sofia" Children's Hospital, University of Athens, Thivon and Papadiamantopoulou, Athens 11527, Greece.

First Endocrine Department and Diabetes Center, Alexandra Hospital, 80 Vassilisis Sofias Avenue, Athens 11528, Greece.

出版信息

Endocrinol Metab Clin North Am. 2014 Sep;43(3):791-806. doi: 10.1016/j.ecl.2014.06.002.

DOI:10.1016/j.ecl.2014.06.002

PMID:25169568

Abstract

HIV infection induces hypothalamic-pituitary-adrenal (HPA) axis derangements. Partial glucocorticoid resistance has been observed in a subset of AIDS patients, possibly owing to HIV-induced altered cytokine secretion and action. Because glucocorticoids have immunomodulatory effects, the severity of the HPA axis disorder could play a central role in disease progression. The characteristic phenotype of AIDS patients (visceral obesity, lipodystrophy) may be owing to effects of HIV proteins on the HPA axis, including changes in glucocorticoid and insulin sensitivity of target tissues, as well as altered cytokine production and interaction with the HPA axis, genetic causes, comorbidities, and, possibly, use of antiretroviral agents.

摘要

HIV感染会导致下丘脑-垂体-肾上腺（HPA）轴紊乱。在一部分艾滋病患者中观察到了部分糖皮质激素抵抗现象，这可能是由于HIV诱导的细胞因子分泌和作用改变所致。由于糖皮质激素具有免疫调节作用，HPA轴紊乱的严重程度可能在疾病进展中起核心作用。艾滋病患者的典型表型（内脏肥胖、脂肪代谢障碍）可能归因于HIV蛋白对HPA轴的影响，包括靶组织糖皮质激素和胰岛素敏感性的变化，以及细胞因子产生的改变和与HPA轴的相互作用、遗传因素、合并症，还有可能是抗逆转录病毒药物的使用。