Jassoy C, Johnson R P, Navia B A, Worth J, Walker B D
Infectious Disease Unit, Massachusetts General Hospital, Boston 02114.
J Immunol. 1992 Nov 1;149(9):3113-9.
AIDS dementia complex is a common neurologic disorder in later stages of HIV-1 infection. Because virus-specific CTL have been shown to contribute to neurologic disease in certain viral illnesses, we examined the cerebrospinal fluid of HIV-1-infected persons with various stages of AIDS dementia complex for the presence of HIV-1-specific CTL. In five of six subjects studied, HIV-1-specific CTL were identified in the cerebrospinal fluid. These CTL were directed at epitopes within the gag, reverse transcriptase, envelope, and nef proteins and restricted by HLA class I Ag. In four of these subjects, virus-specific CTL were detected in higher numbers in the cerebrospinal fluid compared to the peripheral blood, suggesting a specific recruitment to or local induction within the nervous system. These studies demonstrate the presence of a vigorous and broadly directed CTL response to HIV-1 in the central nervous system of infected persons with AIDS dementia complex, and provide immunologic evidence of localized intrathecal infection. Although HIV-1-specific CTL may serve to inhibit viral replication in the central nervous system, the presence of a persistent CTL response in the central nervous system may also contribute to the neurologic disorders characteristic of HIV-1 infection.
艾滋病痴呆综合征是HIV-1感染后期常见的神经系统疾病。由于在某些病毒性疾病中，病毒特异性细胞毒性T淋巴细胞（CTL）已被证明与神经系统疾病有关，我们检测了患有不同阶段艾滋病痴呆综合征的HIV-1感染者的脑脊液中是否存在HIV-1特异性CTL。在研究的6名受试者中，有5名在脑脊液中鉴定出了HIV-1特异性CTL。这些CTL针对gag、逆转录酶、包膜和nef蛋白中的表位，并受HLA I类抗原限制。在其中4名受试者中，脑脊液中检测到的病毒特异性CTL数量高于外周血，这表明在神经系统中存在特异性募集或局部诱导。这些研究证明，在患有艾滋病痴呆综合征的感染者的中枢神经系统中存在对HIV-1的强烈且广泛的CTL反应，并提供了鞘内局部感染的免疫学证据。虽然HIV-1特异性CTL可能有助于抑制中枢神经系统中的病毒复制，但中枢神经系统中持续存在的CTL反应也可能导致HIV-1感染所特有的神经系统疾病。
