Inflammatory changes and breakdown of microvascular integrity in early human immunodeficiency virus dementia.
Increased postcontrast enhancement in contrast-enhanced magnetic resonance imaging (CE-MRI) of the central nervous system (CNS) is a predictor of human immunodeficiency virus (HIV) dementia severity in HIV-infected subjects. The present study confirms this earlier finding in a mildly impaired patient cohort, and demonstrates that the increased postcontrast enhancement is correlated with increased cerebrospinal fluid (CSF) levels of monocyte chemoattractant protein (MCP)-1, an inflammatory chemokine, and increased CNS levels of mI, a microglial marker. These results suggest that early CNS inflammation may underlie the microvascular changes observed, and may be a factor in the development of HIV dementia.
Avison
Malcolm J
MJ
Department of Neurology, University of Kentucky Medical Center, Lexington, USA. calum.avison@vanderbilt.edu
Nath
Avindra
A
Greene-Avison
Robin
R
Schmitt
Frederick A
FA
Bales
Rodney A
RA
Ethisham
As'ad
A
Greenberg
Richard N
RN
Berger
Joseph R
JR
D015526:AIDS Dementia Complex / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001812:Blood-Brain Barrier; D002560:Cerebrovascular Circulation; D003071:Cognition; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008833:Microcirculation / Q000473:pathology*; D008875:Middle Aged; D018579:Patient Selection; D016896:Treatment Outcome