مجله دانشکده پزشکی اصفهان

مجله دانشکده پزشکی اصفهان

آنتی‌اکسیدان‌‌ها و بهبود عملکرد سیستم ایمنی در بیماران آلوده به ویروس HIV: یک مقاله‌ی مروری

نوع مقاله : Review Article

نویسندگان
نرگس جانی 1
قاسم یادگارفر 2
مریم حاجی شفیعی 3
لیلا آزادبخت 4
1 کارشناس، گروه تغذیه، دانشکده‌ی تغذیه و علوم غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
2 استادیار، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
3 دانشجوی کارشناسی، کمیته‌ی تحقیقات دانشجویی، گروه تغذیه، دانشکده‌ی تغذیه و علوم غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
4 دانشیار، مرکز تحقیقات امنیت غذایی، گروه تغذیه‌ی جامعه، دانشکده‌ی تغذیه و علوم غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
چکیده
مقدمه: آمار جهانی بیانگر رشد سریع شیوع ویروس نقص ایمنی انسانی (Human Immunodeficiency virus یا HIV) در جهان است. مطالعات بسیاری در زمینه‌ی عوامل مرتبط با سندرم نقص ایمنی اکتسابی (Acquired immune deficiency syndrome یا AIDS) و شیوع HIV انجام گرفته است که بخشی از آن‌‌ها به بعد تغذیه‌ای این بیماری اختصاص دارد. ضعف و ناتوانی ناشی از دریافت ناکافی مواد غذایی به دلیل بی‌اشتهایی، عدم جذب مناسب مواد مغذی در سطح روده منجر به تشدید ضعف جسمانی افراد آلوده به HIV شده که این ضعف منجر به پیشرفت علایم بیماری ایدز و حملات بیشتر عفونت‌‌های فرصت‌طلب می‌شود. عوامل تغذیه‌ای و متابولیکی به طور قابل توجهی در ضعف و مرگ و میر بیماران مبتلا به ایدز دخیل هستند. پیشرفت بیماری در بدن انسان منجر به تحریک سیستم ایمنی و افزایش استرس اکسیداتیو و به دنبال آن کاهش سطح آنتی‌اکسیدان‌‌ها‌ی پلاسمای خون می‌شود. بنابراین برخورداری از یک رژیم غذایی مناسب و یا استفاده‌ی از مکمل‌‌های آنتی‌اکسیدانی به عنوان یک درمان مؤثر و کم هزینه در کنار سایر درمان‌‌های دارویی منجر به تقویت سیستم ایمنی و بهبود وضعیت بیماران می‌شود. در مطالعه‌ی مروری حاضر به بررسی مطالعات صورت گرفته در زمینه‌ی اثر آنتی‌اکسیدان‌‌ها بر سیستم ایمنی و در نهایت اثر بر روند پیشرفت بیماری ایدز در افراد آلوده به ویروس HIV پرداخته شده است.
کلیدواژه‌ها
ویروس نقص ایمنی انسانی
آنتی‌اکسیدان
استرس اکسیداتیو
سیستم ایمنی

عنوان مقاله English

Antioxidants and Improvement of Immune System Function in HIV infected Patients: A Review Article

نویسندگان English

Narges Jani 1
Ghasem Yadegarfar 2
Maryam Hajishafiyee 3
Leila Azadbakht 4
1 BSc, Department of Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
3 BSc Student, Student Research Committee, Department of Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Associate Professor, Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
چکیده English

Background: World’s statistics show the fast growth of prevalence of Human Immunodeficiency Virus (HIV) in all over the world. A great deal of studies relevant to the all effective factors of HIV/AIDS (Acquired immune deficiency syndrome), some parts of them related to nutrition. Disability to eat and digest foods and to absorb nutrients from food is one of the results of weakness and wasting of all HIV infected patients. This kind of weakness affects to intensification of signs of disease and increase risk of opportunistic infections. Nutritional and metabolic factors significantly affect morbidity and mortality of HIV/AIDS patients. The progression of disease in human body is causing to stimulate the immune system and increase the oxidative stress and also decrease the antioxidants level of plasma.Consequently using diversity diet or antioxidant supplementation as an effective and no expensive treatment is useful along the other clinical treatments to improve immune system and welfare the patient’s status. In this review article we try to examine studies which are related to the effect of antioxidants on the immune system and finally the effects of them on progression of disease in HIV infected patients. 

