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  • 1
    ISSN: 1432-1440
    Keywords: HIV-1 ; Endothelins ; Endothelin-1 ; Cytokine ; Retinal microangiopathic syndrome ; Vascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endothelin-1 is a recently identified cytokine with potent vasoconstrictor activity which is associated with various diseases involving blood vessels. HIV-1 related retinal microangiopathic syndrome is a frequent finding in patients with AIDS or AIDS-related complex, presenting predominantly with retinal cotton-wool spots. We investigated 55 HIV-1 infected patients by ophthalmoscopy and for endothelin-I immunoreactivity in plasma and an additional 76 HIV-1 infected patients only for endothelin-1 levels. For reference values 13 age-matched healthy subjects were studied. In 18 of 55 patients (33%) investigated ophthalmoscopically we found evidence of microangiopathic syndrome. Overall, the mean endothelin-1 immunoreactivity in plasma of HIV-1 infected patients was significantly elevated as compared to controls (4.28 ± 3.62 versus 2.72 ± 0.67 fmol/ml, P 〈 0.0001). HIV-1 infected patients with retinal microangiopathic syndrome had significantly higher plasma levels of endothelin-1 immunoreactivity (4.59 ± 1.38 fmol/ ml) compared to HIV-1 infected patients without microangiopathic syndrome (3.18 ± 1.64 fmol/ml, P = 0.003). Correlation analysis revealed that endothelin-1 immunoreactivity in plasma had no significant association with disease progression, CD4 cell count, β2-mi-croglobulin, neopterin, or age. Endothelin-1 immunoreactivity in plasma was correlated exclusively with retinal microangiopathic syndrome in one or both eyes (r = 0.45, P = 0.0006) and with the number of cotton-wool spots (r = 0.50, P = 0.0001). In conlusion, HIV-1 related retinal microangiopathic syndrome is associated with elevated plasma levels of endothelin-1. By virtue of its potent vasoconstrictor activity endothelin-1 may be involved in the pathogenesis of HIV-1 related vascular disease.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In dieser Studie wurden die Pharmakokinetik von oral appliziertem Zidovudin bei 46 HIV-infizierten Kindern und Erwachsenen untersucht. Zur Auswertung wurden die Patienten in drei Altersgruppen gleicher Größe eingeteilt: Kinder von 4 Monaten bis 4 Jahre (Gruppe 1, n=15), Kinder von 4 bis 13 Jahren (Grupp 2, n=16) und junge Erwachsene (Gruppe 3, n=15). Nach Einnahme einer oralen Einzeldosis wurde halbstündlich über 4 Stunden Blut entnommen. Die Zidovudin-Konzentrationen im Plasma wurden mittels Hochdruckflüssigkeits-Chromatographie bestimmt. Zur besseren Vergleichbarkeit von dosisabhängigen Parametern wurde die Maximalkonzentration (Cmax) und die Fläche unter der Zeit-Konzentrationskurve (AUC) auf die Dosis/Körpergewicht bzw. Dosis/Körperoberfläche normalisiert. Die Zeit bis zum Erreichen von Cmax und die Eliminationshalbwertszeit (t1/2β=63.4±47.6, 74.9±54.9 und 56.9±16.4 min in Gruppe 1, 2 und 3, Mittelwert±Standardabweichung) waren nicht signifikant zwischen den drei Gruppen verschieden. Nach Normalisierung auf Dosis/Körpergewicht wiesen Kinder in Gruppe 1 im Vergleich zu Gruppe 3 signifikant niedrigere Werte für die Cmax (2.7±1.3 vs. 4.6±2.4 µmol/l, p=0.016) und die AUC (226±108 vs 373±224 µmol·min/l, p=0.038) auf. Die Mittelwerte für Cmax und AUC für die Gruppe 2 lagen zwischen den für Gruppe 1 und 3 gemessenen Werten. Nach Normalisierung auf Dosis/Körperoberfläche hingegen, waren die Unterschiede zwischen den drei Gruppen nicht signifikant (Cmax: 6.5±3.3, 7.3±4.2 und 6.8±3.6 µmol/l; AUC: 563±313, 691±351 und 555±342 µmol·min/l, jeweils in Gruppe, 1, 2 und 3). Es ist daher naheliegend, daß altersbedingte Veränderungen im Körperwasseranteil für die beobachteten Unterschiede zumindest teilweise verantwortlich sind. Zusammenfassend läßt sich sagen, daß die Pharmakokinetik von Zidovudin für Kinder älter als 3 Monate nicht altersabhängig zu sein scheint.
    Notes: Summary The pharmacokinetics of oral zidovudine in HIV-infected children and adults are reported. Fourty-six patients were investigated. For data analysis three groups of similar size were formed: young children 4 months −4 years, n=15 (group 1), older children up to 13 years, n=16 (group 2) and young adults, n=15 (group 3). After a single oral dose repeated blood samples were taken 1/2 hourly during a period of 4 hours and zidovudine concentrations in plasma were determined by high performance liquid chromatography. For better comparison of dose dependent parameters peak concentrations (Cmax) and the area under the time-concentration curves (AUC) were normalized either to the dose/body weight (bw) or the dose/body surface area (bs), respectively. Time to reach peak concentrations and mean terminal elimination half-life times (t1/2β=63.4±47.6, 74.9±54.9 and 56.9±16.4 min in group 1, 2 and 3, respectively, mean ± SD) were not significantly different between the three groups. With normalization to dose/bw young children in comparison to adults had significantly lower Cmax (2.7±1.3 vs. 4.6±2.4 µmol/l, p=0.016) and AUC (226±108 vs. 373±224 µmol·min/l, p=0.038). Group 2 gave intermediate values. However, with normalization to dose/bs differences in Cmax (6.5±3.3, 7.3±4.2 and 6.8±3.6 µmol/l, in group 1, 2, and 3, respectively) and AUC (563±313, 691±351 and 555±342 µmol·min/l, in group 1, 2 and 3) were not significant between the three groups. It is likely that changes in body water content with age may account for most of these differences observed. In conclusion, a similar pharmacokinetic profile was found in children older than 3 months as compared to older children or adults.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a cross-sectional, non-randomized, prospective study in an outpatient clinic a possible relationship between the cerebrospinal fluid (CSF) concentrations of the potent vasoconstrictor peptide endothelin-1 (ET-1) and prevalence and degree of HIV-encephalopathy was studied. Forty-eight CSF samples from HIV-infected patients ET-1 was also measured in plasma. Patients were investigated clinically and staged with respect to HIV encephalopathy. Patients with arterial hypertension, diabetes or acute opportunistic infections were excluded from the study. In the remaining, 18 of the CSF samples were from patients with normal neurological findings (grade 0–0.5), whereas 30 were from patients with HIV encephalopathy (grade 1–3). The mean CSF ET-1 concentration was significantly elevated (P = 0.001) in patients with HIV encephalopathy (1.97 ± 2.33 pmol/l) as compared to those patients without encephalopathy (0.57 ± 0.67 pmol/l). Moreover, there was a significant correlation between ET-1 CSF concentrations and the degree of HIV encephalopathy (r = 0.49, P 〈 0.001). In addition, there was a significant correlation between ET-1 levels in the CSF and the IgG serum to CSF ratio. However, we found no correlation between HIV encephalopathy and neither CSF ratio of IgG or albumin. In conclusion, we could demonstrate a close relationship between CSF ET-1 concentrations and the degree of HIV encephalopathy. Thus, by virtue of its long-lasting and potent vasoconstrictor activity ET-1 might contribute to the pathogenesis of HIV encephalopathy.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-2665
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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