title: Cerebrospinal fluid neopterin levels in 159 neurologically asymptomatic persons infected with the human immunodeficiency virus (HIV-1): relationship to immune status.
abstract: Monocytes and brain macrophage-microglial cells are thought to play a crucial role in the neurologic dysfunction associated with HIV-1 disease. Since neopterin is produced by monocytes-macrophages, we asked whether cerebrospinal fluid (CSF) neopterin levels increase before the onset of HIV-1 neurologic disease and whether they correlate with other CSF and peripheral blood immunologic parameters. In this study, CSF neopterin levels from 159 neurologically asymptomatic HIV-positive persons were found to increase as the blood CD4+ T-cell count decreased and as CSF IgG, IgG synthesis, IgG index, and beta 2-microglobulin increased. Neopterin levels in the CSF exceeded those in the serum in 32% of patients, while 25% had CSF levels > 13.5 nmol/liter. CSF neopterin levels vary with immune status, may reflect intrathecal production, and can be elevated in asymptomatic HIV-positive patients with normal neurologic examinations. Long-term follow-up of this patient population should be able to define the clinical correlation between CSF neopterin levels during the asymptomatic phase of HIV-1 disease and the risk of subsequent neurologic disease.
authors.affiliation: Department of Medicine, Wilford Hall USAF Medical Center, Lackland AFB, Texas.
authors.forename: D R
authors.initials: DR
authors.lastname: Lucey
authors.forename: S A
authors.initials: SA
authors.lastname: McGuire
authors.forename: S
authors.initials: S
authors.lastname: Abbadessa
authors.forename: K
authors.initials: K
authors.lastname: Hall
authors.forename: B
authors.initials: B
authors.lastname: Woolford
authors.forename: S
authors.initials: S
authors.lastname: Valtier
authors.forename: C A
authors.initials: CA
authors.lastname: Butzin
authors.forename: G P
authors.initials: GP
authors.lastname: Melcher
authors.forename: C W
authors.initials: CW
authors.lastname: Hendrix
mesh_terms: D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood / Q000134:cerebrospinal fluid; D015496:CD4-Positive T-Lymphocytes; D002490:Central Nervous System / Q000378:metabolism*; D005260:Female; D006679:HIV Seropositivity / Q000134:cerebrospinal fluid* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007958:Leukocyte Count; D008297:Male; D019798:Neopterin; D001613:beta 2-Microglobulin / Q000134:cerebrospinal fluid
chemical_list: D007074:Immunoglobulin G; D001613:beta 2-Microglobulin; D001708:Biopterins; D019798:Neopterin