HIV患者における動脈炎症
Sharath Subramanian1, Ahmed Tawakol, Tricia H Burdo
1MR-PET-CT Program and Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
JAMA
|July 24, 2012
まとめ
ヒト免疫不全ウイルス (HIV) の患者は,制御された疾患と伝統的なリスク要因が低い場合でも,動脈炎症の増加を示します. この炎症は,モノサイトとマクロファージの活性化マーカーと関連しています.
科学分野:
- 心血管研究に関する研究.
- 免疫学 免疫学とは
- 放射線学 放射線学
背景:
- 心血管疾患 (CVD) のリスクは,ヒト免疫不全ウイルス (HIV) に感染した個体において高くなります.
- この心血管疾患のリスクの増加を誘発する正確なメカニズムは不明である.
- 溶性CD163 (sCD163) によって示されるモノサイトおよびマクロファージの活性化が役割を果たす可能性があります.
研究 の 目的:
- HIV患者における動脈壁の炎症を評価するために,18フッ素-2-デオキシ-D-グルコース正陽子放出トモグラフィー (18F-FDG-PET) を使用します.
- sCD163.3を含む従来の非従来の心血管リスクマーカーと動脈炎症を相関させる.
- HIV患者における動脈炎症を,非HIV対照群と比較する.
主な方法:
- マサチューセッツ総合病院で81人の参加者 (27人のHIV感染者,54人の対照群) を対象とした横断的な研究.
- 心臓18F-FDG-PETは,大動脈のターゲットと背景の比率 (TBR) を介して動脈炎症を評価した.
- 冠動脈コンピュータトモグラフィースキャンで冠動脈カルシウム値が評価され,年齢/性別/フレミングハムリスクスコア (FRS) に一致した対照群および動脈硬化対照群との比較が行われました.
主要な成果:
- HIV被験者は,FRSをマッチした対照群と同様の,HIV疾患が良好に制御され,FRSの平均値が低かった.
- 大動脈TBR (動脈炎) は,FRSマッチした対照群と比較して,HIV患者において有意に高かった (P < .001).
- HIV患者における大動脈TBRは,sCD163レベル (P = .04) と関連していたが,C反応性タンパク質やD-ジマーとは関連していなかった.
結論:
- HIVに感染した個人は,同様の心臓リスクプロファイルを持つ非感染者と比較して,動脈炎症の増加を示します.
- この高度な炎症は,モノサイトとマクロファージの活性化マーカーと関連しています.
- 研究結果は,HIV,免疫活性化,および下臨床的血管炎症の間の関連性を示唆しています.
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