EC Paediatrics

We report a simple LC-MS method to measure serum sphingomyelin levels. In brief, we observed that sphingomyelin levels in serum are less variable than are levels of thyroxine. There was no evidence for circhoral variation and levels were not altered after a meal of sphingomyelin-rich foods, including eggs, cheese or pizza. In adults, within 2 days of HIV infection, serum levels of sphingomyelin were not within the normal range. When (if) patients developed HIV-specific antibodies, sphingomyelin levels were restored. Ultimately, when the virus ‘escaped’ from the antibody, sphingomyelin dropped again. In infants at birth, low levels of sphingomyelin predicted which infants of HIV- infected mothers would later develop infection. Sphingomyelin levels were normal in those children with HIV- infection who benefited from AZT therapy but levels did not return to normal in children that did not benefit. In summary, changes in sphingomyelin levels might be a useful marker to evaluate HIV disease status in children. We propose that one of the first biochemical events after HIV infection is stimulation of sphingomyelinase and release of ceramides. One of the ceramides might be an apoptotic factor for CD4 cells.

Keywords: Sphingomyelin; Sphingosine-Phosphocholine; Ceramide; HIV; HTLV; Covid-19

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