AUTHOR=Xu Xiaolei , Ouyang Jing , Yan Jiangyu , Lu Yanqiu , Harypursat Vijay , Wu Hao , Chen Yaokai 

TITLE=Intestinal barrier damage contributes to a higher prevalence of frailty in aging people living with HIV: a retrospective case control study in a Chinese cohort

JOURNAL=Frontiers in Immunology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1480083

DOI=10.3389/fimmu.2024.1480083

ISSN=1664-3224

ABSTRACT=<sec><title>Background</title><p>It has been previously demonstrated that intestinal barrier damage is one of the underlying mechanisms leading to frailty in non-HIV-infected aging populations. However, there is a paucity of direct evidence which demonstrates the association between intestinal barrier damage and frailty in people living with HIV (PLWH).</p></sec><sec><title>Methods</title><p>The present study is a retrospective case control study. Participants older than 50 years old were stratified into a frail/pre-frail group (case group) and non-frail group (control group) according to the Fried frailty phenotype. We collected and curated data concerning socio-demographic variables, psychological states and social functioning, and clinical information associated with the identification of biomarkers of intestinal barrier damage, microbial translocation, and levels of inflammatory cytokines of participants.</p></sec><sec><title>Results</title><p>The case group had significantly higher levels of Reg-3α (<italic>p</italic>=0.042) and I-FABP (<italic>p</italic>=0.045) compared to the control group. We further observed, after adjusting for confounding factors by logistic regression analysis, that I-FABP levels remained significantly higher in the case group compared to the control group (<italic>p</italic>=0.033). Also, Fried Phenotype scores positively correlated with I-FABP levels (r<sub>s</sub>=0.21, <italic>p</italic>=0.01), LPS levels (r<sub>s</sub>=0.20, <italic>p</italic>=0.02), and sCD14 levels (r<sub>s</sub>=0.18, <italic>p</italic>=0.04). Moreover, the study confirmed both the positive correlation between inflammatory cytokines (IL-6 and IP-10) with frailty in aging PLWH, and between inflammatory cytokines (IL-6, IL-8 and IP-10) with biomarkers of intestinal barrier dysfunction in older PLWH.</p></sec><sec><title>Conclusion</title><p>The present study indicates that the inflammation induced by intestinal barrier damage/dysfunction is likely to contribute to frailty in aging PLWH.</p></sec>