Soluble Adhesion Molecules and Endothelial Cell Damage in HIV Infected Patients

Abstract

SummaryEndothelial damage is present in HIV infection but our understanding of markers and mechanisms is incomplete. We found increased levels of markers of endothelial cell damage such as von Willebrand factor (vWf), soluble thrombomodulin (sTM) and adhesion molecule E- selectin in 90 subjects seropositive for HIV relative to healthy controls. sTM was strongly raised in those patients with the lowest CD4+ cell count (p <0.001), but levels of vWf increased at each incremental fall in CD4+ cell count and the two indices correlated significantly (r = -0.485, p <0.001). vWf correlated strongly with levels of the inflammatory cytokines tumor necrosis factor (TNF-α) and alpha interferon (IFN-α) but sTM correlated only weakly with IFN-α. We suggest that increased vWf is largely the result of inflammatory stimulus of the endothelium but that sTM is found only in those patients with more severe disease, and so truely represents endothelial damage.

Expanding Role of Circulating Adhesion Molecules in Assessing Prognosis and Treatment Response in Human Immunodeficiency Virus Infection

“…As we have shown, levels of sEs in HIV-infected patients (without concomitant fever, opportunistic infection, or neoplasm) are elevated compared to those in healthy controls, while a significant increase was observed with disease progression (75). Although some subsequent studies confirmed the elevated levels of sEs compared to those for healthy controls (52,73), in other studies no significant differences were demonstrated (3,28,45) (Table 2). This was probably due to the fact that these studies included patients with concomitant opportunistic infections or neoplasms.…”

What a Cardiologist Needs to Know About Patients With Human Immunodeficiency Virus Infection

“…29 Soluble adhesion molecules indicative of endothelial damage are elevated in HIV-infected patients. 30 In another study, patients receiving HAART had higher levels of P-selectin, plasminogen activator inhibitor type 1, and tissue plasminogen activator but not soluble intracellular adhesion molecule-1, and there was no significant difference in the levels of these markers between patients receiving PIs and non-NRTIs (NNRTIs). 31 …”

Nucleoside reverse transcriptase inhibitors impair endothelium-dependent relaxation by increasing superoxide

“…HIV-1 infection is associated with vasculitis in small blood vessels (3,34) and with aneurysms in medium or large arteries (35). Serum levels of markers of endothelial activation, including von Willebrand factor antigen, soluble thrombomodulin, and E-selectin, correlate with disease severity in patients infected with HIV-1 (44,45). A study examining the capacity of arteries from HIV-positive patients to vasodilate established that postischemic reactive hyperemia, a measure of endothelial function, is impaired in HIVinfected patients (40).…”