Nuovo G J, Gallery F, MacConnell P, Braun A
Department of Pathology, SUNY at Stony Brook 11794-8691.
Am J Pathol. 1994 Apr;144(4):659-66.
This study determined the distribution of in situ polymerase chain reaction (PCR)-amplified HIV-1 nucleic acids in the central nervous system (CNS). Amplified viral DNA was detected in each of the seven HIV-1-positive cases and in none of the seven negative controls. HIV-1 DNA was rarely detected with standard in situ hybridization, consistent with low levels of proviral DNA. In patients with minimal clinical and pathological CNS involvement, only rare HIV-1 DNA-positive perivascular microglial cells were noted. In patients with dementia, many infected neurons and astrocytes as well as microglial cells were detected. Severe disease was also characterized by the detection of tumor necrosis factor-alpha (TNF-alpha) mRNA and viral RNA by reverse transcription (RT) in situ PCR. These results suggest that HIV-1 commonly exists in the CNS in the asymptomatic patient and that progression is marked by a dramatic increase of the number of cells with HIV-1 DNA, including neurons and astrocytes, and a concomitant upregulation of both viral and TNF-alpha transcription.
本研究确定了原位聚合酶链反应（PCR）扩增的HIV-1核酸在中枢神经系统（CNS）中的分布。在7例HIV-1阳性病例中均检测到扩增的病毒DNA，而7例阴性对照中均未检测到。用标准原位杂交很少能检测到HIV-1 DNA，这与前病毒DNA水平较低一致。在临床和病理上中枢神经系统受累较轻的患者中，仅发现罕见的HIV-1 DNA阳性血管周围小胶质细胞。在患有痴呆症的患者中，检测到许多被感染的神经元、星形胶质细胞以及小胶质细胞。严重疾病还表现为通过逆转录（RT）原位PCR检测到肿瘤坏死因子-α（TNF-α）mRNA和病毒RNA。这些结果表明，HIV-1在无症状患者的中枢神经系统中普遍存在，并且疾病进展的特征是含有HIV-1 DNA的细胞数量急剧增加，包括神经元和星形胶质细胞，同时病毒和TNF-α转录上调。
