Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
Curr Top Med Chem. 2021;21(12):1052-1066. doi: 10.2174/1568026621666210412152428.
With the introduction of antiretroviral therapy, the worldwide AIDS-related deaths have decreased, and life expectancy has increased, including the prevalence of AIDS-related neurological disorders or neuroAIDS. HIV-associated neurocognitive disorders such as mild neurocognitive disorder and asymptomatic neurocognitive impairment have largely remained stable or increased among the HIV-infected individuals in the combination antiretroviral therapy era. The emerging evidence that antiretrovirals with high CNS penetration effectiveness score contribute to the neurotoxicity and HIV-associated neurocognitive disorders has ushered the search for natural, nontoxic bioactive constituents having pre-established neuroprotective, anti-inflammatory, and restorative neurocognitive activity. In this review, we have highlighted the probable mechanism of neuroAIDS infection, the problem with the existing antiretroviral therapy, along with various bioactive constituents with in vivo, in vitro, or ex vivo evidence of their neuroprotective activity that can be used as an adjuvant with the current combination antiretroviral therapy regimen or can even serve as an alternate to the antiretrovirals for treatment of HIV associated neurocognitive disorder.
随着抗逆转录病毒疗法的引入，全球与艾滋病相关的死亡人数有所减少，预期寿命也有所提高，包括艾滋病相关的神经障碍或神经艾滋病。在联合抗逆转录病毒疗法时代，艾滋病毒感染者中，艾滋病毒相关的轻度认知障碍和无症状认知障碍等神经认知障碍在很大程度上保持稳定或增加。新出现的证据表明，具有高中枢神经系统穿透效能评分的抗逆转录病毒药物会导致神经毒性和与艾滋病毒相关的神经认知障碍，这促使人们寻找具有预先确定的神经保护、抗炎和恢复神经认知活性的天然、无毒的生物活性成分。在这篇综述中，我们强调了神经艾滋病感染的可能机制、现有抗逆转录病毒疗法存在的问题，以及具有体内、体外或离体神经保护活性证据的各种生物活性成分，这些成分可以作为当前联合抗逆转录病毒疗法方案的辅助治疗，甚至可以替代抗逆转录病毒药物治疗与艾滋病毒相关的神经认知障碍。
