Anti-inflammatory treatment with pentoxifylline improves HIV-related endothelial dysfunction: a pilot study

Abstract

We performed a single-arm, open-label pilot trial of the anti-inflammatory drug pentoxifylline to reduce systemic inflammation and improve endothelial function, measured by flow-mediated dilation of the brachial artery, in HIV-infected patients not requiring antiretroviral therapy. Pentoxifylline significantly reduced circulating levels of vascular cell adhesion molecule-1 and interferon-gamma-induced protein and significantly improved endothelial function during the 8-week trial. Pentoxifylline may reverse HIV-related endothelial dysfunction by directly inhibiting the endothelial leukocyte adhesion pathway.

Figure 1. Changes in flow-mediated dilation (FMD), interferon-gamma-induced protein (IP-10), and soluble vascular cell adhesion molecule-1 (sVCAM-1) with use of pentoxifylline (PTX) in HIV-infected subjects not requiring cART

(A) FMD increased nearly uniformly from baseline in 7 of 8 subjects who completed the 8 week trial. (B) Changes in overall FMD levels as shown as boxplots (medians represented as horizontal lines within the boxes; bottoms and tops of boxes represent 25^th and 75^th percentiles, respectively; lower and upper horizontal lines outside of boxes represent minimum and maximum levels, respectively). Median absolute FMD significantly increased from baseline/week 0 (N=9; 2.1%) to study weeks 4 (N=8; 5.5%; p=0.04) and 8 (N=7; 8.2%; p=0.02). (C) IP-10 levels decreased significantly (P<0.05) over 8 weeks in the 7 subjects who completed the trial. (D) sVCAM-1 levels also decreased significantly (P<0.05) over 8 weeks in the 7 subjects who completed the trial.