Neuro-HIV-New insights into pathogenesis and emerging therapeutic targets
Document Type
Journal Article
Publication Date
12-1-2023
Journal
FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
37
Issue
12
DOI
10.1096/fj.202301239RR
Keywords
HAND; HIV; Nef; cholesterol; epigenetic modifications; extracellular vesicles; inflammation; lipid rafts; trained immunity
Abstract
HIV-associated neurocognitive disorders (HAND) is a term describing a complex set of cognitive impairments accompanying HIV infection. Successful antiretroviral therapy (ART) reduces the most severe forms of HAND, but milder forms affect over 50% of people living with HIV (PLWH). Pathogenesis of HAND in the ART era remains unknown. A variety of pathogenic factors, such as persistent HIV replication in the brain reservoir, HIV proteins released from infected brain cells, HIV-induced neuroinflammation, and some components of ART, have been implicated in driving HAND pathogenesis in ART-treated individuals. Here, we propose another factor-impairment of cholesterol homeostasis and lipid rafts by HIV-1 protein Nef-as a possible contributor to HAND pathogenesis. These effects of Nef on cholesterol may also underlie the effects of other pathogenic factors that constitute the multifactorial nature of HAND pathogenesis. The proposed Nef- and cholesterol-focused mechanism may provide a long-sought unified explanation of HAND pathogenesis that takes into account all contributing factors. Evidence for the impairment by Nef of cellular cholesterol balance, potential effects of this impairment on brain cells, and opportunities to therapeutically target this element of HAND pathogenesis are discussed.
APA Citation
Sviridov, Dmitri and Bukrinsky, Michael, "Neuro-HIV-New insights into pathogenesis and emerging therapeutic targets" (2023). GW Authored Works. Paper 4052.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4052
Department
Microbiology, Immunology, and Tropical Medicine