Pathways to neuronal injury and apoptosis in HIV-associated dementia

• Published in: Nature (London) Vol. 410; no. 6831; pp. 988 - 994
• Main Authors: Kaul, Marcus, Garden, Gwenn A, Lipton, Stuart A
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 19.04.2001
• Subjects: AIDS Dementia Complex - drug therapy; AIDS Dementia Complex - pathology; AIDS Dementia Complex - prevention & control; AIDS Dementia Complex - virology; Apoptosis; Astrocytes - physiology; Astrocytes - virology; Brain - pathology; Brain - physiopathology; Brain - virology; Dementia; Dementia disorders; HIV; HIV-1 - pathogenicity; HIV-1 - physiology; Human immunodeficiency virus; Human immunodeficiency virus 1; Humans; Macrophages - physiology; Macrophages - virology; Microglia - physiology; Microglia - virology; neuronal injury; Neurons; Neurons - pathology; Neurons - physiology; Receptors, Chemokine - physiology; Receptors, HIV - physiology; Retroviridae Proteins - metabolism; Toxins
• ISSN: 0028-0836; 1476-4687
• DOI: 10.1038/35073667

Human immunodeficiency virus-1 (HIV-1) can induce dementia with alarming occurrence worldwide. The mechanism remains poorly understood, but discovery in brain of HIV-1-binding sites (chemokine receptors) provides new insights. HIV-1 infects macrophages and microglia, but not neurons, although neurons are injured and die by apoptosis. The predominant pathway to neuronal injury is indirect through release of macrophage, microglial and astrocyte toxins, although direct injury by viral proteins might also contribute. These toxins overstimulate neurons, resulting in the formation of free radicals and excitotoxicity, similar to other neurodegenerative diseases. Recent advances in understanding the signalling pathways mediating these events offer hope for therapeutic intervention.