Missailidis C, Höijer J, Johansson M, Ekström L, Bratt G, Hejdeman B, Bergman P
Department of Laboratory Medicine (LABMED), Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden.
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Scand J Immunol. 2015 Jul;82(1):55-62. doi: 10.1111/sji.12299.
To study vitamin D (25OH D3 ) in relation to (i) microbial translocation (ii) systemic inflammation and (iii) blood lipid markers, in Caucasian, well-controlled HIV patients and healthy controls, plasma and serum samples from n = 97 male, HIV patients on HAART with immeasurable viral load (<20 copies/ml) since median 6.5 years and no concurrent inflammatory or infectious disease and n = 30 healthy controls were analysed for (i) LPS; (ii) sCD14, hsCRP, IL-4, IL-6, IL-10, IL-17, MCP-1 and IFN-γ; as well as (iii) blood lipids. Vitamin D levels were similarly distributed and equally low in both HIV patients and controls. There was no association between vitamin D levels and markers of microbial translocation, systemic inflammation or dyslipidemia. LPS levels were similar in both groups but HIV patients expressed higher levels of sCD14 and hsCRP, with HIV as an independent risk factor. HIV patients had higher cholesterol and Apo B levels. Notably, more HIV patients smoked and smoking was associated with lower vitamin D levels. In conclusion; these well-treated Caucasian HIV patients had similar vitamin D levels as healthy controls. However, despite perfect virological control, they exhibited slightly increased inflammatory markers and disturbed blood lipids. However, neither of these parameters were associated with low vitamin D levels but appeared to be linked to the HIV-disease per se. Thus, the rationale for vitamin D substitution as a way to improve microbial translocation and systemic inflammation is not fully supported in this HIV population.
为研究维生素D(25-羟基维生素D3)与(i)微生物易位、(ii)全身炎症及(iii)血脂标志物之间的关系,对高加索地区病情得到良好控制的HIV患者及健康对照者进行了研究。分析了n = 97例男性HIV患者(接受高效抗逆转录病毒治疗,病毒载量不可测(<20拷贝/ml),中位数为6.5年,无并发炎症或感染性疾病)及n = 30例健康对照者的血浆和血清样本,检测项目包括:(i)脂多糖;(ii)可溶性CD14、超敏C反应蛋白、白细胞介素-4、白细胞介素-6、白细胞介素-10、白细胞介素-17、单核细胞趋化蛋白-1及干扰素-γ;以及(iii)血脂。维生素D水平在HIV患者和对照者中分布相似且均较低。维生素D水平与微生物易位、全身炎症或血脂异常标志物之间无关联。两组脂多糖水平相似,但HIV患者可溶性CD14和超敏C反应蛋白水平较高,HIV是独立危险因素。HIV患者胆固醇和载脂蛋白B水平较高。值得注意的是,更多HIV患者吸烟,且吸烟与较低的维生素D水平相关。总之,这些经过良好治疗的高加索HIV患者维生素D水平与健康对照者相似。然而,尽管病毒学控制良好,但他们的炎症标志物略有升高且血脂紊乱。然而,这些参数均与低维生素D水平无关,似乎与HIV疾病本身有关。因此,在该HIV人群中,维生素D替代作为改善微生物易位和全身炎症的方法的理论依据未得到充分支持。