학술논문

Distinct Effects of Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors on Soluble Biomarkers in Blood and Cerebrospinal Fluid of People With HIV.
Document Type
Article
Source
Journal of Infectious Diseases. 5/15/2024, Vol. 229 Issue 5, p1266-1276. 11p.
Subject
*SEROTONIN uptake inhibitors
*CEREBROSPINAL fluid
*HIV-positive persons
*REDUCTASE inhibitors
*ACE inhibitors
*MIDDLE-aged men
Language
ISSN
0022-1899
Abstract
Background Persistent inflammation affects people with HIV (PWH) despite antiretroviral therapy (ART). Selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs, SNRIs), HMG-CoA reductase-inhibitors (statins), and angiotensin-converting enzyme inhibitors (ACEIs) have immunomodulant properties. We evaluated the potential impact of these drugs on inflammation and neurodegeneration in PWH. Methods Cross-sectional single-center (United States) analysis in 184 PWH on ART with plasma HIV RNA < 200 copies/mL. All participants had 10 biomarkers measured in blood and cerebrospinal fluid (CSF). To reduce dimensionality, hierarchical clustering and principal components (PCs) analysis were employed. The analyses were adjusted for duration of the drugs and clinical conditions. Results Participants were mostly middle-aged men, with median CD4+ T cells of 620/µL. In adjusted models, SSRI use was associated with 3 PCs: higher CSF and plasma Aβ42 and CSF CCL2 (aβ=.14, P =.040); lower CSF 8-oxo-dG, total tau, and sCD14 (aβ=−.12, P =.042); and higher plasma sCD14 with lower sCD40L (aβ=.15, P =.042). SNRI use was associated with higher values of CSF and plasma neopterin and CSF sTNFR-II (aβ=.22, P =.004). Statins and ACEIs showed no association. Conclusions SSRIs and SNRIs had distinct biomarker signatures. SSRIs were associated with reduced neurodegeneration, immune activation, and oxidative stress in CSF, suggesting a role of SSRIs as adjunctive therapy in PWH. [ABSTRACT FROM AUTHOR]