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Bone metabolism dysfunction mediated by the increase of proinflammatory cytokines in chronic HIV infection

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Abstract

Despite the efficacy of antiretroviral therapy (ART) on the control of viral replication, the current challenge is to decrease the chronic inflammatory status and toxicity of the antiretroviral drugs that contribute to increase the risk of metabolic complications. To verify the influence of proinflammatory cytokines on bone metabolism mediated by chronic HIV infection, a cross-sectional study was conducted with 50 HIV-infected adult men treated or not treated with ART. Dual energy X-ray absorptiometry (DXA) was performed to assess bone mineral density. Biochemical analysis were performed of IL-6, TNF-α, osteocalcin, PTH, 25-OH-D, total calcium, albumin, 24 h urinary calcium, and urinary deoxypyridinoline. The participants not treated with ART exhibited higher values of IL-6 and TNF-α than the participants treated with ART for more than 2 years. The TNF-α values were higher in the participants treated with ART for <2 years than in participants treated with ART for more than 2 years (p < 0.05). The increased values of urinary deoxypyridinoline indicated a high reabsorptive activity of bone tissue in all groups, with a significant difference between the participants not treated with ART and the participants treated with ART for <2 years. Through the DXA we found a bone mass reduction in all bone sites in each group. The increase in production of proinflammatory cytokines, most notably in the viremic group, demonstrated the ability to stimulate osteoclast activity and subsequently affect bone mass. The reduction of bone mineral density was observed in all bone sites, principally for the groups receiving antiretroviral treatment.

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Acknowledgments

The authors would like to thank the Special Treatment Unit for Infectious Diseases of the Clinical Hospital of Ribeirão Preto, University of São Paulo, Brazil; the Foundation for the Support of Teaching, Research and Service—FAEPA of HCRP-FMRP; the Clinical Research Unit—UPC of HCRP-FMRP for supporting this research and the Sao Paulo Research Foundation (FAPESP) Grant#2013/11535-2 and Grant#2013/10765-4 for the support provided to Dr. Anderson Marliere Navarro and Erika Grasiela Marques de Menezes. Dr. Francisco José Albuquerque de Paula received a grant from CNPq (306027/2011-9). The authors are in debt to all the volunteers that participated in the study.

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Authors and Affiliations

  1. Department of Food and Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo - UNESP, Araraquara, Brazil

    Erika Grasiela Marques de Menezes

  2. Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Brazil

    Alcyone Artioli Machado, Francisco José Albuquerque de Paula & Anderson Marliere Navarro

  3. Department of Clinical Analysis, Toxicological and Bromatology, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo - FCFRP/USP, Ribeirao Preto, Brazil

    Fernando Barbosa Jr.

  4. Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil

    Erika Grasiela Marques de Menezes

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  1. Erika Grasiela Marques de Menezes
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  2. Alcyone Artioli Machado
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  3. Fernando Barbosa Jr.
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  4. Francisco José Albuquerque de Paula
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  5. Anderson Marliere Navarro
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Correspondence to Erika Grasiela Marques de Menezes.

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de Menezes, E.G.M., Machado, A.A., Barbosa, F. et al. Bone metabolism dysfunction mediated by the increase of proinflammatory cytokines in chronic HIV infection. J Bone Miner Metab 35, 234–242 (2017). https://doi.org/10.1007/s00774-016-0749-8

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  • DOI: https://doi.org/10.1007/s00774-016-0749-8

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