AIDS Q&A
愛滋Q&A
睡眠不足可能會加劇愛滋病毒感染者的炎症

莉茲·海利曼 / April 24, 2024 / 科學新聞 / POZ

根據在丹佛舉行的反轉錄病毒和伺機性感染會議 (CROI 2024) 上發表的研究,睡眠不足會導致愛滋病毒感染者的發炎增加,而通常抵消這一過程並鼓勵睡眠的補償機制可能無效。

研究顯示,許多 HIV 感染者(可能多達 70%)都難以獲得充足的睡眠。某些藥物的副作用、合併症和壓力都會導致睡眠不佳。睡眠不足與多種健康問題有關,包括心血管疾病。

匹茲堡大學的伯納德·馬卡坦蓋 (Bernard Macatangay) 醫學博士及其同事研究了短期睡眠不足對愛滋病毒陽性人群免疫活化和發炎程度的影響。他們還評估了腺苷途徑的功能,這是一種減少發炎和增加睡眠衝動的補償機制。先前的研究顯示,愛滋病毒感染者的這一通路失調。

這項分析包括 20 名愛滋病毒感染者,其中大多數是男性,他們接受了至少一年的穩定抗病毒治療和病毒抑制。中位數年齡約 60 歲,中位數 CD4 T 細胞數很高。他們首先進行一週的規律睡眠,每晚至少有八小時的睡眠時間,然後保持 24 小時的清醒狀態。

研究人員收集了睡眠剝奪前後的血液樣本,以測量T 細胞、單核細胞和巨噬細胞活化、細胞週期、CD39 和CD73(腺苷途徑活性標記)的T 細胞胞外酶表達以及發炎標記物(包括白血球介素6)的生物標記。

他們發現,睡眠剝奪後,CD8「殺手」T 細胞免疫活化水準顯著增加,但 CD4「輔助」T 細胞活化水準沒有差異。單核細胞和巨噬細胞的活化呈現增加趨勢,但這些差異並未達到統計學顯著性。 CD8 和 CD4 T 細胞的細胞週期均減少。 sCD163 有增加的趨勢,但 IL-6、TNF-α 或 sCD14 沒有差異。

儘管 CD8 活化和發炎增加,但他們沒有看到 T 細胞上 CD39 或 CD73 表達的補償性增加。睡眠剝奪前後的血漿腺苷水平相似,顯示補償途徑沒有啟動。

研究人員總結道:「我們的研究結果顯示,在病毒受到抑制的 HIV 感染者中,睡眠不足可能會通過激活 CD8 T 細胞和巨噬細胞來影響全身炎症」。 「然而,胞外酶的表達並沒有代償性增加,從而可以增加細胞外腺苷並抵消發炎過程」。

這些發現顯示,睡眠不足可能對愛滋病毒感染者特別有害,改善睡眠的介入措施應成為愛滋病毒照護的一部分。

Lack of Sleep May Worsen Inflammation in People With HIV

Liz Highleyman  / April 24, 2024 / SCIENCE NEWS / POZ

Inadequate sleep can contribute to increased inflammation in people living with HIV, and a compensatory mechanism that normally counteracts this process and encourages sleep may be ineffective, according to research presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2024) in Denver.

Studies have shown that many people with HIV—perhaps as many as 70%—have trouble getting enough sleep. Side effects of certain medications, comorbidities and stress can all lead to poor sleep. Inadequate sleep has been linked to a wide range of health problems, including cardiovascular disease.

Bernard Macatangay, MD, and colleagues at the University of Pittsburgh, looked at the effects of short-term sleep deprivation on levels of immune activation and inflammation in HIV-positive people. They also assessed the function of the adenosine pathway, a compensatory mechanism that reduces inflammation and increases the urge to sleep. Prior research has shown that this pathway is dysregulated in people with HIV.

This analysis included 20 people with HIV, mostly men, who were on stable antiretroviral therapy with viral suppression for at least one year. The median age was approximately 60 years, and the median CD4 T-cell count was high. They first had one week of regularized sleep, with at least eight hours of opportunity to sleep each night, then stayed awake for 24 hours.

The researchers collected blood samples before and after sleep deprivation to measure biomarkers of T-cell, monocyte and macrophage activation, cell cycling, T-cell ectoenzyme expression of CD39 and CD73 (markers of adenosine pathway activity) and inflammation markers, including interleukin 6 (IL-6), TNF-alpha, sCD14 and sCD163.

They found that CD8 “killer” T-cell immune activation levels increased significantly after sleep deprivation, though there was no difference in CD4 “helper” T-cell activation. There was a trend toward greater monocyte and macrophage activation, but these differences did not reach statistical significance. Cell cycling decreased for both CD8 and CD4 T cells. There was a trend toward an increase in sCD163, but no differences for IL-6, TNF-alpha or sCD14.

Despite the increase in CD8 activation and inflammation, they did not see a compensatory increase in the expression of CD39 or CD73 on T cells. Plasma adenosine levels were similar before and after sleep deprivation, indicating that the compensatory pathway did not kick in.

“Our results suggest that among virally suppressed people with HIV, sleep deprivation could impact systemic inflammation by activation of CD8 T cells and macrophages,” the researchers concluded. “However, there is no compensatory increase in ectoenzyme expression that can increase extracellular adenosine and counteract the inflammatory process.”

These findings suggest that inadequate sleep may be particularly detrimental for people living with HIV and that interventions to improve sleep should be part of HIV care.

Click here for more reports from CROI 2024.

購物車
Scroll to Top
訂閱電子報
訂閱電子報獲得紅絲帶最新消息!