Summary
Immunostimulation in the central nervous system (CNS) measured as abnormal intrathecal immunoglobulin production or activated lymphocytes in the cerebrospinal fluid (CSF), was found in 22 of 25 HIV seropositive patients. All of 11 patients with symptomatic HIV infection and nine of 14 asymptomatic patients had an increased IgG index or a Tourtellotte's production number indicating CNS infection. The amount of intrathecal immunoglobulin was not correlated to the severity of disease since five of six AIDS patients hat only slightly elevated values, while some patients without AIDS had a high intrathecal immunoglobulin production. Activated lymphocytes and plasma cells in CSF were frequently found in symptomatic HIV patients without AIDS as well as in asymptomatic HIV seropositive patients. Macrophages and activated monocytes were observed in CSF from AIDS patients. The results indicate that HIV has a high neurotropicity and is spread to CNS in all stages of the infection.
Zusammenfassung
Bei 22 von 25 HIV-seropositiven Patienten fanden sich Zeichen der Immunstimulation im ZNS, wie abnorme intrathekale Immunglobulinproduktion oder Nachweis aktivierter Lymphozyten. Ein erhöhter IgG-Index oder eine erhöhte Tourtellotte-Produktionszahl als Hinweis auf eine Infektion des Zentralnervensystems fanden sich bei allen 11 Patienten mit symptomatischer HIV-Infektion und bei neun von 14 asymptomatischen Patienten. Die Menge intrathekal nachweisbaren Immunglobulins korrelierte nicht mit dem Schweregrad der Erkrankung; fünf der sechs AIDS-Patienten hatten nur leicht erhöhte Werte, während die Immunglobulinproduktion im Liquorraum bei einigen Patienten ohne AIDS hoch war. Bei symptomatischen Patienten, die noch nicht das Vollbild von AIDS entwikkelt hatten wie auch bei asymptomatischen HIV-seropositiven Patienten ließen sich häufig aktivierte Lymphozyten und Plasmazellen im Liquor nachweisen. Bei AIDS-Patienten fanden sich Makrophagen und aktivierte Monozyten im Liquor. Die Ergebnisse sprechen dafür, daß HIV stark neurotrop ist und sich in allen Stadien der Infektion in das Zentralnervensystem ausbreitet.
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Literature
Petursson, G., Nathanson, N., Georgsson, G., Panitch, G., Pálson, P. Pathogenesis of visna. I. Sequential virologic, serologic, and pathologic studies. Lab. Invest. 35 (1972) 402–412.
Griffin, D. E., Narayan, O., Bulowski, J. F., Adams, R. J., Cohen, S. R. The cerebrospinal fluid in visna, a slow viral disease of sheep. Ann. Neurol. 4 (1978) 212–218.
Navia, B. A., Jordan, B. D., Price, R. W. The AIDS dementia complex: I. Clinical features. Ann. Neurol. 19 (1986) 517–524.
Navia, B. A., Cho, E.-S., Petito, C. K., Price, R. W. The AIDS dementia complex: II. Neuropathology. Ann. Neurol. 19 (1986) 525–535.
Carne, C. A., Smith, A., Sutherland, S., Elkington, S. G., Daly, H. M., Preston, F. E., Craske, J. Acute encephalopathy coincident with seroconversion for anti-HTLV-III. Lancet II (1985) 1206–1208.
Levy, R. M., Bredesen, D. E., Rosenblum, M. L. Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): Experience at UCSF and review of the literature. J. Neurosurg. 62 (1985) 475–495.
Hagberg, L., Malmvall, B.-E., Svennerholm, L., Alestig, K., Norkrans, G. Guillain-Barré syndrome as an early manifestation of HIV central nervous system infection. Scand. J. Infect. Dis. 18 (1986) 591–592.
Chiodi, F., Åsjö, B., Fenyö, E. M., Norkrans, G., Hagberg, L., Albert, J. Isolation of human immunodeficiency virus from cerebrospinal fluid of an antibody-positive virus carrier without neurological symptoms. Lancet II (1986) 1276–1277.
Update on acquired immune deficiency syndrome (AIDS): United States, Morbid Mortal Weekly Report 31 (1982) 507–514.
Laurell, C. B. Electroimmunoassay. Scand. J. Clin. Lab. Invest. 29 Suppl. 124 (1972) 21–37.
Tourtellotte, W. On cerebrospinal fluid immunoglobulin IgG quotients in multiple sclerosis and other diseases. J. Neurol. Sci. 10 (1970) 279–304.
Resnick, L., di-Marzo-Veronese, F., Schüpbach, J., Tourtellotte, W. W., Ho, D. D., Müller, F., Shapshak, P., Vogt, M., Groopman, J. E., Markham, P. D., Gallo, R. C. Intra blood-brain barrier synthesis of HTLV-III-specific IgG in patients with neurologic symptoms associated with AIDS or AIDS-related complex. N. Engl. J. Med. 313 (1985) 1498–1504.
Goudsmit, J., Wolters, E. C., Bakker, M., Smit, L., van der Noorda, J., Hische, E. A. H., Tutuarima, J. A., van der Helm, H. J. Intrathecal synthesis of antibodies to HTLV-III in patients without AIDS and AIDS related complex. Br. Med. J. 292 (1986) 1231–1234.
Shaw, G. M., Harper, M. E., Hahn, B. H., Epstein, L. G., Gajdusek, D. C., Price, R. W., Navia, B. A., Petito, C. K., O'Hara, C. J., Groopman, J. E., Cho, E.-S., Oleske, J. M., Wong-Staal, F., Gallo, R. C. HTLV-III infection in brains of children and adults with AIDS encephalopathy. Science 227 (1985) 177–181.
Johnson, R. T., McArthur, J. C. “AIDS and the brain”. Trends Neurosci. 9 (1986) 91–94.
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Hagberg, L., Norkrans, G., Forsman, A. et al. Cytological and immunoglobulin findings in cerebrospinal fluid of symptomatic and asymptomatic human immunodeficiency virus (HIV) seropositive patients. Infection 16, 13–18 (1988). https://doi.org/10.1007/BF01646922
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DOI: https://doi.org/10.1007/BF01646922