Acquired immune deficiency syndrome: The glucocorticoid solution

Corley, P.A.

doi:10.1016/s0306-9877(96)90043-2

Cited by 24 publications

(18 citation statements)

References 30 publications

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“…In this sample, adherence to medication does not explain the effect. Alterations in the hypothalamic-pituitary-adrenocortical system, including cortisol, have been demonstrated both in stress and depression, have been predictive of faster disease progression in HIV (4,13), and may stimulate HIV replication (50). Similarly, products of the sympathetic nervous system (norepinephrine) become elevated during stress and have been shown to enhance HIV viral replication in vitro (51,52).…”

Section: Discussionmentioning

confidence: 99%

“…HAART, highly active antiretroviral treatment VL, viral load HIV, human immunodeficiency virus AIDS, acquired immunodeficiency syndrome PI, protease inhibitor HLM, hierarchical linear modeling DR, decline ratio SES, socioeconomic status BDI, Beck Depression Inventory BHS, Beck Hopelessness Scale N/A, not applicable Group average initial CD4 γ 10 Average linear change in CD4 per month γ 20 and γ 30 Average effect on level of CD4 across patients from antiretroviral 1 or 2 γ 40 and γ 50 Average effect on change in CD4 across patients from antiretroviral 1 or 2 γ 11 −γ 15 Effect of the a priori covariates on change in CD4 γ 16 Effect of individual differences on CD4 slope (γ 10 ) attributable to putative psychological variables The u terms represent unexplained individual variance associated with estimation of the γ coefficients. The u terms for the level 2 antiretroviral equations were not significant and were fixed at zero.…”

Section: Glossarymentioning

confidence: 99%

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Psychosocial Factors Predict CD4 and Viral Load Change in Men and Women With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Treatment

Ironson

O’Cleirigh

Fletcher

et al. 2005

Psychosomatic Medicine

312

245

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Objective-Most previous longitudinal studies demonstrating relationships between psychosocial variables and human immunodeficiency virus (HIV) disease progression utilized samples of gay men accrued before the era of highly active antiretroviral treatment (HAART), without including viral load (VL) as an indicator of disease progression or assessing the impact of medication adherence. This study sought to determine whether psychosocial variables would predict both CD4 and VL changes in a diverse sample assessed entirely during the era of HAART and accounting for adherence effects.Methods-This longitudinal study assessed a multiethnic HIV+ sample (n = 177) of men and women in the midrange of illness (CD4 number between 150 and 500; no previous acquired immunodeficiency syndrome [AIDS]-defining symptom) every 6 months for 2 years. Hierarchical linear modeling was used to model change in CD4 and VL controlling for sociodemographics (age, gender, ethnicity, education) and medical variables (baseline CD4/VL, antiretroviral medications at each time point, adherence).Results-Baseline depression, hopelessness, and education predicted the slope of CD4 and VL. Avoidant coping and life event stress predicted VL change. Cumulative variables produced stronger relationships (depression, avoidant coping, and hopelessness with CD4/VL slope and life events stress with VL slope). High cumulative depression and avoidant coping were associated with approximately twice the rate of decline in CD4 as low scorers and greater relative increases in VL. Social support was not significantly related to CD4 or VL slope.Conclusions-Psychosocial factors contribute significantly to the variance in HIV disease progression (assessed through CD4 number and VL) in a diverse sample, accounting for adherence and do so in the era of HAART.

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Section: Discussionmentioning

confidence: 99%

Section: Glossarymentioning

confidence: 99%

Psychosocial Factors Predict CD4 and Viral Load Change in Men and Women With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Treatment

Ironson

O’Cleirigh

Fletcher

et al. 2005

Psychosomatic Medicine

312

245

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“…Depression, depressive symptoms and psychological stress are associated with poor adherence to antiretroviral treatment, deterioration in psychosocial functioning, more rapid progression of HIV/ AIDS and higher mortality (60,(63)(64)(65)67,(74)(75)(76). Evidence also suggests that endocrine/immune system changes associated with depression might affect HIV entry and replication, thereby increasing the risk of HIV infection (72,(77)(78)(79).…”

Section: Hiv/aidsmentioning

confidence: 99%

“…Some evidence suggests that cortisol is positively related to stress and depression in HIV (79) and that cortisol may alter immune response by promoting viral replication (78), altering programmed cell death and cytokines secreted (77,78), changes that have been associated with HIV disease progression. Increased sympathetic activity via norepinephrine has been shown to affect HIV replication.…”

