Ceereena Ubaida-Mohien1, Benjamin Lamberty, Alex M Dickens, Michelle M Mielke, Thomas Marcotte, Ned Sacktor, Igor Grant, Scott Letendre, Donald Franklin, Pawel Cibrowski, Ravi Tharakan, Justin C McArthur, Howard Fox, Norman J Haughey. 1. aIntramural Research Program, National Institute on Aging, Baltimore, Maryland bDepartment of Pharmacology and Experimental Neuroscience, The University of Nebraska Medical Center, Omaha, Nebraska cDepartment of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland dDivision of Epidemiology, Department of Health Sciences Research eDepartment of Neurology College of Medicine, Mayo Clinic, Rochester, Minnesota fHIV Neurobehavioral Research Program and Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California gDepartment of Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Abstract
BACKGROUND: The prevalence of HIV-associated neurocognitive disorders (HAND) has not changed considerably in the last two decades. Potent antiretroviral therapy has shifted the severity of HAND to milder phenotypes, but excess morbidity and mortality continue to be associated with HAND. Changes in numerous markers of immune function, inflammation, and cellular stress have been repeatedly associated with HAND, but the underlying systems that drive these changes have not been identified. METHOD: In this study, we used systems informatics to interrogate the cerebrospinal fluid proteomic content of longitudinal samples obtained from HIV-infected adults with stably unimpaired, stably impaired, worsening, or improving neurocognitive performance. RESULTS AND CONCLUSION: The patterns of change in cerebrospinal fluid protein content implicated the induction of acute phase and complement systems as important regulators of neurocognitive status. Worsening neurocognitive performance was preceded by induction of acute phase and complement systems, whereas improving neurocognitive performance was preceded by a downregulation of these systems.
BACKGROUND: The prevalence of HIV-associated neurocognitive disorders (HAND) has not changed considerably in the last two decades. Potent antiretroviral therapy has shifted the severity of HAND to milder phenotypes, but excess morbidity and mortality continue to be associated with HAND. Changes in numerous markers of immune function, inflammation, and cellular stress have been repeatedly associated with HAND, but the underlying systems that drive these changes have not been identified. METHOD: In this study, we used systems informatics to interrogate the cerebrospinal fluid proteomic content of longitudinal samples obtained from HIV-infected adults with stably unimpaired, stably impaired, worsening, or improving neurocognitive performance. RESULTS AND CONCLUSION: The patterns of change in cerebrospinal fluid protein content implicated the induction of acute phase and complement systems as important regulators of neurocognitive status. Worsening neurocognitive performance was preceded by induction of acute phase and complement systems, whereas improving neurocognitive performance was preceded by a downregulation of these systems.
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