Aukrust P, Müller F, Lien E, Nordoy I, Liabakk N B, Kvale D, Espevik T, Froland S S
Section of Clinical Immunology, Research Institute of Nuclear Medicine,Oslo, Norway.
J Infect Dis. 1999 Jan;179(1):74-82. doi: 10.1086/314572.
Because persistent tumor necrosis factor (TNF)-alpha activation may play a pathogenic role in human immunodeficiency virus infection, TNF component levels were assessed over 78 weeks in plasma and peripheral blood mononuclear cells (PBMC) during highly active antiretroviral therapy (HAART) in 40 HIV-infected patients. HAART induced a significant decline in plasma levels of TNF-alpha and soluble TNF receptors and was associated with a fall in the abnormally increased unstimulated and a rise in the abnormally low Mycobacterium avium complex-purified-protein derivative-stimulated TNF-alpha released from PBMC. However, concentrations of these TNF components were not normalized. Patients with virologic and immunologic treatment failure after 52 weeks had higher levels of several TNF components than other patients early after initiation of therapy, also during periods with adequate virologic response. Although TNF components significantly decreased during HAART, these results support data indicating that full immunologic normalization is not achieved during such therapy. The persistent activation of the TNF system in a subgroup of persons may be involved in treatment failure.
由于持续性肿瘤坏死因子（TNF）-α激活可能在人类免疫缺陷病毒感染中发挥致病作用，因此在40例HIV感染患者接受高效抗逆转录病毒治疗（HAART）的78周期间，对血浆和外周血单核细胞（PBMC）中的TNF成分水平进行了评估。HAART导致血浆中TNF-α和可溶性TNF受体水平显著下降，并与PBMC中异常升高的未刺激状态下的TNF-α下降以及异常低的鸟分枝杆菌复合群纯化蛋白衍生物刺激的TNF-α释放增加有关。然而，这些TNF成分的浓度并未恢复正常。在治疗52周后出现病毒学和免疫学治疗失败的患者，在治疗开始后的早期，包括在病毒学反应良好的时期，其几种TNF成分的水平均高于其他患者。尽管在HAART期间TNF成分显著降低，但这些结果支持了这样的数据，即在此类治疗期间并未实现完全的免疫正常化。一部分人的TNF系统持续激活可能与治疗失败有关。
