title: Elevated central nervous system prostaglandins in human immunodeficiency virus-associated dementia.
abstract: The dementia associated with human immunodeficiency virus (HIV) is poorly understood. Dementia is accompanied by infection and activation of macrophage lineage cells in the brain and production of toxic products by these cells has been postulated to play a role in the pathogenesis of dementia. Eicosanoids are potential products of activated macrophages that can mediate cell injury. We measured the levels of prostaglandin E2 in the cerebrospinal fluid of HIV-positive individuals with dementia and/or myelopathy and compared these levels with those of HIV-negative patients with other neurological diseases and HIV-positive patients without dementia. Cerebrospinal fluid prostaglandin E2 levels were increased in dementia. This increase was associated with severity of dementia and correlated with cerebrospinal fluid levels of neopterin and beta 2-microglobulin. Prostaglandins F2 alpha and thromboxane B2, additional products of the cyclooxygenase pathway of arachidonic acid metabolism, were also elevated in dementia, but leukotriene C4, a product of the lipoxygenase pathway was not. Since synthesis of prostaglandins is regulated in part by the levels of inducible forms of cyclooxygenase, we measured the levels of cyclooxygenase-1 and 2 mRNAs in the brains of HIV-positive individuals with and without dementia by reverse transcriptase polymerase chain reaction. Levels of intact cyclooxygenase-1 mRNA were higher in the brains of demented individuals, but this did not reach statistical significance. These data demonstrate that prostaglandins are increased in the central nervous system in HIV-associated dementia and may play a role in the development of neurological dysfunction.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: D E
authors.initials: DE
authors.lastname: Griffin
authors.forename: S L
authors.initials: SL
authors.lastname: Wesselingh
authors.forename: J C
authors.initials: JC
authors.lastname: McArthur
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid*; D001483:Base Sequence; D001921:Brain / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes; D015331:Cohort Studies; D015232:Dinoprostone / Q000134:cerebrospinal fluid*; D006679:HIV Seropositivity / Q000134:cerebrospinal fluid; D006801:Humans; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D012333:RNA, Messenger / Q000032:analysis; D011863:Radioimmunoassay; D012016:Reference Values
chemical_list: D012333:RNA, Messenger; D011451:Prostaglandin-Endoperoxide Synthases; D015232:Dinoprostone