کلیدواژه‌ها English

Human Immunodeficiency virus (HIV)
Antioxidant
Oxidative Stress
Immune system
  1. Keithley JK, Swanson B. Minimizing HIV/AIDS malnutrition. Medsurg Nurs 1998; 7(5): 256-67.
  2. Colecraft E. HIV/AIDS: nutritional implications and impact on human development. Proc Nutr Soc 2008; 67(1): 109-13.
  3. Thomas AM, Mkandawire SC. The impact of nutrition on physiologic changes in persons who have HIV. Nurs Clin North Am 2006; 41(3): 455-68, viii.
  4. Thuita FM, Mirie W. Nutrition in the manage-ment of acquired immunodeficiency syndrome. East Afr Med J 1999; 76(9): 507-9.
  5. Sherlekar S, Udipi SA. Role of nutrition in the management of HIV infection/AIDS. J Indian Med Assoc 2002; 100(6): 385-90.
  6. Gitau R, Kasonka L, Newens k, Chisenga M, Makasa M, Kasolo F, Sinkala M, Chintu CH, Kaseba CH, Tomkins A, Filteau S. Plasma vita-min A and E levels of HIV-infected and HIV-uninfected Zambian women during pregnancy and lactation. T Roy Soc Trop Med H 2003; 97(6): 627-628.
  7. Treitinger A, Spada C, Verdi JC, Miranda AF, Oliveira OV, Silveira MV, et al. Decreased anti-oxidant defence in individuals infected by the human immunodeficiency virus. Eur J Clin In-vest 2000; 30(5): 454-9.
  8. Wanke C. Nutrition and HIV in the international setting. Nutr Clin Care 2005; 8(1):44-8.
  9. Singhal N, Austin J. A clinical review of micronu-trients in HIV infection. J Int Assoc Physicians AIDS Care (Chic) 2002; 1(2): 63-75.
  10. Baum MK, Shor-Posner G. Micronutrient status in relationship to mortality in HIV-1 disease. Nutr Rev 1998; 56(1 Pt 2): S135-S139.
  11. Chandra RK. Nutrition and immunology: from the clinic to cellular biology and back again. Proc Nutr Soc 1999; 58(3): 681-3.
  12. Hurwitz BE, Klaus JR, Llabre MM, Gonzalez A, Lawrence PJ, Maher KJ, et al. Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Arch Intern Med 2007; 167(2): 148-54.
  13. Abrams DI. Potential interventions for HIV/AIDS wasting: an overview. J Acquir Im-mune Defic Syndr 2000; 25 Suppl 1: S74-S80.
  14. Ball CS. Global issues in pediatric nutrition: AIDS. Nutrition 1998; 14(10): 767-70.
  15. Ravanshad SH. Nutrition in patients with HIV infection. Proceedings of the 5th Iranian congress of nutrition; 1999; Shiraz, Iran.
  16. Allard JP, Aghdassi E, Chau J, Tam C, Kovacs CM, Salit IE, et al. Effects of vitamin E and C supplementation on oxidative stress and viral load in HIV-infected subjects. AIDS 1998 10; 12(13): 1653-9.
  17. Allard JP, Aghdassi E, Chau J, Salit I, Walmsley S. Oxidative stress and plasma antioxidant mi-cronutrients in humans with HIV infection. Am J Clin Nutr 1998; 67(1): 143-7.
  18. Kline D. HIV/AIDS Immune Function & Nutri-tion. Available from:
  19. http://www.nutritiondimension.com. Accessed 29 Nov 2009.
  20. Olaniyi JA, Arinola OG. Essential trace elements and antioxidant status in relation to severity of HIV in Nigerian patients. Med Princ Pract 2007; 16(6): 420-5.
  21. Beck MA. Nutritionally induced oxidative stress: effect on viral disease. Am J Clin Nutr 2000 Jun; 71(6 Suppl): 1676S-81S.
  22. Kruzich LA, Marquis GS, Carriquiry AL, Wilson CM, Stephensen CB. US youths in the early stages of HIV disease have low intakes of some micronutrients important for optimal immune function. J Am Diet Assoc 2004; 104(7): 1095-101.
  23. Taye B, Shiferaw S, Enquselassie F. The impact of malnutrition in survival of HIV infected chil-dren after initiation of antiretroviral treatment (ART). Ethiop Med J 2010; 48(1): 1-10.
