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Báo cáo y học: "Cerebrospinal fluid neopterin: an informative biomarker of central nervous system immune activation in HIV-1 infection"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Cerebrospinal fluid neopterin: an informative biomarker of central nervous system immune activation in HIV-1 infection. | Hagberg et al. AIDS Research and Therapy 2010 7 15 http www.aidsrestherapy.eom content 7 1 15 AIDS RESEARCH AND THERAPY REVIEW Open Access Cerebrospinal fluid neopterin an informative biomarker of central nervous system immune activation in HIV-1 infection Lars Hagberg 1 Paola Cinque2 Magnus Gisslen1 Bruce J Brew3 Serena Spudich4 Arabella Bestetti2 Richard W Price4 and Dietmar Fuchs5 Abstract HIV-1 invades the central nervous system CNS in the context of acute infection persists thereafter in the absence of treatment and leads to chronic intrathecal immunoactivation that can be measured by the macrophage activation marker neopterin in cerebrospinal fluid CSF . In this review we describe our experience with CSF neopterin measurements in 382 untreated HIV-infected patients across the spectrum of immunosuppression and HIV-related neurological diseases in 73 untreated AIDS patients with opportunistic CNS infections and in 233 treated patients. In untreated patients CSF neopterin concentrations are almost always elevated and increase progressively as immunosuppression worsens and blood CD4 cell counts fall. However patients with HIV dementia exhibit particularly high CSF neopterin concentrations above those of patients without neurological disease though patients with CNS opportunistic infections including CMV encephalitis and cryptococcal meningitis also exhibit high levels of CSF neopterin. Combination antiretroviral therapy with its potent effect on CNS HIV infection and CSF HIV RNA mitigates both intrathecal immunoactivation and lowers CSF neopterin. However despite suppression of plasma and CSF HIV RNA to below the detection limits of clinical assays 50 copies HIV RNA mL CSF neopterin often remains mildly elevated indicating persistent low-level intrathecal immune activation and raising the important questions of whether this elevation is driven by continued CNS infection and whether it causes continued indolent CNS injury. Although nonspecific CSF neopterin can .