title: Pentoxifylline decreases tumor necrosis factor expression and serum triglycerides in people with AIDS. NIAID AIDS Clinical Trials Group.
abstract: Tumor necrosis factor-alpha (TNF)-cachectin increases the expression of the human immunodeficiency virus (HIV), reverses the therapeutic efficacy of zidovudine (ZDV), and may contribute to the wasting syndrome. Pentoxifylline (Trental) decreases TNF activity; in cell culture, it decreases HIV replication and down-regulates expression of the HIV long terminal repeat (LTR). Therefore, pentoxifylline was administered to 25 patients with advanced AIDS in this AIDS Clinical Trial Group study (ACTG #160), the goal of which was to investigate the ability of the drug to decrease TNF expression and HIV replication in this patient population. One patient discontinued drug treatment because of toxicity. Data were analyzed on the 17 patients who completed the 8-week study treatment with pentoxifylline, 400 mg, thrice daily. The median pretreatment CD4+ lymphocyte count was 32 cells/mm3. Fasting serum triglycerides, which have previously been shown to correlate with levels of interferon-alpha and/or TNF, fell on average by 66 mg/dl (p = 0.06). TNF mRNA levels in peripheral blood mononuclear cells fell in 10 of 16 patients (p = 0.02). HIV load decreased and increased significantly in four and one patients, respectively, but did not change in the group as a whole. This study demonstrates the safety of pentoxifylline in AIDS patients and its ability to decrease triglycerides and TNF mRNA levels.
authors.forename: B J
authors.initials: BJ
authors.lastname: Dezube
authors.forename: A B
authors.initials: AB
authors.lastname: Pardee
authors.forename: B
authors.initials: B
authors.lastname: Chapman
authors.forename: L A
authors.initials: LA
authors.lastname: Beckett
authors.forename: J A
authors.initials: JA
authors.lastname: Korvick
authors.forename: W J
authors.initials: WJ
authors.lastname: Novick
authors.forename: J
authors.initials: J
authors.lastname: Chiurco
authors.forename: P
authors.initials: P
authors.lastname: Kasdan
authors.forename: C M
authors.initials: CM
authors.lastname: Ahlers
authors.forename: L T
authors.initials: LT
authors.lastname: Ecto
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D001708:Biopterins / Q000031:analogs & derivatives / Q000097:blood; D001835:Body Weight; D015496:CD4-Positive T-Lymphocytes; D015536:Down-Regulation; D015967:Gene Expression Regulation, Viral / Q000187:drug effects; D006678:HIV / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007958:Leukocyte Count; D019798:Neopterin; D010431:Pentoxifylline / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000032:analysis; D012514:Sarcoma, Kaposi / Q000209:etiology; D012878:Skin Neoplasms / Q000209:etiology; D014280:Triglycerides / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000187:drug effects* / Q000235:genetics; D014779:Virus Replication / Q000187:drug effects; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D012333:RNA, Messenger; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D001613:beta 2-Microglobulin; D001708:Biopterins; D019798:Neopterin; D010431:Pentoxifylline