Scutari Rossana, Alteri Claudia, Perno Carlo Federico, Svicher Valentina, Aquaro Stefano
Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome 00133, Italy.
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Arcavacata di Rende (CS) 87036, Italy.
Brain Sci. 2017 Apr 6;7(4):38. doi: 10.3390/brainsci7040038.
The central nervous system (CNS) is a very challenging HIV-1 sanctuary, in which HIV-1 replication is established early on during acute infection and can persist despite potent antiretroviral treatments. HIV-1 infected macrophages play a pivotal role acting as vehicles for HIV-1 to spread into the brain, and can be the major contributor of an early compartmentalization. HIV-1 infection in CNS may lead to a broad spectrum of neurological syndromes, such as dementia, mild neurocognitive disorders, and asymptomatic impairment. These clinical manifestations are caused by the release of neurotoxins from infected cells (mainly macrophages), and also by several HIV-1 proteins, able to activate cell-signaling involved in the control of cellular survival and apoptosis. This review is aimed at highlighting the virological aspects associated with the onset of neurocognitive disorders and at addressing the novel therapeutic approaches to stop HIV-1 replication in this critical sanctuary.
中枢神经系统（CNS）是一个极具挑战性的HIV-1庇护所，在急性感染早期就会建立HIV-1复制，并且即使接受强效抗逆转录病毒治疗也可能持续存在。感染HIV-1的巨噬细胞在HIV-1扩散至大脑的过程中起着关键作用，可成为早期分隔的主要促成因素。中枢神经系统中的HIV-1感染可能导致多种神经综合征，如痴呆、轻度神经认知障碍和无症状损伤。这些临床表现是由受感染细胞（主要是巨噬细胞）释放神经毒素引起的，也是由几种能够激活参与细胞存活和凋亡控制的细胞信号传导的HIV-1蛋白引起的。本综述旨在突出与神经认知障碍发病相关的病毒学方面，并探讨在这个关键庇护所中阻止HIV-1复制的新型治疗方法。
