down other drugs. This process increases blood levels of any medication taken concomitantly with CYP inhibitor, and dose adjustments are necessary in order to prevent side effects and overdosing. Note that this blockage of cytochromes is the rationale for the use of the protease inhibitors ritonavir and saquinavir in combination.

cytokine Any of a large number of proteins produced by cells that influence the activity and behavior of themselves or other cells. Some cytokines increase the intensity of an immune response; others suppress it. Some cytokines create an inflammatory response; others quiet such a response. Still other cytokines regulate the development of immune cells in the bone marrow. Cytokines include lymphokines produced by lymphocytes and monokines produced by monocytes and MACROPHAGES. INTERLEUKINS, TUMOR necrosis factor, and interferons are also examples of cytokines.

Cytolin An experimental HIV treatment. It is a patented monoclonal antibody that prevents the CD8+ cells in the body from attacking the CD4+ cells, as occurs in HIV disease. The product is used to keep the immune system functioning while antivi-rals attack the virus. The product is being developed and produced through the funding of several HlV-positive professionals who started a company called CytoDyn. This is unusual, as most HIV-fighting products are produced by major international pharmaceutical companies. It is currently in phase I/II trials in the United States. It is given as an intravenous drip once every month. No final dosing or frequency has been determined yet in the trials. Because Cytolin is a protein, its use may lessen drug interactions and need for numerous drugs in the system.

cytological screening Testing for cell pathology for diagnostic purposes. Cytological tests can detect and identify both normal and abnormal cells, especially cancer cells, in areas that cannot be easily and directly examined. Specimens to be examined may be obtained from body excretions, secretions, and tissue scrapings. Tests make possible a very early diagnosis and treatment of cancer. They can also indicate hormone activity in the body as well as specific infections and the effect of radiation.

cytology The study of cells. See cytological


cytomegalovirus (CMV) A virus belonging to the herpes family, and a major pathogen in people with AIDS. Before the appearance of AIDS, it was most commonly associated with severe congenital infection in infants and with life-threatening infections in patients who had undergone bone marrow transplants and other procedures requiring suppression of the immune system. CMV's most common target is the retina—the light-sensitive-tissue at the back of the eyes. If left untreated, cmv retinitis causes blindness in the affected eye 90 percent of the time. CMV also infects the gastrointestinal tract, and may involve the entire tract, from mouth to anus, including the liver and pancreas. Most cases of CMV gastrointestinal disease involve the esophagus or colon. CMV can also cause pneumonia or cervicitis in women. There have also been reports of CNS and adrenal disease, although the frequency and significance of these conditions are unclear. As a result of these infections, CMV produces considerable illness and greatly affects the survival of patients with AIDS.

Approximately half of the American population over 50 has evidence of past CMV infection, but prevalence appears to be even higher among homosexual men. Most patients who have CMV disease are infected with it long before they become HIV-infected. CMV is typically contracted in infancy and childhood, but patients may also become infected through sexual contact or after receiving infected blood products. In individuals with intact immune systems, infection either goes unnoticed or may provoke a self-limited one-time illness. After infecting a patient, the virus becomes "latent," hiding in the host's cells. under conditions of immunosuppression, such as with AIDS, the virus may "reactivate" and cause symptomatic disease. This does not usually occur until a patient's CD4 cell count falls below 100, and more typically below 50. CMV infection of the gastrointestinal tract commonly results in inflammation, erosions, and ulceration of the mucosal

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