Document 0228
 DOCN  M9440228
 TI    Intrathecal IgG synthesis and albumin leakage are increased in subjects
       with HIV-1 neurologic disease.
 DT    9404
 AU    Singer EJ; Syndulko K; Fahy-Chandon B; Schmid P; Conrad A; Tourtellotte
       WW; Neurology and Research Services, VAMC West Los Angeles 90073.
 SO    J Acquir Immune Defic Syndr. 1994 Mar;7(3):265-71. Unique Identifier :
       AIDSLINE MED/94149561
 AB    We analyzed matched cerebrospinal fluid and blood samples from 139
       subjects enrolled in a study of the effects of human immunodeficiency
       virus type 1 (HIV-1) on the nervous system. Mean total intrathecal IgG
       synthesis rate was significantly higher in subjects with HIV-1-related
       neurologic disease (NeuroPos) than in HIV-1-seropositive (HIV+) subjects
       without neurologic disease (NeuroNeg) or at-risk seronegative controls
       (SNC). Mean trans-blood-brain barrier (BBB) albumin leakage (AL) rate
       increased significantly across groups (SNC < NeuroNeg < NeuroPos). AL
       was significantly higher in subjects with absolute CD4 counts < 100/mm3
       versus those with > or = 100 cells/mm3 and significantly higher in AIDS
       compared with asymptomatic HIV+. Elevated total intrathecal IgG
       synthesis rate could not be accounted for solely by the presence of a
       damaged BBB, because 79% of subjects with elevated IgG synthesis rates
       had a normal BBB as assessed by the AL formula. Furthermore, the
       Tourtellotte formula inherently corrects for BBB leakage. We confirmed,
       using state-of-the-art albumin and IgG determinations, that intrathecal
       IgG synthesis is prevalent in all stages of HIV-1 disease. In the
       absence of a CNS opportunistic infection or tumor, mean total
       intrathecal IgG synthesis rate and trans-BBB AL are significantly higher
       in subjects with clinical HIV-1 CNS disease than in neurologically
       normally HIV+ subjects.
 DE    Adult  Aged  Albumins/CEREBROSPINAL FLUID/*METABOLISM  Blood-Brain
       Barrier  Cross-Sectional Studies  CD4-CD8 Ratio  Human  HIV
       Infections/BLOOD/*CEREBROSPINAL FLUID  HIV
       Seropositivity/BLOOD/CEREBROSPINAL FLUID  *HIV-1
       IgG/*BIOSYNTHESIS/BLOOD/CEREBROSPINAL FLUID  Leukocyte Count  Male
       Middle Age  Nephelometry and Turbidimetry  Nervous System
       Diseases/BLOOD/*CEREBROSPINAL FLUID  Serum Albumin/ANALYSIS  Support,
       Non-U.S. Gov't  Support, U.S. Gov't, Non-P.H.S.  Support, U.S. Gov't,
       P.H.S.  T4 Lymphocytes  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).