ROLE OF SECONDARY ILLNESS AND THE WASTING OF AIDS

继发疾病的作用和艾滋病的浪费

• 批准号: 2150200
• 负责人: Carl Grunfeld
• 金额: $ 16.64万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1998-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2150200
• 关键词: AIDS; AIDS therapy; Mycobacterium avium; bioenergetics; cachexia; human immunodeficiency virus; human subject; nutrient intake activity; opportunistic infections; secondary infection

DESCRIPTION: The wasting syndrome in AIDS is increasing in prevalence and leading to considerable morbidity and contributing to mortality. Wasting in AIDS was initially thought to be an inevitable consequence of HIV infection. However, data from the laboratory of the investigator and others have suggested that wasting is an intermittent phenomenon induced primarily by secondary illnesses, including systemic infections and gastrointestinal disease. Although there may be periods of weight stability and even weight gain, most patients show incomplete recovery from episodes of weight loss leading to the long term progressive wasting. The specific metabolic changes that cause secondary illnesses to induce weight loss in AIDS are not adequately understood.In addition, the ability of therapy for these secondary illnesses to reverse the metabolic changes, allowing weight gain, has not been properly explored. It is not known whether secondary infection induces increased replication of HIV itself or what the result of increased HIV replication are on energy balance. Finally, the mechanisms by which gastrointestinal disease leads to weight loss are not known. In order to understand the role of secondary illnesses and their treatment in the wasting syndrome of AIDS, the investigator proposes the following specific aims: 1) to determine which components of the energy balance equation, including resting energy expenditure, total energy expenditure and caloric intake, improve with the successful treatment of secondary infections; 2) to determine whether treatment of mycobacterium avium complex results in similar improvements in energy balance since sterilization of bacteria is not always possible; 3) to determine whether opportunistic infections increase HIV viral burden and to determine whether that increase is reversed with treatment of the infection; 4) to determine the effect of HIV viral burden on metabolism; and 5) to determine whether the wasting due to gastrointestinal disease and diarrhea is caused by failed compensatory responses in energy expenditure in the face of decreased food intake. It is the aim of this project, in the determination of the mechanisms of wasting induced by secondary illness, to potentially develop possible new therapeutic approaches in AIDS.

描述：艾滋病中的浪费综合症正在增加，并且 导致相当大的发病率并导致死亡率。 最初认为在艾滋病中浪费是不可避免的结果 艾滋病毒感染。但是，研究人员实验室的数据 其他人建议浪费是一种间歇现象 主要由继发性疾病诱导，包括全身感染 和胃肠道疾病。 虽然可能有体重 稳定性甚至体重增加，大多数患者表现出不完整的康复 从体重减轻发作，导致长期进行 浪费。 引起继发性疾病的特定代谢变化 诱导艾滋病的体重减轻并没有充分理解。加上 这些继发性疾病的治疗能力扭转了 代谢变化允许体重增加，尚未正确探索。 尚不清楚继发感染是否诱导复制增加 艾滋病毒本身或艾滋病毒复制增加的结果 能量平衡。 最后，胃肠道的机制 疾病导致体重减轻。 为了了解 继发性疾病的作用及其在浪费综合征中的治疗 在艾滋病中，研究人员提出了以下特定目的：1） 确定能源平衡方程的哪些组成部分，包括 静止的能量消耗，总能量消耗和热量摄入量， 通过成功治疗继发感染来改善； 2）到 确定治疗分枝杆菌复合物是否会导致 由于细菌灭菌，能量平衡的类似改善 并非总是可能的； 3）确定机会性感染是否 增加HIV病毒负担，并确定这种增加是否是 随着感染的治疗而逆转； 4）确定效果 艾滋病毒负担对代谢； 5）确定是否浪费 由于胃肠道疾病和腹泻是由失败引起的 面对减少的能量消耗的补偿性响应 食物摄入量。 这是该项目的目的 因继发疾病引起的浪费的机制，可能 在艾滋病中开发可能的新治疗方法。