AIDS, ALCOHOL, ENDOTHELIUM, AND IMMUNITY

Analogies are drawn between important unknowns in AIDS and alcohol res earch, related to underlying common pathogenetic mechanisms, immunodys regulation, cofactors, and prominent vascular manifestations. The cent ral role of the blood and lymphatic vasculatures and specifically thei r endothelial lining in many facets of the immune response is reviewed . Evidence is presented that both alcohol and HIV (as well as other co infecting viruses in AIDS) target and alter endothelial cells and the angiogenic process. These concepts are further illustrated by a serend ipitous viral epidemic among rats on continuous long-term alcoholic an d control nonalcoholic diets, where synergism between alcohol and viru s appeared to underlie multiple vascular proliferative lesions in the liver. In AIDS and alcoholism/alcoholic liver disease (ALD), the promi nent features of dysregulated angiogenesis point to the endothelium as a key player in pathogenesis of these seemingly disparate disorders a nd potentially in immunomodulation.