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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Progress in clinical neurosciences: the neuropathogenesis of HIV infection: host-virus interaction and the impact of therapy.
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Progress in clinical neurosciences: the neuropathogenesis of HIV infection: host-virus interaction and the impact of therapy.

机译：临床神经科学进展：HIV感染的神经发病机制：宿主与病毒的相互作用以及治疗的影响。

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摘要

Despite the availability of highly active antiretroviral therapy (HAART), primary HIV-related neurological diseases remain major problems in HIV clinics. The present review examines the pathogenesis of HIV-related dementia and the less severe minor cognitive and motor deficit, together with distal sensory and drug-induced toxic polyneuropathies. Abnormal host immune responses within the nervous system and the role of viral expression and diversity are emphasized in relation to neurovirulence. Induction of innate immune responses within the central and peripheral nervous systems, largely mediated by cells of macrophage lineage, appear to be common to the development of primary HIV-related neurological disease. Activation of these cell types results in the release of a cascade of inflammatory molecules including cytokines, chemokines, matrix metalloproteinases, and arachidonic acid metabolites that influence neuronal survival. Individual viral proteins encoded by envelope and tat genes and discrete sequences within these genes influence the extent to which these pro-inflammatory molecules are induced. At the same time, systemic immune suppression may influence the occurrence and severity of HIV-related neurological diseases. Implementation of HAART and neuroprotective treatments improves neurological function although the evolution of drug-resistant viral strains limits the sustained benefits of HAART.
机译：尽管可以使用高度有效的抗逆转录病毒疗法（HAART），但与HIV相关的原发性神经系统疾病仍然是HIV诊所的主要问题。本文综述了HIV相关痴呆的发病机理以及较轻的轻微认知和运动功能障碍，以及远端感觉和药物诱发的毒性多发性神经病。与神经毒力有关，强调了神经系统内宿主免疫反应异常以及病毒表达和多样性的作用。主要由巨噬细胞谱系细胞介导的中枢和周围神经系统内先天免疫应答的诱导似乎是原发性HIV相关神经疾病发展的普遍现象。这些细胞类型的激活导致一系列炎症分子的释放，包括影响神经元存活的细胞因子，趋化因子，基质金属蛋白酶和花生四烯酸代谢产物。由包膜和tat基因以及这些基因中的离散序列编码的单个病毒蛋白会影响这些促炎分子的诱导程度。同时，全身性免疫抑制可能会影响HIV相关神经系统疾病的发生和严重程度。尽管抗药性病毒株的进化限制了HAART的持续益处，但实施HAART和神经保护性治疗可改善神经功能。

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