Veera Venkata Ratnam Bandaru1, Michelle M Mielke, Ned Sacktor, Justin C McArthur, Igor Grant, Scott Letendre, Linda Chang, Valerie Wojna, Carlos Pardo, Peter Calabresi, Sody Munsaka, Norman J Haughey. 1. From the Department of Neurology, Division of Neuroimmunology and Neurological Infections (V.V.R.B., N.S., J.C.M., C.P., P.C., N.J.H.), and the Department of Psychiatry (N.J.H.), The Johns Hopkins University, School of Medicine, Baltimore, MD; the Department of Health Sciences Research (M.M.M.), Division of Epidemiology, The Mayo Clinic, Rochester, MN; HIV Neurobehavioral Research Program and Department of Psychiatry (I.G., S.L.), School of Medicine, University of California, San Diego, La Jolla; the Department of Psychiatry (L.C., S.M.), University of Hawaii, John A. Burns School of Medicine, Honolulu; and the Department of Neurology (V.W.), Specialized Neurosciences Research Program, University of Puerto Rico Medical Sciences Campus, San Juan.
Abstract
OBJECTIVE: In this multicenter cohort study, we sought to identify prognostic and associative metabolic indicators for HIV-associated neurocognitive disorders (HAND). METHODS: A quantitative lipidomic analysis was conducted on 524 longitudinal CSF samples collected from 7 different performance sites across the mainland United States, Hawaii, and Puerto Rico. Subjects included HIV-infected individuals with longitudinal clinical and cognitive testing data and cognitively normal HIV-negative healthy controls. RESULTS: At baseline, HIV+ subjects could be differentiated from HIV- controls by reductions in a single ceramide species and increases in multiple forms of cholesterol. Perturbations in cholesterol metabolism and ceramide were influenced by combined antiretroviral therapy (cART) use. There were no cross-sectional baseline differences in any lipid metabolite when HIV+ subjects were grouped according to cognitive status. However, a single sphingolipid metabolite and reduced levels of esterified cholesterols were prognostic indicators of incident cognitive decline. Longitudinal patterns of these disturbances in sphingolipid and sterol metabolism suggest that a progressive disorder of lipid metabolism that is similar to disorders of lipid storage may contribute to the pathogenesis of HAND. CONCLUSIONS: These findings suggest that HIV infection and cART are independently associated with a CNS metabolic disturbance, identify surrogate markers that are prognostic for cognitive decline, and implicate a lipid storage-like disorder in the progression of HAND.
OBJECTIVE: In this multicenter cohort study, we sought to identify prognostic and associative metabolic indicators for HIV-associated neurocognitive disorders (HAND). METHODS: A quantitative lipidomic analysis was conducted on 524 longitudinal CSF samples collected from 7 different performance sites across the mainland United States, Hawaii, and Puerto Rico. Subjects included HIV-infected individuals with longitudinal clinical and cognitive testing data and cognitively normal HIV-negative healthy controls. RESULTS: At baseline, HIV+ subjects could be differentiated from HIV- controls by reductions in a single ceramide species and increases in multiple forms of cholesterol. Perturbations in cholesterol metabolism and ceramide were influenced by combined antiretroviral therapy (cART) use. There were no cross-sectional baseline differences in any lipid metabolite when HIV+ subjects were grouped according to cognitive status. However, a single sphingolipid metabolite and reduced levels of esterified cholesterols were prognostic indicators of incident cognitive decline. Longitudinal patterns of these disturbances in sphingolipid and sterol metabolism suggest that a progressive disorder of lipid metabolism that is similar to disorders of lipid storage may contribute to the pathogenesis of HAND. CONCLUSIONS: These findings suggest that HIV infection and cART are independently associated with a CNS metabolic disturbance, identify surrogate markers that are prognostic for cognitive decline, and implicate a lipid storage-like disorder in the progression of HAND.
Authors: T Saint-Marc; M Partisani; I Poizot-Martin; F Bruno; O Rouviere; J M Lang; J A Gastaut; J L Touraine Journal: AIDS Date: 1999-09-10 Impact factor: 4.177
Authors: Edward Acheampong; Zahida Parveen; Aschalew Mengistu; Noel Ngoubilly; Brian Wigdahl; Albert S Lossinsky; Roger J Pomerantz; Muhammad Mukhtar Journal: J Virol Date: 2006-11-15 Impact factor: 5.103
Authors: María José Hernández-Corbacho; Russell W Jenkins; Christopher J Clarke; Yusuf A Hannun; Lina M Obeid; Ashley J Snider; Leah J Siskind Journal: PLoS One Date: 2011-06-08 Impact factor: 3.240
Authors: Ernest T Chivero; Ming-Lei Guo; Palsamy Periyasamy; Ke Liao; Shannon E Callen; Shilpa Buch Journal: J Neurosci Date: 2017-03-07 Impact factor: 6.167
Authors: Gary B Fogel; Susanna L Lamers; Andrew J Levine; Miguel Valdes-Sueiras; Michael S McGrath; Paul Shapshak; Elyse J Singer Journal: J Neurovirol Date: 2014-11-18 Impact factor: 2.643
Authors: B Lee Peterlin; Michelle M Mielke; Alex M Dickens; Subroto Chatterjee; Paul Dash; Guillermo Alexander; Rebeca V A Vieira; Veera Venkata Ratnam Bandaru; Joelle M Dorskind; Gretchen E Tietjen; Norman H Haughey Journal: Neurology Date: 2015-09-09 Impact factor: 9.910
Authors: Andrew D Sauerbeck; J Lukas Laws; Veera V R Bandaru; Phillip G Popovich; Norman J Haughey; Dana M McTigue Journal: J Neurotrauma Date: 2014-10-21 Impact factor: 5.269