Document 0020
 DOCN  M9550020
 TI    Intrathecal synthesis of anti-myelin basic protein IgG in HIV-1+
       patients.
 DT    9505
 AU    Maimone D; Annunziata P; Cioni C; Leonardi A; Guazzi GC; Institute of
       Neurological Sciences, University of Siena, Italy.
 SO    Acta Neurol Scand. 1994 Oct;90(4):285-92. Unique Identifier : AIDSLINE
       MED/95141775
 AB    Human immunodeficiency virus type 1 (HIV-1)-infected individuals
       frequently develop a broad spectrum of neurological syndromes,
       classified as HIV-1-associated cognitive/motor complex. Diffuse
       demyelination of hemispheric white matter is a commonly observed in
       HIV-1 infected brain, but the events leading to myelin destruction are
       still obscure. Since oligodendrocyte infection by HIV-1 is not proven as
       yet, myelin damage in HIV-1 infection may result from indirect
       mechanisms such as the excessive release of myelinotoxic substances or
       the triggering of autoimmune responses directed to myelin constituents.
       To verify the latter hypothesis, we searched for elevated anti-myelin
       basic protein (MBP) IgG levels in the cerebrospinal fluid (CSF) and
       serum of 25 patients with HIV-1 infection, 12 with multiple sclerosis
       (MS), and 9 with non-inflammatory neurological diseases (NIND). CSF, but
       not serum, anti-MBP IgG levels were more frequently elevated in HIV-1+
       (16/25, 64%) than in MS (3/12, 25%) or NIND (0/9) patients. By using the
       anti-MBP IgG index, the anti-MBP IgG antibody specificity index (ASI),
       and the search for anti-MBP oligoclonal IgG, we ascertained that
       anti-MBP IgG were produced within the CNS in 13 of 25 (52%) HIV-1+, in 6
       of 12 (50%) MS, and in none of NIND patients. The incidence of increased
       CSF anti-MBP IgG levels was higher among HIV-1+ patients at stage II-III
       (4/4, 100%) or at stage IV B (7/9, 78%) than among those at stage IV
       C-IV D (5/12, 42%). Although our data indicate that intrathecal anti-MBP
       IgG may occur early during HIV-1 infection and that they are more common
       in patients with HIV-1-associated cognitive/motor complex, the possible
       demyelinating role of these antibodies remains to be demonstrated.
 DE    Autoantibodies/*CEREBROSPINAL FLUID  AIDS Dementia
       Complex/DIAGNOSIS/*IMMUNOLOGY  Blood-Brain Barrier/IMMUNOLOGY
       Diagnosis, Differential  Encephalitogenic Basic Proteins/*IMMUNOLOGY
       Enzyme-Linked Immunosorbent Assay  Human  HIV
       Seropositivity/DIAGNOSIS/*IMMUNOLOGY  HIV-1/*IMMUNOLOGY
       IgG/*CEREBROSPINAL FLUID  Immunoglobulins/CEREBROSPINAL FLUID  Multiple
       Sclerosis/DIAGNOSIS/IMMUNOLOGY  Myelin Sheath/IMMUNOLOGY  Nervous System
       Diseases/DIAGNOSIS/IMMUNOLOGY  Neurologic Examination
       Neuropsychological Tests  Support, Non-U.S. Gov't  JOURNAL ARTICLE

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