Tumor Necrosis Factor-α in Children with Human Immunodeficiency Virus Infection

Keywords HIV, intracellular avium infection, rnycobacterium, TNF-aIn recent years our knowledge has expanded about a battery of soluble proteins released by stimulated immune cells-the cytokines.One of these is tumor necrosis factor-a (TNF-a).TNF-a is synthesized by various activated phagocytic and nonphagocytic cells, including macrophaged monocytes, lymphocytes, natural killer cells, astrocytes and microglial cells of the brain, and Kupffer's cells of the liver.A wide variety of infections or inflammatory stimuli are capable of triggering TNF-a biosynthesis, eg, bacterial endotoxins/lipopolysaccharide, enterotoxin, mycobacterial cord factor, viruses, fungal or parasitic antigens, C5a, and interleukin-1 (IL-1) [ 13.Tumor necrosis factor-a has a broad spectrum of biologic properties that can be deleterious or beneficial depending on the quantity produced, the duration of release, and the biochemical milieu of the re- sponding cells.These biologic properties participate in acute infections and septic shock, cachexia, and inflammation [2, 31.In this context, Ellaurie and Rubinstein [4] have added their data demonstrating that serum TNF-a levels were markedly increased in a group of l l pediatric acquired immunodeficiency syndrome (AIDS) patients with Mycobacte- rium avium intracellular (MAI) infection, compared with the levels in 11 patients with symptomatic human immunodeficiency virus type 1 (HIV-1) infection without MA1 infection.They also demonstrated a high correlation between elevated TNF-a levels and degree of anemia.These authors concluded that the elevated serum TNF-a levels could contribute to the fever and anemia found in pediatric AIDS patients with MA1 infection [4].