title: Detection of a vigorous HIV-1-specific cytotoxic T lymphocyte response in cerebrospinal fluid from infected persons with AIDS dementia complex.
abstract: AIDS dementia complex is a common neurologic disorder in later stages of HIV-1 infection. Because virus-specific CTL have been shown to contribute to neurologic disease in certain viral illnesses, we examined the cerebrospinal fluid of HIV-1-infected persons with various stages of AIDS dementia complex for the presence of HIV-1-specific CTL. In five of six subjects studied, HIV-1-specific CTL were identified in the cerebrospinal fluid. These CTL were directed at epitopes within the gag, reverse transcriptase, envelope, and nef proteins and restricted by HLA class I Ag. In four of these subjects, virus-specific CTL were detected in higher numbers in the cerebrospinal fluid compared to the peripheral blood, suggesting a specific recruitment to or local induction within the nervous system. These studies demonstrate the presence of a vigorous and broadly directed CTL response to HIV-1 in the central nervous system of infected persons with AIDS dementia complex, and provide immunologic evidence of localized intrathecal infection. Although HIV-1-specific CTL may serve to inhibit viral replication in the central nervous system, the presence of a persistent CTL response in the central nervous system may also contribute to the neurologic disorders characteristic of HIV-1 infection.
authors.affiliation: Infectious Disease Unit, Massachusetts General Hospital, Boston 02114.
authors.forename: C
authors.initials: C
authors.lastname: Jassoy
authors.forename: R P
authors.initials: RP
authors.lastname: Johnson
authors.forename: B A
authors.initials: BA
authors.lastname: Navia
authors.forename: J
authors.initials: J
authors.lastname: Worth
authors.forename: B D
authors.initials: BD
authors.lastname: Walker
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid* / Q000276:immunology; D000595:Amino Acid Sequence; D002555:Cerebrospinal Fluid / Q000166:cytology*; D003602:Cytotoxicity, Immunologic; D000939:Epitopes / Q000235:genetics; D015686:Gene Products, env / Q000276:immunology; D015683:Gene Products, gag / Q000276:immunology; D015693:Gene Products, nef / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007111:Immunity, Cellular; D016130:Immunophenotyping; D008969:Molecular Sequence Data; D012194:RNA-Directed DNA Polymerase / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*; D001616:beta-Galactosidase / Q000276:immunology; D054311:nef Gene Products, Human Immunodeficiency Virus
chemical_list: D000939:Epitopes; D015686:Gene Products, env; D015683:Gene Products, gag; D015693:Gene Products, nef; D006680:HLA Antigens; D054311:nef Gene Products, Human Immunodeficiency Virus; D012194:RNA-Directed DNA Polymerase; D001616:beta-Galactosidase