Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea
Identifieur interne : 003694 ( Istex/Corpus ); précédent : 003693; suivant : 003695Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea
Auteurs : P. Kelly ; C. Summerbell ; B. Ngwenya ; B. Mandanda ; M. Hosp ; D. Fuchs ; H. Wachter ; N. P. Luo ; J. O. M. Pobee ; M. J. G. FarthingSource :
- QJM: An International Journal of Medicine [ 1460-2725 ] ; 1996-11.
Abstract
Wasting in African AIDS patients is severe, and its aetiology is probably multifactorial: persistent diarrhoea, poverty and tuberculosis may all contribute. We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m2 range 11–22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, r = −0.64; 95%CI: −0.80, −0.41; p < 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference we have observed.
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DOI: 10.1093/qjmed/89.11.831
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Kelly</name><affiliation><mods:affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>Address correspondence to Dr Paul Kelly, Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry, Turner. Street, London El 2AD</mods:affiliation></affiliation></author><author><name sortKey="Summerbell, C" sort="Summerbell, C" uniqKey="Summerbell C" first="C." last="Summerbell">C. Summerbell</name><affiliation><mods:affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</mods:affiliation></affiliation></author><author><name sortKey="Ngwenya, B" sort="Ngwenya, B" uniqKey="Ngwenya B" first="B." last="Ngwenya">B. Ngwenya</name><affiliation><mods:affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</mods:affiliation></affiliation></author><author><name sortKey="Mandanda, B" sort="Mandanda, B" uniqKey="Mandanda B" first="B." last="Mandanda">B. Mandanda</name><affiliation><mods:affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</mods:affiliation></affiliation></author><author><name sortKey="Hosp, M" sort="Hosp, M" uniqKey="Hosp M" first="M." last="Hosp">M. Hosp</name><affiliation><mods:affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</mods:affiliation></affiliation></author><author><name sortKey="Fuchs, D" sort="Fuchs, D" uniqKey="Fuchs D" first="D." last="Fuchs">D. 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Pobee</name><affiliation><mods:affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</mods:affiliation></affiliation></author><author><name sortKey="Farthing, M J G" sort="Farthing, M J G" uniqKey="Farthing M" first="M. J. G." last="Farthing">M. J. G. 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We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m2 range 11–22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, r = −0.64; 95%CI: −0.80, −0.41; p < 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference we have observed.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>P. Kelly</name><affiliations><json:string>University of Zambia School of Medicine Lusaka, Zambia, UK</json:string><json:string>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</json:string></affiliations></json:item><json:item><name>C. Summerbell</name><affiliations><json:string>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</json:string></affiliations></json:item><json:item><name>B. 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We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m2 range 11–22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, r = −0.64; 95%CI: −0.80, −0.41; p > 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. 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Street, London El 2AD</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea</title><author xml:id="author-0000"><persName><forename type="first">P.</forename><surname>Kelly</surname></persName><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</affiliation><affiliation>Address correspondence to Dr Paul Kelly, Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry, Turner. Street, London El 2AD</affiliation></author><author xml:id="author-0001"><persName><forename type="first">C.</forename><surname>Summerbell</surname></persName><affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</affiliation></author><author xml:id="author-0002"><persName><forename type="first">B.</forename><surname>Ngwenya</surname></persName><note type="biography">*Deceased</note><affiliation>*Deceased</affiliation><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation></author><author xml:id="author-0003"><persName><forename type="first">B.</forename><surname>Mandanda</surname></persName><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation></author><author xml:id="author-0004"><persName><forename type="first">M.</forename><surname>Hosp</surname></persName><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation></author><author xml:id="author-0005"><persName><forename type="first">D.