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COROLLARY TWO: Effective Treatment for HIV/AIDS Should Involve Correcting Deficiencies of Glutathione Peroxidase and its Nutritional Precursors COROLLARY TWO: Effective Treatment for HIV/AIDS shown that glycyl-glutamine improves lymphocyte proliferation Should Involve Correcting Deficiencies of Glutathione in AIDS patients. Peroxidase and its Nutritional Precursors I am not aware of any clinical trials conducted to test the There is a wealth of evidence that correcting one or more of impact of tryptophan supplementation on HIV/AIDS. However, the deficiencies of selenium, cysteine, glutamine and tryptophan, it is interesting to note that antiretroviral drug therapy, designed which are characteristic of HIV/AIDS, has significant health ben- to prevent HIV-1 replication, slows the rate of tryptophan loss efits. Selenium, for example, is a key immunological enhance- seen in seropositive individuals.*' Similarly, plasma tryptophan ment agent that has a strong impact on lymphocyte proliferation. levels can be increased in HIV-infected patients by nicotinamide This relationship was confirmed by Peretz and co-workers,” supplements.” This is perhaps not surprising, given the close who monitored enhanced lymphocyte response in elderly chemical association between this nutrient and the tryptophan subjects given a daily 100-microgram selenium supplement over derivative, niacin. a six-month clinical trial. This seems to be because selenium is Simply put, there is a great deal of evidence that HIV/AIDS essential for lymphocytes—as shown by patients are typically deficient in glutathione Porter and colleagues,” who demonstrated peroxidase and its precursors—selenium, that plasma proteins carry selenium to cysteine, glutamine and tryptophan. Beyond lymphocytes which absorb it. Further, Simply put, there is a this, it is clear from clinical trials that sur- Wang and co-workers” have demonstrated . vival rates and patients’ symptoms are that selenium enhances lectin-stimulated T- great deal of evidence improved by supplementation with such . P y supp lymphocyte proliferation and is an that HIV/AIDS patients nutrients. important modulator for immune response. i Het] i Indeed, one might go so far as to say it It is not surprising, therefore, that are typically deficient i would be medical malpractice not to give HIV/AIDS patients with depressed plasma glutathione peroxidase these nutrients to those who are HIV selenium also show T-lymphocyte and its precursors— seropositive. abnormalities. . . There have been numerous clinical trials selenium, cysteine, COROLLARY THREE: Reversing to explore the impact of cysteine supple- glutamine and Deficiencies of the Precursors of Glutathione Peroxidase Should Reverse the Symptoms of HIV/AIDS The hypothesis presented here sug- gests that HIV/AIDS is a disease that is caused by the combined deficiencies of glutathione peroxidase and its pre- cursors. If this is correct, then the symptoms normally associated with a deficiency of each one of these sub- stances ought to occur in AIDS patients. There is a wealth of evidence that suggests this is the case. Baum and co-workers® have shown mentation (usually given as N—acetylcys- teine) on HIV/AIDS symptoms. De Rosa and co-workers’° at Stanford University, for example, have shown that the oral administration of N-acetylcysteine significantly replen- ished glutathione in HIV-infected indi- viduals. This is very significant, since subsequent research has established that glutathione levels in HIV-positive patients is a predictor of survival rates.” As previously mentioned, cysteine is a significant source of sulphur and HIV/AIDS patients are very deficient that adults and children dying of AIDS in this element. A trial carried out in display both depressed CD4 T- Germany by Breitkreutz and colleagues’? showed that lymphocyte counts and very depleted plasma selenium stores. N-acetylcysteine supplementation helped to correct this sulphur This seems to be part of a positive feedback system, since one of deficiency while simultaneously improving immunological the most significant symptoms of selenium deficiency is a functions in HIV/AIDS patients. reduction of CD4 T-lymphocytes, which occurs because this Glutamine is a major requirement of cells which are rapidly trace element is needed for their production. A lowering of CD4 proliferating. As a result there is a significant requirement for it T-lymphocyte levels causes a drop in the efficiency of the tryptophan. Indeed, one might go so far as to say it would be medical malpractice not to give these nutrients to those who are HIV seropositive. in the digestive tract, where it is essential for intestinal cell pro- immune system, encouraging infection by other pathogens and liferation, intestinal fluid/electrolyte absorption and mitogenic resulting in a further decline in selenium. I have termed this response to growth factors. Since glutamine deficiency is so positive feedback system the selenium CD4 T-cell tailspin. characteristic of HIV/AIDS, it is not surprising that patients typi- HIV/AIDS patients also often display a hypothyroid or low T3 cally suffer badly from digestive malfunction and diarrhoea. It (tri-iodothyronine) syndrome.* This seems to occur because has been demonstrated by Noyer and co-workers,” at the Albert selenium deficiency causes a reduction in deiodinase, the enzyme Einstein College of Medicine, that glutamine therapy improves required to convert T4 (thyroxine) to T3. It has been further sug- intestinal permeability in AIDS patients, although the amount gested that such a selenium deficiency abnormality of the thyroid required to enhance intestinal absorption may be as much as 20 may be a significant factor in the AIDS wasting process. grams per day. Selenium deficiency has been linked to depression in the gen- Glutamine is also essential for muscle building; in HIV/AIDS eral population.*’** It is not surprising, therefore, that this is also patients, deficiencies of it seem linked to loss of body cell mass. a characteristic of people with HIV/AIDS. Shabert and his colleagues” have demonstrated that glutamine It would appear, therefore, that at least three of the major and antioxidant supplements can reverse the weight loss typically symptoms of HIV/AIDS—namely, depressed CD4 T-lymphocyte seen in such patients, while Kohler and co-workers® also have count, lowered tri-iodothyronine production and depression—can Simply put, there is a great deal of evidence that HIV/AIDS patients are typically deficient in glutathione peroxidase and its precursors— selenium, cysteine, glutamine and tryptophan. Indeed, one might go so far as to say it would be medical malpractice not to give these nutrients to those who are HIV seropositive. 40 = NEXUS www.nexusmagazine.com FEBRUARY — MARCH 2004