  24. Sarrafzadegan N, Azadbakht L, Mohammadi-fard N, Esmaillzadeh A, Safavi M, Sajadi F, et al. Do lifestyle interventions affect dietary diver-sity score in the general population? Public Health Nutr 2009; 12(10): 1924-30.
  25. Mirmiran P, Azadbakht L, Azizi F. Dietary diver-sity within food groups: an indicator of specific nutrient adequacy in Tehranian women. J Am Coll Nutr 2006; 25(4): 354-61.
  26. Azadbakht L, Mirmiran P, Hosseini F, Azizi F. Diet quality status of most Tehranian adults needs improvement. Asia Pac J Clin Nutr 2005; 14(2): 163-8.
  27. Suresh DR, Annam V, Pratibha K, Prasad BV. Total antioxidant capacity--a novel early bio-chemical marker of oxidative stress in HIV in-fected individuals. J Biomed Sci 2009; 16: 61.
  28. Pace GW, Leaf CD. The role of oxidative stress in HIV disease. Free Radic Biol Med 1995; 19(4): 523-8.
  29. Jaruga P, Jaruga B, Gackowski D, Olczak A, Halota W, Pawlowska M, et al. Supplementation with antioxidant vitamins prevents oxidative modification of DNA in lymphocytes of HIV-infected patients. Free Radic Biol Med 2002; 32(5): 414-20.
  30. Coaccioli S, Crapa G, Fantera M, Del GR, Lav-agna A, Standoli ML, et al. Oxidant/antioxidant status in patients with chronic HIV infection. Clin Ter 2010; 161(1): 55-8.
  31. Drain PK, Kupka R, Mugusi F, Fawzi WW. Mi-cronutrients in HIV-positive persons receiving highly active antiretroviral therapy. Am J Clin Nutr 2007; 85(2): 333-45.
  32. Packer L, Suzuki YJ. Vitamin E and alpha-lipoate: role in antioxidant recycling and activa-tion of the NF-kappa B transcription factor. Mol Aspects Med 1993; 14(3): 229-39.
  33. Szondy Z, Toth R, Szegezdi E, Reichert U, An-cian P, Fesus L. Cell death in HIV pathogenesis and its modulation by retinoids. Ann N Y Acad Sci 2001; 946: 95-107.
  34. Elbim C, Pillet S, Prevost MH, Preira A, Girard PM, Rogine N, et al. The role of phagocytes in HIV-related oxidative stress. J Clin Virol 2001; 20(3):99-109.
  35. Airo P, Torti C, Uccelli MC, Malacarne F, Palva-rini L, Carosi G, et al. Naive CD4+ T lympho-cytes express high levels of Bcl-2 after highly ac-tive antiretroviral therapy for HIV infection. AIDS Res Hum Retroviruses 2000; 16(17): 1805-7.
  36. Sepulveda RT, Watson RR. Treatment of anti-oxidant deficiencies in AIDS patients. Nutrition Research 2002; 22(1):27-37.
  37. Azzi A, Stocker A. Vitamin E: non-antioxidant roles. Prog Lipid Res 2000; 39(3): 231-55.
  38. Karimi I, Kasaian N, Ataiee B, Taieri K, Zare M, Azadbakht L. Assessment of anthropometric in-dices and food intake in patients with HIV infec-tion. Journal of Isfahan Medical School 2010; 28: 238-247
  39. Jiamton S, Pepin J, Suttent R, Filteau S, Mahak-kanukrauh B, Hanshaoworakul W, et al. A ran-domized trial of the impact of multiple micronu-trient supplementation on mortality among HIV-infected individuals living in Bangkok. AIDS 2003; 17(17): 2461-9.
  40. Muller F, Svardal AM, Nordoy I, Berge RK, Aukrust P, Froland SS. Virological and immuno-logical effects of antioxidant treatment in pa-tients with HIV infection. Eur J Clin Invest 2000; 30(10): 905-14.
  41. Visser ME, Maartens G, Kossew G, Hussey GD. Plasma vitamin A and zinc levels in HIV-infected adults in Cape Town, South Africa. Br J Nutr 2003; 89(4): 475-82.
