Proopiomelanocortin-Derived Peptides and Cytokines: Relations in Patients with Acquired Immunodeficiency Syndrome

α-Melanocyte-stimulating hormone (α-MSH), adrenocorticotropic hormone (ACTH), β-endorphin, cortisol, and the cytokines interleukin 1β (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor α (TNFα) were measured in 80 AIDS patients (group IV CDC) and in healthy hospital personnel. The average plasma α-MSH was significantly greater in AIDS patients than in control subjects; no significant differences between groups were observed in the average concentrations of ACTH, cortisol, and β-endorphin; plasma cytokines were likewise similar in the two groups. Plasma concentrations of α-MSH and ACTH were inversely related in AIDS patients and a similar inverse relation between α-MSH and IL-6 was also observed in these patients. There were positive relations among elevated circulating ACTH, cortisol, IL-6, and high fever in AIDS patients with severe concomitant disease. Plasma α-MSH concentrations within a specific range correlated positively with 6 month survival. Because cytokines can stimulate HIV expression in certain cell types and they are believed to have a role in disease progression in HIV-infected patients, it may be that a potent endogenous modulator of cytokine action such as α-MSH is crucial to survival in these patients.