Objective: To study the immunologic effects of recombinant human growth hormone (rhGH), recombinant human insulin-like growth factor type 1 (rhIGF-1), or the combination, in patients with moderately advanced HIV infection. Design: Randomized but not blinded trial. Setting: Government medical research center. Patients: Twenty-four HIV-infected patients with CD4 cell counts of 100-400 x 106/l who were receiving nucleoside antiretroviral therapy. Interventions: Either rhGH, rhIGF-1, or the combination was administered subcutaneously for 12 weeks. Main outcome measures: Immunologic parameters, including T-cell subsets and assays of in vitro interleukin (IL)-2 production in response to antigens and mitogens, and safety profile. Results: Plasma IGF-1 levels were low or low-normal prior to treatment and increased with all three therapies. There were no significant changes in CD4 cell counts, RA/RO CD4 cell subsets, natural killer cell function, immunoglobulin levels, or in vitro IL-2 production in response to mitogen or alloantigens. However, there was an upward trend (and for p18(IIIB) a statistically significant increase) in the in vitro IL-2 production in response to each of five HIV envelope peptides. Potential toxic effects included fatigue, arthralgia, edema, myalgia, and headache. Patients also were noted to have weight gain averaging 4 kg early in the course of treatment. Conclusions: These results suggest that treatment with rhGH/rhIGF-1 was reasonably well tolerated and that modest improvement in HIV-specific immune function was attained. Further studies will help clarify the therapeutic potential of rhGH/rhIGF-1 as an immunostimulator in the setting of HIV infection.
|Titolo:||Pilot study of the immunologic effects of recombinant human growth hormone and recombinant insulin-like growth factor in HIV-infected patients|
CLERICI, MARIO SALVATORE (Secondo)
|Parole Chiave:||Cellular immunity; Growth hormone; Immune reconstitution; Immunotherapy; Insulin-like growth factor; T-cell subset; Therapy; Wasting|
|Settore Scientifico Disciplinare:||Settore MED/04 - Patologia Generale|
|Data di pubblicazione:||1998|
|Digital Object Identifier (DOI):||10.1097/00002030-199808000-00012|
|Appare nelle tipologie:||01 - Articolo su periodico|