Chang H R, Dulloo A G, Bistrian B R
Laboratory of Nutrition/Infection, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215-5310, USA.
Nutrition. 1998 Nov-Dec;14(11-12):853-63. doi: 10.1016/s0899-9007(98)00108-7.
There is now a large literature implicating cytokines in the development of wasting and cachexia commonly observed in a variety of pathophysiologic conditions. In the acquired immunodeficiency syndrome (AIDS), cytokines elicited by primary and secondary infections seem to exert subtle and sustained effects on behavioral, hormonal, and metabolic axes, and their combined effects on appetite and metabolism have been postulated to drive wasting. However, correlations of increased blood levels of a particular cytokine with wasting in AIDS have not been consistent observations, perhaps because cytokines act principally as paracrine and autocrine hormones, as well as indirectly by activating other systems. A better understanding of the mechanisms underlying the catabolic effects of cytokines in clearly needed if more efficacious strategies are to be developed for the prevention and treatment of wasting in AIDS. In this review we first examine the interacting factors contributing to the AIDS wasting syndrome. We then analyze the complex and overlapping role of cytokines in the pathophysiology of this condition, and put forward a number of hypotheses to explain some of the most important features of this syndrome.
目前有大量文献表明，细胞因子与在多种病理生理状况下常见的消瘦和恶病质的发生有关。在获得性免疫缺陷综合征（艾滋病）中，原发性和继发性感染引发的细胞因子似乎对行为、激素和代谢轴产生微妙而持久的影响，并且据推测它们对食欲和代谢的综合作用会导致消瘦。然而，特定细胞因子血液水平升高与艾滋病患者消瘦之间的相关性并非一致的观察结果，这可能是因为细胞因子主要作为旁分泌和自分泌激素起作用，并且还通过激活其他系统间接发挥作用。如果要开发出更有效的策略来预防和治疗艾滋病患者的消瘦，就显然需要更好地理解细胞因子分解代谢作用的潜在机制。在这篇综述中，我们首先研究导致艾滋病消瘦综合征的相互作用因素。然后我们分析细胞因子在这种病症病理生理学中的复杂且重叠的作用，并提出一些假说来解释该综合征的一些最重要特征。
