Uso de probióticos em indivíduos HIV positivos

  • Arissa Felipe Borges Escola de Ciências Sociais e da Saúde, Faculdade de Nutrição, Pontifícia Universidade Católica de Goiás
  • Vanessa Roriz Ferreira de Abreu Escola de Ciências Sociais e da Saúde, Faculdade de Nutrição, Pontifícia Universidade Católica de Goiás
Palavras-chave: HIV, Síndrome da Imunodeficiência Adquirida, Probióticos

Resumo

Introdução: O vírus da imunodeficiência humana (HIV) reduz progressivamente a eficácia do sistema imunológico e aumenta a suscetibilidade para infecções oportunistas. Além disso, aumenta a permeabilidade intestinal e translocação microbiana que contribuem para a ativação imune sistêmica, caracterizando a evolução para a síndrome da imunodeficiência adquirida (AIDS). A modulação imunológica da barreira gastrointestinal no HIV com o uso de probióticos apresenta efeitos benéficos no equilíbrio microbiano do hospedeiro. Objetivo: O presente estudo teve como objetivo levantar dados da literatura de estudos clínicos, referente ao uso de probióticos em pacientes infectados pelo HIV em uso ou não de terapia antirretroviral. Material e Métodos: Foi realizada revisão da literatura científica, por meio da PUBMED utilizando os seguintes descritores em Ciências da Saúde (DeCS), de forma isolada ou em combinação: “human immunodeficiency vírus”, “HIV”, “probiotics”. Foram selecionados estudos de ensaios clínicos randomizados controlados que envolveram a abordagem do uso de probióticos em pacientes infectados com HIV. Foram selecionados 11 artigos que apresentavam conteúdos que contribuíam para o cumprimento dos objetivos deste trabalho, no idioma inglês, publicados no período de 2014 a 2018. Resultados: Além das diversas características dos pacientes selecionados nos estudos, diferentes probióticos foram testados. As interações com os receptores imunes e com a microbiota intestinal ainda não foram totalmente definidos, podendo apresentar diferentes efeitos na regulação intestinal e imunidade sistêmica. Conclusões: Entender a interação entre o microbioma intestinal e seus produtos no ajuste da imunidade no indivíduo HIV+ permitirá definir novas intervenções que possam diminuir a inflamação e comorbidades associadas a doença.

Referências

Zevin AS, Mckinnon L, Burgener A, Klatt NR. Microbial translocation and microbiome dysbiosis in HIV-associated immune activation. Curr Opin HIV AIDS. 2017; 11:182-90.

Thaiss CA, Levy M, Suez J, Elinav E. The interplay between the innate immune system and the microbiota. Curr Opin Immunol. 2014; 26:41-8.

Villar-García J, Hernández JJ, Güerri-Fernández R, González A, Lerma E, Guelar A, Saenz D, Sorlí L, Montero M, Horcajada JP, Knobel Freud H. Effect of probiotics (Saccharomyces boulardii) on microbial translocation and inflammation in HIV-treated patients: a double-blind, randomized, placebo-controlled trial. J Acquir Immune Defic Syndr. 2015; 68:256-63.

Klatt NR, Chomont N, Douek DC, Deeks SG. Immune activation and HIV persistence: implications for curative approaches to HIV infection. Immunol Rev. 2013; 254:326-42.

Joint United Nations Programme on HIV/AIDS. Resumo informativo: estatísticas globais sobre HIV [internet]. Brasília: 2017. [Acesso em 2018 May 11]. Disponível em: https://unaids.org.br/wp-content/uploads/2017/12/UNAIDSBR_FactSheet.pdf.

Ministério da Saúde (BR). Boletim epidemiológico HIV/AIDS. Brasília: 2017.

Pope M, Haase AT. Transmission, acute HIV-1 infection and the quest for strategies to prevent infection. Nat Med. 2003; 9:847-52.

Geskus RB, Prins M, Hubert JB, Miedema F, Berkhout B, Rouzioux C et al. The HIV RNA setpoint theory revisited. Retrovirology. 2007; 4:1-9.

Simon V, Ho DD, Karim QA. HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. Lancet. 2006; 368:489-504.

Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Douek DC. Microbial translocation is a cause of systemic immune activation in chronic HIV infection. Nat Med. 2006; 12:1365-71.

Dinh DM, Volpw GE, Duffalo C, Bhalchandra S, Tai AK, Kane AV et al. Intestinal microbiota, microbial translocation, and systemic inflammation in chronic HIV infection. J Infect Dis. 2015; 211:19-27.

Louis P, Flint HJ. Diversity, metabolism and microbial ecology of butyrate-producing bacteria from the human large intestine. FEMS Microbiol Lett. 2009; 294:1-8.

Sandler NG, Douek DC. Microbial translocation in HIV infection: causes, consequences and treatment opportunities. Nat Rev Microbiol. 2012; 10:655-66.

Estes JD, Harris LD, Klatt NR, Tabb B, Pittaluga S, Paiardini et al. Damaged intestinal epithelial integrity linked to microbial translocation in pathogenic simian immunodeficiency virus infections. PLoS Pathog. 2010; 6:1-12.

Nazli A, Chan O, Dobson-Belaire WN, Ouellet M, Tremblay MJ, Gray-Owen et al. Exposure to HIV-1 directly impairs mucosal epithelial barrier integrity allowing microbial translocation. PLoS Pathog. 2010; 6:1-20.

Yim HC, Li JC, Lau JS, Lau AS. HIV-1 Tat dysregulation of lipopolysaccharide-induced cytokine responses: Microbial interactions in HIV infection. AIDS. 2009; 23:1473-84.

