Seilhean D, Dzia-Lepfoundzou A, Sazdovitch V, Cannella B, Raine C S, Katlama C, Bricaire F, Duyckaerts C, Hauw J J
Raymond Escourolle Laboratory of Neuropathology, La Salpêtrière Hospital, Paris, France.
Neuropathol Appl Neurobiol. 1997 Apr;23(2):83-92.
Half of AIDS dementia cases are associated with HIV-encephalitis or myelin pallor. Another half die with no HIV-related neuropathological changes. Previous observations suggest that cerebral dysfunction may result from more subtle cellular interactions. and that some of them may be mediated by cell adhesion molecules. In the present study the expression by astrocytes and endothelial cells of intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) was analysed as a function of the neuropathological diagnosis, the density of astrogliosis and of HIV-1 positive cells, and of the mental status. Twelve AIDS cases, without focal brain lesion, eight of whom were demented, were selected from a prospective study. They were compared with six control cases with multiple sclerosis, and with six control patients without neurological disease. ICAM-1 and VCAM-1 expression was localized by immunofluorescence and confocal microscopy. HIV protein gp41 was detected by immunohistochemistry on adjacent sections. Endothelial expression of ICAM-1 and VCAM-1 was significantly up-regulated in all AIDS patients. VCAM-1 only was related to myelin pallor. The density of VCAM-1 or ICAM-1 positive astrocytes increased in demented AIDS patients, independently of the neuropathological findings or the density of gp41 positive cells. Expression of cell adhesion molecules, together with other secondary mechanisms such as secretion of cytokines may play a role in the pathogenesis of white matter lesions leading to HIV-1-associated cognitive changes.
一半的艾滋病痴呆病例与HIV脑炎或髓鞘苍白有关。另一半患者死亡时无HIV相关的神经病理改变。先前的观察表明，脑功能障碍可能源于更微妙的细胞相互作用，其中一些可能由细胞粘附分子介导。在本研究中，分析了星形胶质细胞和内皮细胞的细胞间粘附分子-1（ICAM-1）和血管细胞粘附分子-1（VCAM-1）的表达与神经病理诊断、星形胶质细胞增生密度、HIV-1阳性细胞以及精神状态的关系。从一项前瞻性研究中选取了12例无局灶性脑病变的艾滋病病例，其中8例患有痴呆。将他们与6例患有多发性硬化症的对照病例以及6例无神经疾病的对照患者进行比较。通过免疫荧光和共聚焦显微镜对ICAM-1和VCAM-1的表达进行定位。在相邻切片上通过免疫组织化学检测HIV蛋白gp41。所有艾滋病患者内皮细胞中ICAM-1和VCAM-1的表达均显著上调。仅VCAM-1与髓鞘苍白有关。痴呆的艾滋病患者中VCAM-1或ICAM-1阳性星形胶质细胞的密度增加，与神经病理结果或gp41阳性细胞的密度无关。细胞粘附分子的表达，连同其他次要机制如细胞因子的分泌，可能在导致HIV-1相关认知改变的白质病变发病机制中起作用。
