HIV-1 effects on neuropsychological performance in a resource-limited country, Zambia.

Zambia has substantially been affected by the HIV/AIDS epidemic with prevalence rates at 14% in a population estimated at 12 million. Yet, the extent of HIV-associated neurocognitive disorders (HAND) in this population remains to be clearly understood. A series of culturally appropriate neuropsychological (NP) assessments [International HIV Dementia Scale (IHDS), Color Trails Test 1 and 2, Grooved pegboard Test, and Time Gait Test] were used to test the effects of HIV on NP performance of HIV seropositive and seronegative individuals. Twenty-two percent HIV positive individuals ARV naïve met the criteria for IHDS-defined NP impairment. Gender significantly influenced the performance on NP tests with females performing more poorly compared to males. Larger studies that will accommodate gender differences and age are necessary to generate appropriate norms in Zambia in order to better assess the prevalence of HAND in the developing country setting.

Links between progressive HIV-1 infection of humanized mice and viral neuropathogenesis.

Few rodent models of human immunodeficiency virus type one (HIV-1) infection can reflect the course of viral infection in humans. To this end, we investigated the relationships between progressive HIV-1 infection, immune compromise, and neuroinflammatory responses in NOD/scid-IL-2Rγ(c)(null) mice reconstituted with human hematopoietic CD34(+) stem cells. Human blood-borne macrophages repopulated the meninges and perivascular spaces of chimeric animals. Viral infection in lymphoid tissue led to the accelerated entry of human cells into the brain, marked neuroinflammation, and HIV-1 replication in human mononuclear phagocytes. A meningitis and less commonly an encephalitis followed cM-T807 antibody-mediated CD8(+) cell depletion. We conclude that HIV-1-infected NOD/scid-IL-2Rγ(c)(null) humanized mice can, at least in part, recapitulate lentiviral neuropathobiology. This model of neuroAIDS reflects the virological, immunological, and early disease-associated neuropathological components of human disease.

Modulation of innate immunity by copolymer-1 leads to neuroprotection in murine HIV-1 encephalitis.

Virus-infected and immune-competent mononuclear phagocytes (MP; perivascular macrophages and microglia) drive the neuropathogenesis of human immunodeficiency virus type 1 (HIV-1) infection. Modulation of the MP phenotype from neurodestructive to neuroprotective underlies adjunctive therapeutic strategies for human disease. We reasoned that, as Copolymer-1 (Cop-1) can induce neuroprotective activities in a number of neuroinflammatory and neurodegenerative disorders, it could directly modulate HIV-1-infected MP neurotoxic activities. We now demonstrate that, in laboratory assays, Cop-1-stimulated virus-infected human monocyte-derived macrophages (MDM) protect against neuronal injury. Severe combined immune-deficient (SCID) mice were stereotactically injected with HIV-1-infected human MDM, into the basal ganglia, to induce HIV-1 encephalitis (HIVE). Cop-1 was administered subcutaneously for 7 days. In HIVE mice, Cop-1 treatment led to anti-inflammatory and neuroprotective responses. Reduced micro- and astrogliosis, and conserved NeuN/MAP-2 levels were observed in virus-affected brain regions in Cop-1-treated mice. These were linked to interleukin-10 and brain-derived neurotrophic factor expression and downregulation of inducible nitric oxide synthase. The data, taken together, demonstrate that Cop-1 can modulate innate immunity and, as such, improve disease outcomes in an animal model of HIVE.

Copolymer-1 induces adaptive immune anti-inflammatory glial and neuroprotective responses in a murine model of HIV-1 encephalitis.

Copolymer-1 (COP-1) elicits neuroprotective activities in a wide range of neurodegenerative disorders. This occurs, in part, by adaptive immune-mediated suppression of microglial inflammatory responses. Because HIV infection and immune activation of perivascular macrophages and microglia drive a metabolic encephalopathy, we reasoned that COP-1 could be developed as an adjunctive therapy for disease. To test this, we developed a novel animal model system that reflects HIV-1 encephalitis in rodents with both innate and adaptive arms of the immune system. Bone marrow-derived macrophages were infected with HIV-1/vesicular stomatitis-pseudotyped virus and stereotactically injected into the basal ganglia of syngeneic mice. HIV-1 pseudotyped with vesicular stomatitis virus envelope-infected bone marrow-derived macrophages induced significant neuroinflammation, including astrogliosis and microglial activation with subsequent neuronal damage. Importantly, COP-1 immunization reduced astro- and microgliosis while diminishing neurodegeneration. Hippocampal neurogenesis was, in part, restored. This paralleled reductions in proinflammatory cytokines, including TNF-alpha and IL-1beta, and inducible NO synthase, and increases in brain-derived neurotrophic factor. Ingress of Foxp3- and IL-4-expressing lymphocytes into brains of COP-1-immunized animals was observed. We conclude that COP-1 may warrant therapeutic consideration for HIV-1-associated cognitive impairments.

