Human immunodeficiency virus infection and acquired immunodeficiency syndrome dementia complex: role of cells of monocyte-macrophage lineage.
The entry of human immunodeficiency virus (HIV) into the central nervous system (CNS) causes both the establishment of a lifelong viral reservoir in the brain and symptoms of neurological dysfunction that have an AIDS dementia complex (ADC) clinical appearance. Neurological dysfunction in ADC patients still remains an unresolved problem. However, ADC pathogenesis may be a multistep process that starts with HIV invasion of CNS by crossing the blood-brain barrier (BBB). It progresses by developing a chronic inflammatory status that can cause dysfunction in neurons and astrocytes that result in apoptotic death. Monocytes-macrophages (M/M) may play an important role by concealing the HIV transfer across the BBB. Furthermore, HIV-infected M/M could produce and release neurotoxic factors. In this review the main mediators and cells involved in pathogenesis and development of ADC are highlighted. A better understanding of the mechanisms involved in this process may help in a successful therapeutic approach to the neuropathogenesis of HIV infection.
Department of Experimental Medicine and Biochemical Sciences, University of Rome "Tor Vergata,", Rome, Italy. aquaro@uniroma2.it
Stefano
S
Aquaro
Luigi
L
Ronga
Michela
M
Pollicita
Andrea
A
Antinori
Alessandro
A
Ranazzi
Carlo Federico
CF
Perno
D015526:AIDS Dementia Complex / Q000150:complications* / Q000821:virology; D001921:Brain / Q000276:immunology / Q000473:pathology / Q000821:virology*; D019070:Cell Lineage; D004197:Disease Reservoirs; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006801:Humans; D008264:Macrophages / Q000166:cytology / Q000276:immunology / Q000821:virology*; D009000:Monocytes / Q000166:cytology / Q000276:immunology / Q000821:virology*; D015398:Signal Transduction / Q000276:immunology*