Abstract
Plasma glycoproteins are a composite biomarker of inflammation and can be detected by 1H-NMR. The aim of this study was to prospectively appraise the clinical value of plasma glycoproteins assessed by 1H-NMR in people living with HIV (PLWH). A total of 221 patients with HIV infection were recruited and studied at baseline and at 48 and 144 weeks. Patients were distributed into two groups according to baseline CD4+ T-cell number below or above 200 cells/µL. Patients with fewer than 200 cells/µL were distributed into the responders and nonresponders according to antiretroviral therapy (ART) response at 144 weeks. Glycoprotein concentrations were determined by 1H-NMR arising from the protein bond N-acetylglucosamine and N-acetylgalactosamine signals (GlycA); and N-acetylneuraminic acid signal (GlycB) associated with the sugar–protein bond concentration and aggregation state (shapes (height/width)). Basal glycoprotein concentrations were higher in patients with < 200 CD4+ T-cell/μL (Glyc A: 1040(917.9–1199.1) vs. 950.4(845.5–1050.9), p < 0.001, and Glyc B: 521(440.3–610.3) vs. 468.6(417.9–507.0) μ mol/L, p < 0.001) being reduced by ART. The height/width (H/W) ratio was the parameter showing a better association with this clinical status. Baseline glycoproteins predict the condition of responder/nonresponder. In this study, 1H-NMR glycoproteins provide novel insights to assess inflammation status and have prognostic value in PLWH.
Highlights
In recent decades, antiretroviral therapy (ART) has produced a drastic decrease in mortality related to immunosuppression in HIV-infected patients [1], exchanging a deadly disease for a chronic disease
Several reports elsewhere have evidenced that subsequent non-AIDS events are more prevalent in patients who present with advanced disease who do not fully restore immunity despite appropriate viral suppression, the so-called immunological nonresponders (INRs) [11,12,13,14,15]
We have studied plasma glycoprotein profiles assessed by 1H-NMR as marker of low-grade inflammation in patients with HIV infection and their correlation with clinical and standard biochemical parameters and, prospectively, their clinical prognosis value
Summary
Antiretroviral therapy (ART) has produced a drastic decrease in mortality related to immunosuppression in HIV-infected patients [1], exchanging a deadly disease for a chronic disease This is due to the powerful effects that ART produces on viral suppression and immune restoration. ART does not completely restore immunity, in patients presenting with advanced disease, instead maintaining a state of systemic dysfunctional activation of the immune system [2]. This state is associated with proinflammatory mediators, dysfunctional and senescent regulator T-cells, and a decrease in global immune competence, among others [3]. The correlation is not always present, and there is no precise and standardized relationship between its plasma concentrations and the appearance of events [18]; searching for new systemic inflammation markers such as glycoproteins is warranted
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