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Abstract Details
Growth Hormone Releasing Hormone Reduces Circulating Markers of Immune Activation in Parallel with Effects on Hepatic Immune Pathways in Individuals with HIV-infection and Nonalcoholic Fatty Liver Disease
Clin Infect Dis. 2021 Aug 16;73(4):621-630.doi: 10.1093/cid/ciab019.
Takara L Stanley1, Lindsay T Fourman1, Lai Ping Wong2, Ruslan Sadreyev2, James M Billingsley3, Meghan N Feldpausch1, Isabel Zheng1, Chelsea S Pan1, Autumn Boutin1, Hang Lee4, Kathleen E Corey5, Martin Torriani6, David E Kleiner7, Raymond T Chung5, Colleen M Hadigan8, Steven K Grinspoon1
Author information
1Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
2Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
3Harvard Chan Bioinformatics Core, Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA.
4Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
5Liver Center, Gastroenterology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
6Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
7Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA.
8National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Massachusetts, USA.
Abstract
Background: The growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis modulates critical metabolic pathways; however, little is known regarding effects of augmenting pulsatile GH secretion on immune function in humans. This study used proteomics and gene set enrichment analysis to assess effects of a GH releasing hormone (GHRH) analog, tesamorelin, on circulating immune markers and liver tissue in people with human immunodeficiency virus (HIV) (PWH) and nonalcoholic fatty liver disease (NAFLD).
Methods: 92 biomarkers associated with immunity, chemotaxis, and metabolism were measured in plasma samples from 61 PWH with NAFLD who participated in a double-blind, randomized trial of tesamorelin versus placebo for 12 months. Gene set enrichment analysis was performed on serial liver biopsies targeted to immune pathways.
Results: Tesamorelin, compared to placebo, decreased interconnected proteins related to cytotoxic T-cell and monocyte activation. Circulating concentrations of 13 proteins were significantly decreased, and no proteins increased, by tesamorelin. These included 4 chemokines (CCL3, CCL4, CCL13 [MCP4], IL8 [CXCL8]), 2 cytokines (IL-10 and CSF-1), and 4 T-cell associated molecules (CD8A, CRTAM, GZMA, ADGRG1), as well as ARG1, Gal-9, and HGF. Network analysis indicated close interaction among the gene pathways responsible for these proteins, with imputational analyses suggesting down-regulation of a closely related cluster of immune pathways. Targeted transcriptomics using liver tissue confirmed a significant end-organ signal of down-regulated immune activation pathways.
Conclusions: Long-term treatment with a GHRH analog reduced markers of T-cell and monocyte/macrophage activity, suggesting that augmentation of the GH axis may ameliorate immune activation in an HIV population with metabolic dysregulation, systemic and end organ inflammation. Clinical Trials Registration. NCT02196831.