Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
NEUROIMMUNOLOGY OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION
AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 347-75, 1988.. Unique Identifier : AIDSLINE ICDB/89648475 Houff SA; Infectious Diseases Branch, Natl. Inst. of Neurological and; Communicative Diseases and Stroke, NIH, 9000 Rockville Pike,; Bldg. 36, Room 5D-06, Bethesda, MD 20892
Abstract:
The neurological syndromes in patients (pts) with AIDS and AIDS-related complex and those with antibodies to HIV are determined at least in part by the degree of immune impairment resulting from HIV infection. Neuroimmunology of HIV infection is discussed, including general immunology, immunology of the CNS, immunological consequences of HIV infection, neuroimmunological responses to infection (parasitic infections, fungal infections, bacterial infections, and viral infections), neuroimmunological responses to nervous system cancers, neuroimmunology of HIV infection of the nervous system and future research. Neurological infection appears to occur early in the clinical course of HIV infection. The pathogenesis of peripheral nerve diseases in AIDS pts is unknown. HIV infection of cells of the peripheral nervous system could result in an immune response that attacks peripheral nerves and causes inflammatory polyneuropathies. Several immune abnormalities in AIDS pts could contribute to autoimmune diseases. Polyclonal B-cell activation may result in autoantibodies directed against self-antigens. HIV infection of the CNS results in a humoral immune response and the appearance of antiviral antibodies in the cerebrospinal fluid (CSF). Pts without neurological disease may have antibodies to HIV in the CSF. Intra-blood-brain barrier synthesis of IgG to HIV in asymptomatic pts suggests that HIV infects the nervous system early. The demonstration of CD4 antigen on human brain cells is also an important contribution to the understanding of HIV-related neurological diseases. The distribution of the glycoprotein in the cortex, paralimbic system, and hippocampus may help to explain the dementia in pts with subacute encephalitis. The presence of CD4 glycoproteins on cell surfaces within the brain confirms the presence of the putative receptor for HIV within the nervous system. What remains to be resolved is whether internalization and replication of HIV will occur after binding to the cell surface takes place. Without these subsequent steps in viral replication, HIV binding to CD4 glycoproteins within the brain may not explain the neurological diseases caused by HIV. (88 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*IMMUNOLOGY Animal Bacterial Infections/ETIOLOGY/IMMUNOLOGY Blood-Brain Barrier Brain/IMMUNOLOGY Brain Diseases/ETIOLOGY/*IMMUNOLOGY Brain Neoplasms/ETIOLOGY/IMMUNOLOGY Glycoproteins/IMMUNOLOGY Human HIV/IMMUNOLOGY Immunologic Surveillance Opportunistic Infections/ETIOLOGY/IMMUNOLOGY T-Lymphocytes, Helper-Inducer/IMMUNOLOGY T-Lymphocytes, Suppressor-Effector/IMMUNOLOGY Virus Diseases/ETIOLOGY/IMMUNOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
