Evaluation of immunological, inflammatory and biochemical parameters in HIV-positive patients using antiretroviral therapy in combination with propolis

Author(s)

Fernanda Lopes Conte

• Document type: Doctoral Thesis
• Press: Botucatu. 2021-04-16.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Medicina. Botucatu
• Defense date: 2021-04-07
• Advisor: José Maurício Sforcin; Karen Ingrid Tasca

Abstract

HIV infection represents a serious public health problem in the world, with millions of people infected and new cases registered annually. Antiretroviral therapy (ART) has completely changed the infection scenario, providing a marked reduction in the mortality of people living with HIV/AIDS (PLWHA). Despite the benefits of the ART, its chronic use can lead to side effects such as cytotoxicity and metabolic disorders, what contributes to persistent immune activation and inflammatory status in PLWHA. Thus, we aimed to investigate whether propolis, a bee product presenting several therapeutic properties, could be able to improve the health of asymptomatic PLWHA under ART. After a double-blind randomization of 40 patients, two groups (500 mg/day propolis versus placebo) were analyzed in two moments: before (M0) and 3 months after (M1) the intervention. Plasma HIV viral load, CD4+ /CD8+ T cell count, complete blood count and biochemical/metabolic profile were obtained via electronic medical record. The concentration of plasma cytokines (TNF-α, IL-6, IL-10, IL-17, IL2 and IL-4) and lymphocyte proliferation were determined by flow cytometry. The production of cytokines (IFN-γ, IL-5, IL-17, IL-10, IL-18, IL-1β and IL-33) by peripheral blood mononuclear cells (PBMC) was determined by Enzyme-Linked Immunosorbent Assay (ELISA). The expression of the T-bet, GATA-3, RORγt and Foxp3 genes was evaluated by real time reverse transcription polymerase chain reaction (RT-qPCR). There was an increase in creatinophosphokinase activity after propolis intake, although without clinical significance. The same group also showed increased magnesium levels, a positive correlation between IL-10 (anti-inflammatory cytokine) and CD4+ T cell count, a negative correlation between IL-10 and IFN-γ (proinflammatory cytokine), an increased Foxp3 expression and CD4+ T lymphocytes proliferation. Our findings indicate that the use of propolis is safe and may be an alternative for improving the immune response and reducing inflammation in asymptomatic patients, inducing regulatory T cells. Additional findings were obtained using a human monocytic cell line in a parallel project, indicating that propolis exerted an antioxidant activity, potentially involved in its anti-inflammatory and antiallergic action, what can also be a contribution to PLWHA. However, more studies are needed to confirm these findings and consider propolis an effective intervention for PLWHA, especially those with comorbidities or therapeutic failures, who was not included in this study. (AU)

• FAPESP's process: 16/24591-6 - Evaluation of immunological, inflammatory and biochemical parameters in HIV-infected individuals under antiretroviral therapy in association with propolis
• Grantee: Fernanda Lopes Conte
• Support Opportunities: Scholarships in Brazil - Doctorate