Irish Bryan P, Khan Zafar K, Jain Pooja, Nonnemacher Michael R, Pirrone Vanessa, Rahman Saifur, Rajagopalan Nirmala, Suchitra Joyce B, Mostoller Kate, Wigdahl Brian
Department of Microbiology and Immunology, Center for Molecular Virology and Neuroimmunology, Center for Molecular Therapeutics and Resistance, Center for International Medicine, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129, USA.
Am J Infect Dis. 2009 Jul 1;5(3):231-258. doi: 10.3844/ajidsp.2009.231.258.
Infection with retroviruses such as human immunodeficiency virus type 1 (HIV-1) and human T cell leukemia virus type 1 (HTLV-1) have been shown to lead to neurodegenerative diseases such as HIV-associated dementia (HAD) or neuroAIDS and HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP), respectively. APPROACH: HIV-1-induced neurologic disease is associated with an influx of HIV-infected monocytic cells across the blood-brain barrier. Following neuroinvasion, HIV-1 and viral proteins, in addition to cellular mediators released from infected and uninfected cells participate in astrocytic and neuronal dysregulation, leading to mild to severe neurocognitive disorders. RESULTS: The molecular architecture of viral regulatory components including the Long Terminal Repeat (LTR), genes encoding the viral proteins Tat, Vpr and Nef as well as the envelope gene encoding gp120 and gp41 have been implicated in 'indirect' mechanisms of neuronal injury, mechanisms which are likely responsible for the majority of CNS damage induced by HIV-1 infection. The neuropathogenesis of HAM/TSP is linked, in part, with both intra-and extracellular effectors functions of the viral transactivator protein Tax and likely other viral proteins. Tax is traditionally known to localize in the nucleus of infected cells serving as a regulator of both viral and cellular gene expression. CONCLUSION/RECOMMENDATIONS: However, recent evidence has suggested that Tax may also accumulate in the cytoplasm and be released from the infected cell through regulated cellular secretion processes. Once in the extracellular environment, Tax may cause functional alterations in cells of the peripheral blood, lymphoid organs and the central nervous system. These extracellular biological activities of Tax are likely very relevant to the neuropathogenesis of HTLV-1 and represent attractive targets for therapeutic intervention.
已证明感染逆转录病毒,如1型人类免疫缺陷病毒(HIV-1)和1型人类T细胞白血病病毒(HTLV-1),分别会导致神经退行性疾病,如HIV相关痴呆(HAD)或神经艾滋病以及HTLV-1相关脊髓病/热带痉挛性截瘫(HAM/TSP)。
HIV-1诱导的神经疾病与受HIV感染的单核细胞穿过血脑屏障的流入有关。神经入侵后,HIV-1和病毒蛋白,以及从感染和未感染细胞释放的细胞介质,参与星形细胞和神经元失调,导致轻度至重度神经认知障碍。
病毒调节成分的分子结构,包括长末端重复序列(LTR)、编码病毒蛋白Tat、Vpr和Nef的基因,以及编码gp120和gp41的包膜基因,已被认为与神经元损伤的“间接”机制有关,这些机制可能是HIV-1感染引起的大多数中枢神经系统损伤的原因。HAM/TSP的神经发病机制部分与病毒反式激活蛋白Tax的细胞内和细胞外效应器功能以及可能的其他病毒蛋白有关。传统上已知Tax定位于受感染细胞的细胞核,作为病毒和细胞基因表达的调节因子。
结论/建议:然而,最近的证据表明,Tax也可能在细胞质中积累,并通过调节细胞分泌过程从受感染细胞中释放出来。一旦进入细胞外环境,Tax可能会导致外周血、淋巴器官和中枢神经系统细胞的功能改变。Tax的这些细胞外生物学活性可能与HTLV-1的神经发病机制非常相关,并且是治疗干预的有吸引力的靶点。