</forename><surname>Fuchs</surname></persName><affiliation>Institute for Medical Chemistry and Biochemistry and Ludwig Boltzmann Institute for AIDS Research, University of Innsbruck Austria</affiliation></author><author xml:id="author-0006"><persName><forename type="first">H.</forename><surname>Wachter</surname></persName><affiliation>Institute for Medical Chemistry and Biochemistry and Ludwig Boltzmann Institute for AIDS Research, University of Innsbruck Austria</affiliation></author><author xml:id="author-0007"><persName><forename type="first">N.P.</forename><surname>Luo</surname></persName><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation></author><author xml:id="author-0008"><persName><forename type="first">J.O.M.</forename><surname>Pobee</surname></persName><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation></author><author xml:id="author-0009"><persName><forename type="first">M.J.G.</forename><surname>Farthing</surname></persName><affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</affiliation></author><idno type="istex">A6F5F505C27ED5EDFF3FE0BA36943C04E1207567</idno><idno type="ark">ark:/67375/HXZ-5TPD2LFL-P</idno><idno type="DOI">10.1093/qjmed/89.11.831</idno></analytic><monogr><title level="j">QJM: An International Journal of Medicine</title><idno type="pISSN">1460-2725</idno><idno type="eISSN">1460-2393</idno><idno type="publisher-id">qjmedj</idno><idno type="PublisherID-hwp">qjmed</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="1996-11"></date><biblScope unit="volume">89</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="831">831</biblScope><biblScope unit="page" to="838">838</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1996</date></creation><abstract><p>Wasting in African AIDS patients is severe, and its aetiology is probably multifactorial: persistent diarrhoea, poverty and tuberculosis may all contribute. We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m2 range 11–22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, r = −0.64; 95%CI: −0.80, −0.41; p < 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference we have observed.</p></abstract><textClass><keywords scheme="Journal Subject"><list><head></head><item><term>Original Papers</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1996-11">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2017-10-5">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/A6F5F505C27ED5EDFF3FE0BA36943C04E1207567/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup, element #text not found" wicri:toSee="no header"><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article">
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<name><surname>Kelly</surname><given-names>P.</given-names></name><xref ref-type="aff" rid="au1">1</xref><xref ref-type="aff" rid="au2">2</xref><xref ref-type="corresp" rid="cor1"></xref>
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<name><surname>Summerbell</surname><given-names>C.</given-names></name><xref ref-type="aff" rid="au2">2</xref>
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<name><surname>Ngwenya</surname><given-names>B.</given-names></name><xref ref-type="aff" rid="au1">1</xref><xref ref-type="fn" rid="fn1">*</xref>
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<name><surname>Mandanda</surname><given-names>B.</given-names></name><xref ref-type="aff" rid="au1">1</xref>
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<name><surname>Hosp</surname><given-names>M.</given-names></name><xref ref-type="aff" rid="au1">1</xref>
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<name><surname>Fuchs</surname><given-names>D.</given-names></name><xref ref-type="aff" rid="au3">3</xref>
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<name><surname>Wachter</surname><given-names>H.</given-names></name><xref ref-type="aff" rid="au3">3</xref>
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<name><surname>Luo</surname><given-names>N.P.</given-names></name><xref ref-type="aff" rid="au1">1</xref>
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<name><surname>Pobee</surname><given-names>J.O.M.</given-names></name><xref ref-type="aff" rid="au1">1</xref>
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<name><surname>Farthing</surname><given-names>M.J.G.</given-names></name><xref ref-type="aff" rid="au2">2</xref>
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<aff id="au1"><label>1</label><institution>University of Zambia School of Medicine</institution> <addr-line>Lusaka, Zambia, UK</addr-line></aff>
<aff id="au2"><label>2</label><institution>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry</institution> <addr-line>London, UK</addr-line></aff>
<aff id="au3"><label>3</label><institution>Institute for Medical Chemistry and Biochemistry and Ludwig Boltzmann Institute for AIDS Research, University of Innsbruck</institution> <addr-line>Austria</addr-line></aff>