  42. Humphrey JH, Iliff PJ, Marinda ET, Mutasa K, Moulton LH, Chidawanyika H, et al. Effects of a single large dose of vitamin A, given during the postpartum period to HIV-positive women and their infants, on child HIV infection, HIV-free survival, and mortality. J Infect Dis 2006; 193(6): 860-71.
  43. Mehta S, Fawzi W. Effects of vitamins, including vitamin A, on HIV/AIDS patients. Vitam Horm 2007; 75: 355-83.
  44. Chandra RK. Nutrition and the immune system. Proc Nutr Soc 1993; 52(1): 77-84.
  45. Kohrl J, Brigelius-Flohe R, Bock A, Gartner R, Meyer O, Flohe L. Selenium in biology: facts and medical perspectives. Biol Chem 2000; 381(9-10): 849-64.
  46. Beck MA, Levander OA. Host nutritional status and its effect on a viral pathogen. J Infect Dis 2000; 182 (Suppl 1): S93-S96.
  47. Forceville X, Vitoux D, Gauzit R, Combes A, Lahilaire P, Chappuis P. Selenium, systemic im-mune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med 1998; 26(9): 1536-44.
  48. Kupka R, Msamanga GI, Spiegelman D, Morris S, Mugusi F, Hunter DJ, et al. Selenium status is associated with accelerated HIV disease progres-sion among HIV-1-infected pregnant women in Tanzania. J Nutr 2004; 134(10): 2556-60.
  49. Baum MK, Miguez-Burbano MJ, Campa A, Shor-Posner G. Selenium and interleukins in per-sons infected with human immunodeficiency vi-rus type 1. J Infect Dis 2000; 182 (Suppl 1): S69-S73.
  50. Staal F. Antioxidant therapy for AIDS. Eur J Clin Invest 2000; 30(10): 841-2.
  51. Aukrust P, Muller F. Glutathione redox disturb-ances in human immunodeficiency virus infec-tion: immunologic and therapeutic consequenc-es. Nutrition 1999; 15(2): 165-7.
  52. Khalili H, Soudbakhsh A, Hajiabdolbaghi M, Dashti-Khavidaki S, Poorzare A, Saeedi AA, et al. Nutritional status and serum zinc and seleni-um levels in Iranian HIV infected individuals. BMC Infect Dis 2008; 8: 165.
  53. Glass DJ. Signalling pathways that mediate skel-etal muscle hypertrophy and atrophy. Nat Cell Biol 2003; 5(2): 87-90.
  54. Koch J, Neal EA, Schlott MJ, Garcia-Shelton YL, Chan MF, Weaver KE, et al. Zinc levels and in-fections in hospitalized patients with AIDS. Nu-trition 1996; 12(7-8): 515-8.
  55. Kupka R, Fawzi W. Zinc nutrition and HIV in-fection. Nutr Rev 2002; 60(3): 69-79.
  56. Kelly P, Katubulushi M, Todd J, Banda R, Yam-bayamba V, Fwoloshi M, et al. Micronutrient supplementation has limited effects on intestinal infectious disease and mortality in a Zambian population of mixed HIV status: a cluster ran-domized trial. Am J Clin Nutr 2008; 88(4): 1010-7.
  57. Fawzi WW, Msamanga GI, Kupka R, Spiegel-man D, Villamor E, Mugusi F, et al. Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tan-zania. Am J Clin Nutr 2007; 85(5): 1335-43.
  58. Azadbakht L, Esmaillzadeh A. Dietary diversity score is related to obesity and abdominal adipos-ity among Iranian female youth. Public Health Nutr 2011; 14(1): 62-9.
  59. Azadbakht L, Kimiagar M, Mehrabi Y, Esmaill-zadeh A, Hu FB, Willett WC. Soy consumption, markers of inflammation, and endothelial func-tion: a cross-over study in postmenopausal women with the metabolic syndrome. Diabetes Care 2007; 30(4): 967-73.
  60. Sharma TS, Kinnamon DD, Duggan C, Weinberg GA, Furuta L, Bechard L, et al. Changes in mac-ronutrient intake among HIV-infected children between 1995 and 2004. Am J Clin Nutr 2008; 88(2): 384-91.
مجله دانشکده پزشکی اصفهان
دوره 29، شماره 135 - شماره پیاپی 135
خرداد و تیر 1390
صفحه 445-456

  • تاریخ دریافت 01 آذر 1389
  • تاریخ پذیرش 17 فروردین 1401