Improvement of immune functions in HIV infection by sulfur supplementation: two randomized trials.
To determine the therapeutic effect of sulfur amino acid supplementation in HIV infection we randomized 40 patients with antiretroviral therapy (ART; study 1) and 29 patients without ART (study 2) to treatment for 7 months with N-acetyl-cysteine or placebo at an individually adjusted dose according to a defined scheme. The main outcome measures were the change in immunological parameters including natural killer (NK) cell and T cell functions and the viral load. Both studies showed consistently that N-acetyl-cysteine causes a marked increase in immunological functions and plasma albumin concentrations. The effect of N-acetyl-cysteine on the viral load, in contrast, was not consistent and may warrant further studies. Our findings suggest that the impairment of immunological functions in HIV+ patients results at least partly from cysteine deficiency. Because immune reconstitution is a widely accepted aim of HIV treatment, N-acetyl-cysteine treatment may be recommended for patients with and without ART. Our previous report on the massive loss of sulfur in HIV-infected subjects and the present demonstration of the immunoreconstituting effect of cysteine supplementation indicate that the HIV-induced cysteine depletion is a novel mechanism by which a virus destroys the immune defense of the host and escapes immune elimination.
Breitkreutz
R
R
Deutsches Krebsforschungszentrum, Division of Immunochemistry, Heidelberg, Germany.
Pittack
N
N
Nebe
C T
CT
Schuster
D
D
Brust
J
J
Beichert
M
M
Hack
V
V
Daniel
V
V
Edler
L
L
Dröge
W
W
D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000097:blood; D015497:HIV-1; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007694:Killer Cells, Natural / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012709:Serum Albumin / Q000378:metabolism; D013601:T-Lymphocytes / Q000378:metabolism; D013879:Thioredoxins / Q000097:blood; D019562:Viral Load
D015703:Antigens, CD; D015850:Interleukin-6; D010919:Placebos; D012709:Serum Albumin; D005973:Glutamine; D013879:Thioredoxins; D000111:Acetylcysteine