Section: Mechanisms Of Hiv Effect and Depressionmentioning

confidence: 99%

Medical Co-Morbidity in Depressive Disorders

Benton

Staab

Evans

2007

Annals of Clinical Psychiatry

137

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Background. Depression is much more prevalent among those with chronic medical conditions compared to the general population of the United States. Depression is recognized as a cause of increased morbidity and mortality and has been associated with higher health care costs, adverse health behaviors, significant functional impairment, lost work productivity, occupational disability and increased health care utilization. Method. Searches of Medline, OVIDMedline, PubMed and PsycINFO of all English-language articles published between 1966 and 2007 were conducted using the keywords mood disorders, medical comorbidity, depression, antidepressant therapy. Supplemental references were manually extracted from relevant articles and chapters. Reviews of mechanistic studies and open label and randomized controlled trials of depression in patients with medical co morbidities were reviewed. Results. Depressive disorders are prevalent among the medically ill and the relationship between depression and medical illness may be bidirectional. Antidepressant medications are effective in the treatment of depression in the medically ill. Conclusions. Depressive disorders can adversely impact the course of medical illnesses. Available antidepressant treatments are effective for the treatment of depression in the medically ill. Early identification and treatment of depression in medical illness can positively influence medical outcomes and quality of life.

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“…Excessive cortisol synthesis leads to changes in metabolism, cognitive impairment (McEwen, 1994), and immunosuppression (Chrousos and Gold, 1992). Indeed, abnormalities at different levels of the hypothalamic-pituitary-adrenal (HPA) axis have been reported in several diseases such as psychiatric disorders, including depression and mood alteration (Kiraly et al, 1997;Tafet et al, 2001); acquired immunodeficiency syndrome (AIDS) (Corley, 1996;Bhansali et al, 2000;Christeff et al, 2000); multiple sclerosis (Erkut et al, 2002); dementia (Maeda et al, 1991;Polleri et al, 2002), including Alzheimer's disease (AD) (Swaab et al, 1994;O'Brien et al, 1996;Weiner et al, 1997;Giubilei et al, 2001;Rasmuson et al, 2002); and breast cancer outcome (Luecken and Compas, 2002). It has been proposed that disruption of hormonal balance in these diseases leads to increased cortisol production, resulting in elevated concentrations of cortisol in cerebrospinal fluid (Swaab et al, 1994;Erkut et al, 2002), blood (Weiner et al, 1997;Bhansali et al, 2000;Rasmuson et al, 2002), urine (Maeda et al, 1991), and saliva (Giubilei et al, 2001).…”

mentioning

confidence: 99%

Inhibition of Adrenal Cortical Steroid Formation by Procaine Is Mediated by Reduction of the cAMP-Induced 3-Hydroxy-3-methylglutaryl-coenzyme A Reductase Messenger Ribonucleic Acid Levels

Xu¹,

Lecanu²,

Han³

et al. 2003

J Pharmacol Exp Ther

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Elevated glucocorticoid levels are associated with many diseases, including age-related depression, hypertension, Alzheimer's disease, and acquired immunodeficiency syndrome. Cortisol-lowering agents could provide useful complementary therapy for these disorders. We examined the effect of procaine and procaine in a pharmaceutical formulation on adrenal cortical steroid formation. Procaine inhibited dibutyryl cyclic AMP (dbcAMP)-induced corticosteroid synthesis by murine Y1 and human H295R adrenal cells in a dose-dependent manner without affecting basal steroid formation. Treatment of rats with the procaine-based formulation reduced circulating corticosterone levels. This steroidogenesis-inhibiting activity of procaine was not observed in Leydig cells, suggesting that the effect was specific to adrenocortical cells. In search of the mechanism underlying this inhibitory effect on cAMP-induced corticosteroidogenesis, procaine was found to affect neither the cAMPdependent protein kinase activity nor key proteins involved in cholesterol transport into mitochondria, cytochrome P450 side chain cleavage enzyme expression, and enzymatic activities associated with cholesterol metabolism to final steroid products. However, procaine reduced in a dose-dependent manner the 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCoA) activity and the dbcAMP-induced HMG-CoA reductase mRNA levels by affecting mRNA stability. These data suggest that the inhibitory effect of procaine on cAMP-induced corticosteroid formation is due to the reduced synthesis of cholesterol. This modulatory effect of procaine on HMG-CoA reductase mRNA expression was also seen in dbcAMP-stimulated Hepa1-6 mouse liver hepatoma cells. Taken together, these results suggest that procaine may provide a pharmacological means for the control of hormone-induced HMG-CoA reductase mRNA expression and hypercortisolemia.

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Acquired immune deficiency syndrome: The glucocorticoid solution

Cited by 24 publications

References 30 publications

Psychosocial Factors Predict CD4 and Viral Load Change in Men and Women With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Treatment

Psychosocial Factors Predict CD4 and Viral Load Change in Men and Women With Human Immunodeficiency Virus in the Era of Highly Active Antiretroviral Treatment

Medical Co-Morbidity in Depressive Disorders

Inhibition of Adrenal Cortical Steroid Formation by Procaine Is Mediated by Reduction of the cAMP-Induced 3-Hydroxy-3-methylglutaryl-coenzyme A Reductase Messenger Ribonucleic Acid Levels

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