A comparative study: long and short term effect of a nutrition sensitive approach to delay the progression of HIV to AIDS among people living with HIV (PLWH) in Nigeria

Background: Malnutrition has a negative impact on optimal immune function, thus increasing susceptibility to morbidity and mortality among HIV positive patients. Evidence indicates that the prevalence of macro and micronutrient deficiencies (particularly magnesium, selenium, zinc, and vitamin C) has a negative impact on optimal immune function, through the progressive depletion of CD4 T-lymphocyte cells, which thereby increases susceptibility to morbidity and mortality among PLWH. Objective: To assess the short and long term effects of a nutrition sensitive intervention to delay the progression of human immune-deficiency virus (HIV) to AIDS among people living with HIV in Abuja, Nigeria. Methods: A randomized control trial was carried out on 400 PLWH (adult, male and female of different religious background) in Nigeria between January and December 2012. Out of these 400 participants, 100 were randomly selected for the pilot study, which took place over six months (January to June, 2012). The participants in the pilot study overlapped to form part of the scale-up participants (n 400) monitored from June to December 2012. The comparative effect of daily 354.92 kcal/d optimized meals consumed for six and twelve months was ascertained through the nutritional status and biochemical indices of the study participants (n=100 pilot interventions), who were and were not taking the intervention meal. The meal consisted of: Glycine max 50g (Soya bean); Pennisetum americanum 20g (Millet); Moringa oleifera 15g (Moringa); Daucus carota spp. sativa 15g (Carrot). Results: At the end of sixth month intervention, mean CD4 cell count (cell/mm3) for Pre-ART and ART Test groups increased by 6.31% and 12.12% respectively. Mean mid upper arm circumference (MUAC) for Pre-ART and ART Test groups increased by 2.72% and 2.52% within the same period (n 400). Comparatively, participants who overlapped from pilot to scale-up intervention (long term use, n 100) were assessed for 12 months. Mean CD4 cell count (cell/mm3) for Pre-ART and ART test groups increased by 2.21% and 12.14%. Mean MUAC for Pre-ART and ART test groups increased by 2.08% and 3.95% respectively. Moreover, student’s t-test analysis suggests a strong association between the intervention meal, MUAC, and CD4 count on long term use of optimized meal in the group of participants being treated with antiretroviral therapy (ART) (P<0.05). Conclusion: Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal will be suitable to sustain the gained improvements in the anthropometric and biochemical indices of PLWHIV in Nigeria.

The effect of melanocortin peptides on Interleukin 1-beta induced chondrocyte cell death and inflammation

ntroduction: Osteoarthritis (OA) is a degenerative joint disease affecting more than 8.5 million people in the UK. Disruption in the catabolic and anabolic balance, with the catabolic cytokine Interleukin 1 beta (IL-1β) being involved in the initiation and progression of OA (1). Melanocortin peptides (α-MSH and D[Trp8]-γ-MSH) exert their anti-inflammatory effects via activation of melanocortin receptors (MC), with both MC1 and MC3 being identified as promising candidates as novel targets for OA (2). This study aims to assess the chondroprotective and anti-inflammatory effects of the pan melanocortin receptor agonist α-MSH and MC3 agonist D[Trp8]-γ-MSH following IL-1β chondrocyte stimulation. Methods: RT-PCR/ Western Blot: Human C-20/A4 chondrocytic cell-line were cultured in 6 well plates (1x106 cells/well) and harvested to determine MC and IL-1β expression by RT-PCR, and Western Blot. Cell-Culture: Cells were cultured in 96 well plates (1x106 cells/well) and stimulated with H2O2 (0.3%), TNF-α (60 pg/ml) or IL-1β (0-5000pg/ml) for 0-72h and cell viability determined. Drug Treatment: In separate experiments cells were pre-treated with 3 μg/ml α-MSH (Sigma-Aldrich Inc. Poole, UK), or D[Trp8]-γ-MSH (Phoenix Pharmaceuticals, Karlsrhue, Germany) (all dissolved in PBS) for 30 minutes prior to IL-1β (5000pg/ml) stimulation for 6-24h. Analysis: Cell viability was determined by using the three cell viability assays; Alamar Blue, MTT and the Neutral Red (NR) assay. Cell-free supernatants were collected and analysed for Interleukin -6 (IL-6) and IL-8 release by ELISA. Data expressed as Mean ± SD of n=4-8 determination in quadruplicate. *p≤ 0.05 vs. control. Results: Both RT-PCR, and Western Blot showed MC1 and MC3 expression on C-20/A4 cells. Cell viability analysis: IL-1β stimulation led to a maximal cell death of 35% at 6h (Alamar Blue), and 40% and 75% with MTT and Neutral Red respectively at 24h compared to control. The three cell viability assays have different cellular uptake pathways, which accounts for the variations observed in cell viability in response to the concentration of IL-1β, and time. Cytokine analysis by ELISA: IL-1β (5000pg/ml) stimulation for 6 and 24h showed maximal IL-6 production 292.3 ±3.8 and 275.5 ±5.0 respectively, and IL-8 production 353.3 ±2.6 and 598.3 ±8.6 respectively. Pre-treatment of cells with α-MSH and D[Trp8]-γ-MSH caused significant reductions in both IL-6 and IL-8 respectively following IL-1β stimulation at 6h. Conclusion: MC1/3 are expressed on C-20/A4 cells, activation by melanocortin peptides led to an inhibition of IL-1β induced cell death and pro-inflammatory cytokine release.