Premium
Inadequate Erythropoietin Response to Anaemia in HIV Patients: Relationship to Serum Levels of Tumour Necrosis Factor‐Alpha, Interleukin‐6 and Their Soluble receptors
Author(s) -
KREUZER KARLANTON,
ROCKSTROH JU¨RGEN KURT,
JELKMANN WOLFGANG,
THEISEN ALBERT,
SPENGLER ULRICH,
SAUERBRUCH TILMANN
Publication year - 1997
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1997.d01-2031.x
Subject(s) - erythropoietin , cytokine , tumor necrosis factor alpha , receptor , medicine , immunology , endocrinology , alpha (finance) , surgery , construct validity , patient satisfaction
Severe anaemia is a frequent complication in advanced HIV infection. In our study we investigated the interaction between cytokine network, HIV infection and erythropoietin (Epo) response with increasing anaemia levels. No correlations could be established between circulating tumour necrosis factor (TNF)‐alpha and any of the examined parameters. However, a negative correlation was found between haemoglobin values and soluble TNF receptor levels (sTNF‐R‐I: r = −0.54; P < 0.001; sTNF‐R II: r = −0.47; P < 0.001) as well as interleukin‐6 levels ( r = −0.29; P < 0.001). In contrast, no significant increase in log[Epo], counterbalancing haemoglobin decline and paralleling the rise in sTNF receptors, was found. In patients classified as stage III, according to the Centers for Disease Control (CDC) classification, the erythropoietin response was significantly more impaired than in patients from CDC groups I and II ( P < 0.001). The results of this study suggest that similar to its action in vitro , activation of the TNF/TNF‐R system may impair erythropoietin production in HIV‐associated anaemia. Due to the brief half‐life of TNF‐α, this activation is particularly reflected by elevations of soluble TNF receptor levels.