Characterization of the temporo-spatial effects of chronic bilateral intrahippocampal cannulae on interleukin-1beta

The implantation of a foreign object in the brain produces an acute neuroinflammatory state in which glia (astrocytes and microglia) may remain chronically activated in response to the inert foreign object. Activated glia can exhibit a sensitized pro-inflammatory response to immunogenic stimuli. This may be relevant to intracranial cannula implantation, which is commonly used to administer substances directly into the brain. If intracranial cannulation activates glia, a subsequent neuroinflammatory stimulus might induce a potentiated pro-inflammatory response, thereby introducing a potential experimental confound. We tested the temporal and spatial responses of interleukin-1β (IL-1β) to an acute immune challenge produced by lipopolysaccharide (LPS) in animals with chronic bilateral intrahippocampal cannulae implants (stainless steel). Cannulation increased the gene expression of the microglia activation antigens MHC II and CD11b, but not the astrocyte antigen GFAP. Moreover, this activation was temporally and spatially dependent. In addition, IL-1β mRNA, but not IL-1β protein, was significantly elevated in cannulated animals. Administration of LPS, however, significantly potentiated the brain IL-1β response in cannulated animals, but not in stab wounded or naïve animals. This IL-1β response was also temporo-spatially dependent. Thus, the pro-inflammatory sequelae of intracranial cannulation should be considered when designing studies of neuroinflammatory processes(AU)

Characterization of the temporo-spatial effects of chronic bilateral intrahippocampal cannulae on interleukin-1beta.

The implantation of a foreign object in the brain produces an acute neuroinflammatory state in which glia (astrocytes and microglia) may remain chronically activated in response to the inert foreign object. Activated glia can exhibit a sensitized pro-inflammatory response to immunogenic stimuli. This may be relevant to intracranial cannula implantation, which is commonly used to administer substances directly into the brain. If intracranial cannulation activates glia, a subsequent neuroinflammatory stimulus might induce a potentiated pro-inflammatory response, thereby introducing a potential experimental confound. We tested the temporal and spatial responses of interleukin-1beta (IL-1beta) to an acute immune challenge produced by lipopolysaccharide (LPS) in animals with chronic bilateral intrahippocampal cannulae implants (stainless steel). Cannulation increased the gene expression of the microglia activation antigens MHC II and CD11b, but not the astrocyte antigen GFAP. Moreover, this activation was temporally and spatially dependent. In addition, IL-1beta mRNA, but not IL-1beta protein, was significantly elevated in cannulated animals. Administration of LPS, however, significantly potentiated the brain IL-1beta response in cannulated animals, but not in stab wounded or naïve animals. This IL-1beta response was also temporo-spatially dependent. Thus, the pro-inflammatory sequelae of intracranial cannulation should be considered when designing studies of neuroinflammatory processes.

HIV-1 gp120 stimulates proinflammatory cytokine-mediated pain facilitation via activation of nitric oxide synthase-I (nNOS).

It has become clear that spinal cord glia (microglia and astrocytes) importantly contribute to the creation of exaggerated pain responses. One model used to study this is peri-spinal (intrathecal, i.t.) administration of gp120, an envelope protein of HIV-1 known to activate glia. Previous studies demonstrated that i.t. gp120 produces pain facilitation via the release of glial proinflammatory cytokines. The present series of studies tested whether spinal nitric oxide (NO) contributes to i.t. gp120-induced mechanical allodynia and, if so, what effect NO has on spinal proinflammatory cytokines. gp120 stimulation of acutely isolated lumbar dorsal spinal cords released NO as well as proinflammatory cytokines (tumor necrosis factor-alpha, interleukin-1beta (IL1), interleukin-6 (IL6)), thus identifying NO as a candidate mediator of gp120-induced behavioral effects. Behaviorally, identical effects were observed when gp120-induced mechanical allodynia was challenged by i.t. pre-treatment with either a broad-spectrum nitric oxide synthase (NOS) inhibitor (L-NAME) or 7-NINA, a selective inhibitor of NOS type-I (nNOS). Both abolished gp120-induced mechanical allodynia. While the literature pre-dominantly documents that proinflammatory cytokines stimulate the production of NO rather than the reverse, here we show that gp120-induced NO increases proinflammatory cytokine mRNA levels (RT-PCR) and both protein expression and protein release (serial ELISA). Furthermore, gp120 increases mRNA for IL1 converting enzyme and matrix metalloproteinase-9, enzymes responsible for activation and release of proinflammatory cytokines.

A method for measuring multiple cytokines from small samples.

Commercially available enzyme-linked immunosorbent assay (ELISA) kits are commonly used to assess levels of proinflammatory cytokines in biological samples. Most of these kits require sample volumes of at least 50 microl. Thus, in order to examine multiple cytokines, volumes greater than 100 microl must be collected. However, the volume of many biological samples, especially those collected from the central nervous system (i.e., microdialysates, push-pull perfusions, or cerebrospinal fluid samples), is much less than 100 microl. Therefore, we developed a method for analyzing multiple cytokines from a single, low-volume biological sample, which involves serially assaying the samples on multiple proinflammatory cytokine ELISA kits. In many cases, assaying for one cytokine does not interfere with subsequent assay for another cytokine in the same sample. Moreover, when interference is observed, the interfering factor can be identified and its effect minimized.