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HIV 感染者脑细胞外游离水的纵向分析。

A longitudinal analysis of brain extracellular free water in HIV infected individuals.

机构信息

Department of Neurology, University of Rochester, Rochester, NY, USA.

Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA.

出版信息

Sci Rep. 2021 Apr 15;11(1):8273. doi: 10.1038/s41598-021-87801-y.

DOI:10.1038/s41598-021-87801-y
PMID:33859326
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8050285/
Abstract

Initiation of combination antiretroviral therapy (cART) reduces inflammation in HIV-infected (HIV+) individuals. Recent studies demonstrated that diffusion MRI based extracellular free water (FW) modeling can be sensitive to neuroinflammation. Here, we investigate the FW in HIV-infection, its temporal evolution, and its association with blood markers, and cognitive scores. Using 96 age-matched participants, we found that FW was significantly elevated in grey and white matter in cART-naïve HIV+ compared to HIV-uninfected (HIV-) individuals at baseline. These increased FW values positively correlated with neurofilament light chain (NfL) and negatively correlated with CD4 counts. FW in grey and white matter, as well as NfL decreased in the HIV+ after 12 weeks of cART treatment. No significant FW differences were noted between the HIV+ and HIV- cohorts at 1 and 2-year follow-up. Results suggest that FW elevation in cART-naïve HIV+ participants is likely due to neuroinflammation. The correlation between FW and NfL, and the improvement in both FW and NfL after 12 weeks of cART treatment further reinforces this conclusion. The longer follow-up at 1 and 2 years suggests that cART helped control neuroinflammation as inferred by FW. Therefore, FW could be used as a biomarker to monitor HIV-associated neuroinflammation.

摘要

起始联合抗逆转录病毒疗法（cART）可降低 HIV 感染者的炎症水平。最近的研究表明，基于弥散磁共振成像的细胞外游离水（FW）建模可以敏感地反映神经炎症。在此，我们研究了 HIV 感染中的 FW，其时间演变及其与血液标志物和认知评分的关系。通过对 96 名年龄匹配的参与者进行研究，我们发现，在基线时，未经 cART 治疗的 HIV+患者的灰质和白质中的 FW 明显高于 HIV-未感染者。这些增加的 FW 值与神经丝轻链（NfL）呈正相关，与 CD4 计数呈负相关。在 cART 治疗 12 周后，HIV+患者的灰质和白质中的 FW 以及 NfL 均降低。在 1 年和 2 年的随访中，HIV+患者和 HIV-患者之间未观察到 FW 的显著差异。结果表明，FW 在未经 cART 治疗的 HIV+患者中的升高可能是由于神经炎症所致。FW 与 NfL 之间的相关性，以及 cART 治疗 12 周后 FW 和 NfL 的改善，进一步证实了这一结论。在 1 年和 2 年的更长随访中，FW 表明 cART 有助于控制神经炎症。因此，FW 可作为监测 HIV 相关神经炎症的生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/1c8edc30ae72/41598_2021_87801_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/7dbaab3dad10/41598_2021_87801_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/3746817428a1/41598_2021_87801_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/f1cec65fb828/41598_2021_87801_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/1c8edc30ae72/41598_2021_87801_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/7dbaab3dad10/41598_2021_87801_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/3746817428a1/41598_2021_87801_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/f1cec65fb828/41598_2021_87801_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a6a/8050285/1c8edc30ae72/41598_2021_87801_Fig4_HTML.jpg

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