The impact of intravenous heroin use on immune activation in treated HIV

静脉注射海洛因对治疗艾滋病毒的免疫激活的影响

• 批准号: 10160860
• 负责人: Corrilynn Olesky Hileman
• 金额: $ 85.72万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10160860
• 关键词: Acquired Immunodeficiency Syndrome; Adult; Age; Bacterial Infections; Blood Vessels; CD4 Lymphocyte Count; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic; Clinical Management; Cohort Studies; Complex; Control Groups; Data; Enrollment; Functional disorder; Funding; General Population; Goals; HIV; HIV Infections; HIV therapy; Harm Reduction; Health Services Accessibility; Hepatitis C; Heroin; Heroin Users; Immune response; Immunologic Markers; Individual; Inflammation; Inflammatory; Intravenous; Knowledge; Lead; Life Expectancy; Link; Lymphocyte; Malignant Neoplasms; Measures; Mediating; Methadone; Myocardial Infarction; NF-kappa B; Natural Immunity; Ohio; Opioid; Participant; Pathogenesis; Pathway interactions; Patients; Permeability; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phenotype; Play; Population; Provider; Risk; Risk Factors; Role; Standardization; Stroke; Suboxone; T-Lymphocyte; Time; Vascular Diseases; Vascular Endothelium; Viral; Woman; adaptive immunity; antiretroviral therapy; cardiovascular disorder risk; cardiovascular risk factor; cohort; comorbidity; empowered; endothelial dysfunction; experience; heroin overdose; heroin use; high risk; high risk behavior/lifestyle; immune activation; indexing; intravenous drug use; intravenous drug user; medication-assisted treatment; men; methadone treatment; microbial; monocyte; mortality; opioid use disorder; overdose death; oxidized lipid; prospective; recruit; sex; systemic inflammatory response; transmission process; treatment program; vascular inflammation; virology

The proposal in this application will study the extent and specifics of immune activation, its cardiovascular consequences, and mechanisms as they relate to gut integrity in HIV-infected intravenous (IV) heroin users virologically-suppressed on antiretroviral therapy. Overreaching goals are 1) to define the extent and specifics of immune activation in HV-infected IV heroin users; 2) to define the effect of IV heroin on gut integrity and permeability, and the relationship of gut integrity alteration and immune activation; 3) importantly, to study the reversibility of immune activation, inflammation, and gut dysfunction after cessation of IV heroin, and to that effect, compare two strategies for medication assisted treatment—buprenorphine/naloxone versus methadone maintenance; 4) to study if heightened immune activation associated with active intravenous drug use (IVDU) is associated with higher cardiovascular disease risk, including endothelial dysfunction and arterial inflammation, and if these effects are reversible with buprenorphine/naloxone or methadone. To answer these complex questions an expert team has been assembled with the plan to recruit a cohort of ART-treated, HIV- infected persons who use IV heroin, and very carefully matched HIV-infected controls who have never used IV drugs. A second cohort of ART-treated HIV-infected persons who use IV heroin choosing medication assisted treatment with either buprenorphine/naloxone or methadone to stop using will also be established. These cohorts will be followed serially and data will be collected regarding virologic and immunologic responses to continued IV heroin use versus no IVDU and to buprenorphine/naloxone versus methadone. Levels of cellular activation with phenotyping of T-lymphocytes, as well as levels of soluble markers of immune activation and inflammation will be measured. The effect and reversibility of IVDU on arterial inflammation and endothelial dysfunction will be serially measured, before and after buprenorphine/naloxone or methadone.

本申请中的提案将研究免疫激活的程度和细节及其对心血管的影响 感染 HIV 的静脉注射 (IV) 海洛因吸食者与肠道完整性相关的后果和机制 抗逆转录病毒治疗的病毒学抑制目标是 1) 确定程度和细节。 感染 HV 的静脉注射海洛因使用者的免疫激活作用；2) 确定静脉注射海洛因对肠道完整性的影响； 渗透性，以及肠道完整性改变和免疫激活的关系；3）重要的是，研究 停止静脉注射海洛因后免疫激活、炎症和肠道功能障碍的可逆性 效果，比较两种药物辅助治疗策略——丁丙诺啡/纳洛酮与美沙酮 维持；4) 研究香水免疫激活是否与主动静脉吸毒（IVDU）相关 与较高的心血管疾病风险相关，包括内皮功能障碍和动脉粥样硬化 炎症，以及这些影响是否可以通过丁丙诺啡/纳洛酮或美沙酮逆转来回答这些问题。 一个专家小组已经组建了一个复杂的问题，并计划招募一批接受过抗逆转录病毒疗法治疗的艾滋病毒感染者。 使用静脉注射海洛因的感染者和从未使用过静脉注射的艾滋病毒感染者进行非常仔细的匹配 第二组接受 ART 治疗、使用静脉注射海洛因的 HIV 感染者选择药物辅助。 还将确定用丁丙诺啡/纳洛酮或美沙酮治疗以停止使用这些药物。 将连续跟踪队列并收集有关病毒学和免疫学反应的数据 继续静脉注射海洛因与不使用 IVDU 以及丁丙诺啡/纳洛酮与美沙酮的细胞水平。 通过 T 淋巴细胞表型分析来激活，以及免疫激活和可溶性标记物的水平 将测量 IVDU 对动脉炎症和内皮细胞的影响和可逆性。 将在丁丙诺啡/纳洛酮或美沙酮之前和之后连续测量功能障碍。

项目成果

Heroin Use Is Associated With Vascular Inflammation in Human Immunodeficiency Virus.

海洛因的使用与人类免疫缺陷病毒的血管炎症有关。

• DOI: 10.1093/cid/ciac812
• 发表时间: 2023
• 期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
• 作者: Hileman,CorrilynnO;Durieux,JaredC;Janus,ScottE;Bowman,Emily;Kettelhut,Aaren;Nguyen,Trong-Tuong;Avery,AnnK;Funderburg,Nicholas;Sullivan,Claire;McComsey,GraceA
• 通讯作者: McComsey,GraceA

Anisocytosis Is Associated With Reduced Bone Marrow Activity Evaluated by Positron Emission Tomography.

通过正电子发射断层扫描评估，细胞大小不均与骨髓活性降低有关。

• DOI: 10.1016/j.amjcard.2021.05.001
• 发表时间: 2021
• 期刊: The American journal of cardiology
• 作者: Janus,ScottE;Al-Kindi,SadeerG;Hajjari,Jamal;Chami,Tarek;Avery,Ann;Labbato,Danielle;Smith,Cheryl;Sullivan,Claire;Hileman,CorrilynnO;McComsey,GraceA
• 通讯作者: McComsey,GraceA