Document 0288
 DOCN  M9590288
 TI    HIV neuropathology: consequences of direct infection.
 DT    9509
 AU    Gonzales M; Neuropathology Research Laboratory, Royal Melbourne
       Hospital,; Parkville, VIC.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:222 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291811
 AB    The appearance of HIV-specific antibodies in CSF soon after
       seroconversion and the subsequent development of a range of
       neuropathological changes reflect HIV neurotropism. Lymphoma and a range
       of opportunistic infections are components of the spectrum of
       HIV-related CNS pathology but a slowly developing encephalopathy
       involving white and deep grey matter appears to be a consequence of
       direct CNS infection. This encephalopathy contributes to a clinical
       syndrome of motor and cognitive deficits for which HIV-1 associated
       cognitive/motor complex has been suggested. The essential pathological
       features of this complex include microglial nodules containing
       multinucleated giant cells (MNGC's) in white matter, vacuolation of
       myelin and astrocytic proliferation. There is also a variable degree of
       cortical neuronal loss and reduction in synaptic density. Intrinsic
       microglial cells and the MNGC's, formed from bone marrow derived
       monocyte/macrophages appear to be the only cells that are productively
       infected. However there are some data to suggest restrictive infection
       of astrocytes, particularly in young children with encepahalopathy. The
       pathology of the HIV-associated cognitive/motor complex appears to be an
       indirect consequence of infection of MNGC's and microglia, mediated
       through gp120, cytokines, in particular TNF-a and arachidonic acid
       metabolites. Some of these activate neuronal NMDA receptors. Neuronal
       loss may be related to nitric oxide toxicity. A similar mechanism
       resulting in degeneration of dorsal root ganglia neurones may contribute
       to the distal predominantly sensory neuropathy which is commonly seen in
       patients with AIDS.
 DE    Acquired Immunodeficiency Syndrome/PATHOLOGY  Adult
       Astrocytes/PATHOLOGY  AIDS Dementia Complex/*PATHOLOGY  Child  Ganglia,
       Spinal/PATHOLOGY  Human  Motor Neuron Disease/*PATHOLOGY  Nerve
       Degeneration/PHYSIOLOGY  Syndrome  MEETING ABSTRACT

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