Immunoglobulin deposition in sural nerves of AIDS patients with distal-symmetric HIV-associated polyneuropathy.
The most frequent neurological diagnosis in peripheral nerve function of HIV-positive individuals is distal-symmetric polyneuropathy (DSPN). In this study we investigated the histopathology as well as the immunohistochemical expression of immunoglobulins IgA, IgG and IgM in post-mortem sural nerve tissue gained from 11 patients who had suffered from DSPN in the clinical course of AIDS (CDC 3C). We found that all 11 sural nerves showed signs of demyelination while in 6 out of 11 cases axonal degeneration could also be detected. Immunohistochemical expression of at least one immunoglobulin was found in all but two cases with deposits uniformly being located immediately beneath the basement membrane of capillary blood vessels and within the perineurium while endoneurial staining was discernable in three cases. The most commonly expressed immunoglobulin was IgA which was identified in 7 cases, followed by IgG and IgM which were positive in 6 and 5 cases, respectively. All three immunoglobulins were found to be expressed simultaneously in only two cases. Thus, our study shows that immunoglobulin deposits among other factors may be implicated in altering the function of sural nerves or enhance their vulnerability. In peripheral nerves they may be responsible for some of the common alterations in the development of AIDS-associated distal symmetric polyneuropathy.
Rickert
C H
CH
Gerhard-Domagk-Institute of Pathology, University Hospital Münster, Germany. rickchr@uni-muenster.de
Evers
S
S
Heese
C
C
Reichelt
D
D
Husstedt
I W
IW
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology* / Q000473:pathology; D000328:Adult; D000936:Antigen-Antibody Complex / Q000032:analysis; D001369:Axons / Q000276:immunology / Q000473:pathology / Q000821:virology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007136:Immunoglobulins / Q000032:analysis*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D013497:Sural Nerve / Q000276:immunology* / Q000473:pathology / Q000821:virology
D000936:Antigen-Antibody Complex; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007136:Immunoglobulins