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1996-02-27
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Document 0035
DOCN M9630035
TI Role of HIV in the pathogenesis of distal symmetrical peripheral
neuropathy.
DT 9603
AU Rizzuto N; Cavallaro T; Monaco S; Morbin M; Bonetti B; Ferrari S;
Galiazzo-Rizzuto S; Zanette G; Bertolasi L; Department of Neurological
and Visual Sciences, University of; Verona, Italy.
SO Acta Neuropathol (Berl). 1995;90(3):244-50. Unique Identifier : AIDSLINE
MED/96049767
AB We report the results of a clinical, electrophysiological and
pathological study conducted in 18 AIDS patients presenting a distal
symmetrical predominantly sensory polyneuropathy (DSPN) characterized by
painful dysesthesias as main complaint. Onset of the neuropathy was at
CDC (Center for Disease Control) stage II in 2 patients, at CDC stage
III in 5 patients and at CDC stage IV in the remainder.
Electrophysiological investigation confirmed the presence of an axonal
alteration in the sensory nerves, but also revealed motor involvement in
all cases. The neuropathological features of sensory nerves were fiber
loss and axonal degeneration with macrophagic activation. The expression
of monocyte-macrophage markers and of major histocompatibility complex
class II antigens appeared up-regulated in endoneurial ramified cells,
while expression of CR3, a complement receptor involved in the process
of phagocytosis, was down-regulated. In six nerve biopsy samples and in
two out of five DSPN dorsal root ganglia we found HIV-related mRNA and
protein located in scattered cells of the endoneurium which we presume
to be macrophages. These data suggest that: (a) DSPN may occur early in
the course of the disease and is not limited to later stages; (b) DSPN
is not a ganglionitis but is actually a sensory-motor neuropathy; (c)
the virus enters the peripheral nervous system and induces changes in
the immunocompetent cell population with activation of macrophages.
Storage of the virus inside macrophages may act both as a reservoir for
the virus and as a putative cause of nerve damage, probably through
release of cytotoxins and/or interaction with trophic factors.
DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Autopsy
Biopsy Electrophysiology Female Ganglia, Spinal/*PATHOLOGY Human
HIV Immunohistochemistry In Situ Hybridization Male Middle Age
Peripheral Nervous System/*PATHOLOGY 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).