Brenchley JM, Douek DC. Microbial translocation across the GI tract. Annu Rev Immunol. 2012; 30:149-73.

Erlandson KM, Allshouse AA, Jankowski CM, Lee EJ, Rufner KM, Palmer BE et al. Association of functional impairment with inflammation and immune activation in HIV type 1-infected adults receiving effective antiretroviral therapy. Journal of Infectious Diseases. 2013; 208:249-59.

Koethe JR, Dee K, Bian A, Shintani A, Turner M, Bebawy S et al. Circulating interleukin-6, soluble CD14, and other inflammation biomarker levels differ between obese and nonobese HIV-infected adults on antiretroviral therapy. AIDS Res Hum Retroviruses. 2013; 29:1019-25.

Stehle JR, Leng X, Kitzman DW, Nicklas BJ, Kritchevsky SB, High KP. Lipopolysaccharide-binding protein, a surrogate marker of microbial translocation, is associated with physical function in healthy older adults. J Gerontol A Biol Sci Med Sci. 2012; 67:1212-8.

Stein DS, Lyles RH, Graham NM, Tassoni CJ, Margolick JB, Phair JP et al. Predicting clinical progression or death in subjects with early-stage human immunodeficiency virus (HIV) infection: a comparative analysis of quantification of HIV RNA, soluble tumor necrosis factor type II receptors, neopterin, and beta2-microglobulin. Multicenter AIDS Cohort Study. J Infect Dis. 1997; 176:1161-7.

Nixon DE, Landay AL. Biomarkers of immune dysfunction in HIV. Curr Opin HIV/AIDS. 2010; 5:498-503.

Mchardy IH, Li X, Tong M, Ruegger P, Jacobs J, Borneman J et al. HIV infection is associated with compositional and functional shifts in the rectal mucosal microbiota. Microbiome. 2013; 1:1-12.

Lozupone CA, Rhodes ME, Neff CP, Fontenot AP, Campbell TB, Palmer BE. HIV-induced alteration in gut microbiota: driving factors, consequences, and effects of antiretroviral therapy. Gut Microbes. 2014; 5:562-70.

Leblanc JG, Milani C, Giori GS, Sesma F, Van Sinderen D, Ventura M. Bacteria as vitamin suppliers to their host: a gut microbiota perspective. Curr Opin Biotechnol. 2013; 24:160-68.

Ceccarelli G, Fratino M, Selvaggi C. A pilot study on the effects of probiotic supplementation on neuropsychological performance and micro-RNA-29a-c levels in antiretroviral-treated HIV-1-infected patients. Brain Behavior. 2016; 7:e00756.

Ceccarelli G, Fratino M, Selvaggi C, Giustini N, Serafino S, Schietroma I et al. A pilot study on the effects of probiotic supplementation on neuropsychological performance and microRNA-29a-c levels in antiretroviral-treated HIV-1-infected patients. Brain Behavior. 2017; 7:e00756.

Arnbjerg CJ, Vestad B, Hov JR, Pedersen KK, Jespers S, Johannesen HH et al. Effect of Lactobacillus rhamnosus GG supplementation on intestinal inflamation assessed by PET/MRI scans and gut microbiota composition in HIV infected individuals. J Acquir Immune Defic Syndr. 2018; 78:450-7.

D’ettorre G, Rossi G, Scagnolari C. Probiotic supplementation promotes a reduction in T-cell activation, an increase in Th17 frequencies and a recovery of intestinal epithelium integrity and mitochondrial morphology in ART-treated HIV-1-positive patients. Immun Inflamm Dis. 2017; 5:244-60.

D’ettorre G, Ceccarelli G, Giustini N. Probiotics reduce inflammation in antiretroviral treated, HIV-infected individuals: results of the ‘Probio-HIV’ clinical trial. PLoS One. 2015; 10:e01372005.

Ishizaki A, Bi X, Nguyen LV, Matsud K, Pham HV, Phan CTT et al. Effects of short-term probiotic ingestion on immune profiles and microbial translocation among HIV-1-infected vietnamese children. Int J Mol Sci. 2017; 18:2185.

Stiksrud B, Nowak P, Nwosu FC, Kvale D, Thalme A, Sonnerborg A et al. Reduced levels of D-dimer and changes in gut microbiota composition after probiotic intervention in HIV-infected individuals on stable ART. J Acquir Immune Defic Syndr. 2015; 70:329-37.

Falasca K, Vecchiet J, Ucciferri C. Effect of probiotic supplement on cytokine levels in HIV-infected individuals: a preliminary study. Nutrients. 2017; 7:8335-47.

Bron PA, Van Baarlen P, Kleerebezem M. Emerging molecular insights into the interaction between probiotics and the host intestinal mucosa. Nat Rev Microbiol. 2011; 10:66-78.

Yang OO, Kelesidis T, Cordova R, Khanlou H. Immunomodulation of antiretroviral drug-suppressed. AIDS Res Hum Retroviruses. 2014; 30:988-95.

Serrano-Villar S, Lagarde M, Vázquez-Castellanos J, Bernadino JI, Madrid N, Matarranz M et al. Effects of immunonutrition in advanced HIV disease: a randomized placebo controlled clinical trial (Promaltia Study). Clin Infect Dis. 2019; 68(1):120-30.

Publicado
2020-06-08
Como Citar
1.
Felipe Borges A, Roriz Ferreira de Abreu V. Uso de probióticos em indivíduos HIV positivos. hu rev [Internet]. 8º de junho de 2020 [citado 10º de julho de 2020];460:1-. Disponível em: https://periodicos.ufjf.br/index.php/hurevista/article/view/28233
Seção
Artigos de Revisão da Literatura