</contrib-group>
<author-notes>
<corresp id="cor1">Address correspondence to Dr Paul Kelly, Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry, Turner. Street, London El 2AD</corresp>
<fn id="fn1"><label>*</label><p>Deceased</p></fn>
</author-notes>
<pub-date pub-type="ppub">
<month>11</month>
<year>1996</year>
</pub-date>
<volume>89</volume>
<issue>11</issue>
<fpage>831</fpage>
<lpage>838</lpage>
<history>
<date date-type="received">
<day>06</day>
<month>8</month>
<year>1996</year>
</date>
<date date-type="rev-recd">
<day>12</day>
<month>9</month>
<year>1996</year>
</date>
</history>
<copyright-statement>© 1996 Oxford University Press</copyright-statement>
<copyright-year>1996</copyright-year>
<abstract>
<title>Summary</title>
<p>Wasting in African AIDS patients is severe, and its aetiology is probably multifactorial: persistent diarrhoea, poverty and tuberculosis may all contribute. We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m<sup>2</sup> range 11–22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, <italic>r</italic> = −0.64; 95%CI: −0.80, −0.41; <italic>p</italic> < 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference we have observed.</p>
</abstract>
</article-meta>
</front>
</article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Systemic immune activation as a potential determinant of wasting in Zambians with HIV-related diarrhoea</title></titleInfo><name type="personal"><namePart type="given">P.</namePart><namePart type="family">Kelly</namePart><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</affiliation><affiliation>Address correspondence to Dr Paul Kelly, Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry, Turner. Street, London El 2AD</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Summerbell</namePart><affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Ngwenya</namePart><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><description>*Deceased</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Mandanda</namePart><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Hosp</namePart><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D.</namePart><namePart type="family">Fuchs</namePart><affiliation>Institute for Medical Chemistry and Biochemistry and Ludwig Boltzmann Institute for AIDS Research, University of Innsbruck Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H.</namePart><namePart type="family">Wachter</namePart><affiliation>Institute for Medical Chemistry and Biochemistry and Ludwig Boltzmann Institute for AIDS Research, University of Innsbruck Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">N.P.</namePart><namePart type="family">Luo</namePart><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.O.M.</namePart><namePart type="family">Pobee</namePart><affiliation>University of Zambia School of Medicine Lusaka, Zambia, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.J.G.</namePart><namePart type="family">Farthing</namePart><affiliation>Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">1996-11</dateIssued><copyrightDate encoding="w3cdtf">1996</copyrightDate></originInfo><abstract>Wasting in African AIDS patients is severe, and its aetiology is probably multifactorial: persistent diarrhoea, poverty and tuberculosis may all contribute. We report a cross-sectional study of body composition measured anthropometrically in 75 adult patients with HIV-related persistent diarrhoea in Lusaka, and its relationship to gastrointestinal infection and systemic immune activation assessed using serum neopterin and soluble tumour necrosis factor receptor (sTNF-R55) concentrations. Patients as a group were generally severely wasted (mean body mass index (BMI) 15.8 kg/m2 range 11–22), but the severity of wasting was related neither to oesophageal candidiasis nor to intestinal infection. In men but not women, all measures of nutritional status were negatively related to serum sTNF-R55 concentration (fat-free mass in men, r = −0.64; 95%CI: −0.80, −0.41; p < 0.0001). Some wasted patients had cutaneous features of malnutrition, again associated with higher sTNFR55 concentrations, and two had peripheral oedema. The diarrhoea-wasting syndrome in this part of Africa seems to be associated with evidence of high cytokine activity in men, rather than oesophageal candidiasis or any particular intestinal opportunistic infection. This immune activation requires further investigation in the context of the sex difference we have observed.</abstract><note type="footnotes">Deceased</note><note type="author-notes">Address correspondence to Dr Paul Kelly, Digestive Diseases Research Centre, St Bartholomew's and The Royal London School of Medicine and Dentistry, Turner. 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