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Immunoendocrinologic abnormalities in human immunodeficiency virus infection.

M Clerici1, M Galli, S Bosis

  • 1Cattedra di Immunologia, Università di Milano, DISP LITA Vialba, Milano, Italy. mago@mailserver.unimi.it

Annals of the New York Academy of Sciences
|March 28, 2001
PubMed
Summary

HIV infection alters adrenal steroids and cytokines. Increased cortisol and decreased dehydroepiandrosterone (DHEA) may drive the shift from type-1 to type-2 immunity, impacting T-cell survival and IgE production.

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Area of Science:

  • Endocrinology and Immunology
  • Viral Pathogenesis

Background:

  • HIV infection is associated with altered adrenal steroid production and dysregulated cytokine profiles.
  • Cortisol levels rise, while dehydroepiandrosterone (DHEA) levels fall, impacting immune regulation.
  • A shift from type-1 to type-2 cytokine production occurs during HIV progression.

Purpose of the Study:

  • To investigate the role of adrenal steroid alterations in the immune dysregulation observed in HIV infection.
  • To explore the link between cortisol, DHEA, and the shift in cytokine profiles.
  • To understand the mechanisms driving T-cell changes and B-cell differentiation in HIV.

Main Methods:

  • Analysis of adrenal steroid levels (cortisol, DHEA) in HIV patients.
  • Assessment of cytokine profiles, including interferon gamma (IFN-γ), interleukins (IL-2, IL-4, IL-5, IL-6, IL-10, IL-12).

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  • Evaluation of glucocorticoid (GC) and IL-4 effects on lymphocyte differentiation and programmed cell death (PCD).

    • Main Results:

    • Elevated cortisol and reduced DHEA levels correlate with HIV progression.
    • A shift towards increased type-2 cytokines (IL-4, IL-5, IL-6, IL-10) and decreased type-1 cytokines (IFN-γ, IL-2, IL-12) was observed.
    • Glucocorticoids (GC) suppress type-1 cytokines, stimulate IL-4, promote IgE-producing plasma cells, and induce PCD in T-lymphocytes.

    Conclusions:

    • Increased cortisol and decreased DHEA may contribute to the type-1 to type-2 cytokine shift in HIV.
    • This shift, potentially driven by hormonal changes, could be exacerbated by GC-induced T-cell PCD and enhanced B-cell differentiation.
    • While highly active antiretroviral therapy (HAART) controls viremia, its impact on immune reconstitution and endocrine side effects warrants further investigation.