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

Front Immunol. 2024 Oct 25:15:1480083. doi: 10.3389/fimmu.2024.1480083. eCollection 2024.

Abstract

Background: 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).

Methods: 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.

Results: The case group had significantly higher levels of Reg-3α (p=0.042) and I-FABP (p=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 (p=0.033). Also, Fried Phenotype scores positively correlated with I-FABP levels (rs=0.21, p=0.01), LPS levels (rs=0.20, p=0.02), and sCD14 levels (rs=0.18, p=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.

Conclusion: The present study indicates that the inflammation induced by intestinal barrier damage/dysfunction is likely to contribute to frailty in aging PLWH.

Keywords: HIV; aging; frailty; inflammation; intestinal barrier.

MeSH terms

  • Aged
  • Aging* / immunology
  • Biomarkers
  • Case-Control Studies
  • China / epidemiology
  • Cytokines / blood
  • East Asian People
  • Fatty Acid-Binding Proteins / blood
  • Female
  • Frailty* / epidemiology
  • HIV Infections* / complications
  • HIV Infections* / immunology
  • Humans
  • Intestinal Mucosa* / immunology
  • Intestinal Mucosa* / metabolism
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies

Substances

  • Biomarkers
  • Fatty Acid-Binding Proteins
  • FABP2 protein, human
  • Cytokines

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Chongqing Science and Technology Bureau Research Program (CSTB2022TIAD-KPX0180), the Joint Medical Research Projects of Chongqing Health Committee and Chongqing Science and Technology Bureau (2022QNXM032, 2020FYYX066, 2024ZDXM015), the Chongqing Talent Cultivation Program (cstc2021ycjh-bgzxm0275), the Medical Research Project of Chongqing Science & Technology Bureau(CSTB2023TIAD-KPX0063-3).