Journal ArticleDOI
The AIDS dementia complex: II. Neuropathology
TLDR
The AIDS dementia complex is established as a distinct clinical and pathological entity and, together with accumulating virological evidence, suggests that it is caused by direct LAV/HTLV‐III brain infection.Abstract:
In order to define the histopathological substrate of the dementia that frequently complicates the acquired immune deficiency syndrome (AIDS), we analyzed the neuropathological findings in 70 autopsied adult AIDS patients, 46 of whom had suffered clinically overt dementia. Less than 10% of the brains were histologically normal. Abnormalities were found predominantly in the white matter and in subcortical structures, with relative sparing of the cortex. Their frequency and severity generally correlated well with the degree and duration of clinical dementia. Most commonly noted was diffuse pallor in the white matter, which in the pathologically milder cases was accompanied by scanty perivascular infiltrates of lymphocytes and brown-pigmented macrophages, and in the most advanced cases by clusters of foamy macrophages and multinucleated cells associated with multifocal rarefaction of the white matter. However, in nearly one third of the demented cases the histopathological findings were remarkably bland in relation to the severity of clinical dysfunction. In addition, similar mild changes were noted in over one half of the nondemented patients, consistent with subclinical involvement. Vacuolar myelopathy was found in 23 patients and was generally more common and severe in patients with advanced brain pathology. Evidence of cytomegalovirus (CMV) infection was noted in nearly one quarter of the brains and was associated with a relative abundance of microglial nodules, but correlated neither with the major subcortical neuropathology nor with the clinical dementia, indicating that CMV infection likely represented a second, superimposed process. This study establishes the AIDS dementia complex as a distinct clinical and pathological entity and, together with accumulating virological evidence, suggests that it is caused by direct LAV/HTLV-III brain infection.read more
Citations
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Journal ArticleDOI
The AIDS dementia complex: I. Clinical features.
TL;DR: In the most advanced stage of this AIDS dementia complex, patients exhibited a stereotyped picture of severe dementia, mutism, incontinence, paraplegia, and in some cases, myoclonus.
Journal ArticleDOI
The AIDS Dementia Complex
Richard W. Price,Bruce J. Brew +1 more
TL;DR: The views of the current state of knowledge regarding the etiology, clinical presentation, and diagnostic and therapeutic approaches to the AIDS dementia complex are presented.
Journal ArticleDOI
The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex
Richard W. Price,Bruce J. Brew,John J. Sidtis,Marc K. Rosenblum,Adrienne C. Scheck,Paul D. Cleary +5 more
TL;DR: Within the context of the permissive effect of immunosuppression, genetic changes in HIV-1 may underlie the neuropathological heterogeneity of the AIDS dementia complex and its relatively independent course in relation to the systemic manifestations of AIDS noted in some patients.
Journal ArticleDOI
Macrophages and microglia in the nervous system
V. Hugh Perry,Siamon Gordon +1 more
TL;DR: The possible functions of resident and recruited macrophages in the developing and adult nervous system are reviewed and what contribution these cells might make to repair mechanisms in the central and peripheral nervous systems are examined.
Journal ArticleDOI
The role of microglia and macrophages in the pathophysiology of the CNS.
Guido Stoll,Sebastian Jander +1 more
TL;DR: There is increasing evidence that microglia play an active part in degenerative CNS diseases, in Alzheimer's disease activated microglian appear to be involved in plaque formation, and in experimental globoid cell dystrophy T-cell independent induction of major histocompatibility complex class II molecules on microglio accelerates demyelination.
References
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TL;DR: From these studies it is concluded that this virus as well as the previous HTLV isolates belong to a general family of T-lymphotropic retroviruses that are horizontally transmitted in humans and may be involved in several pathological syndromes, including AIDS.
Journal ArticleDOI
Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS
Robert C. Gallo,Syed Zaki Salahuddin,Mikulas Popovic,Gene M. Shearer,Mark H. Kaplan,Barton F. Haynes,Thomas J. Palker,Robert R. Redfield,James M. Oleske,Bijan Safai,Gilbert C. White,Paul Foster,Phillip D. Markham +12 more
TL;DR: Peripheral blood lymphocytes from patients with the acquired immunodeficiency syndrome (AIDS) or with signs or symptoms that frequently precede AIDS (pre-AIDS) were grown in vitro with added T-cell growth factor and assayed for the expression and release of human T-lymphotropic retroviruses (HTLV).
Journal ArticleDOI
Detection, Isolation, and Continuous Production of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and Pre-AIDS
TL;DR: A cell system was developed for the reproducible detection of human T-lymphotropic retroviruses (HTLV family) from patients with the acquired immunodeficiency syndrome (AIDS) or with signs or symptoms that frequently precede AIDS (pre-AIDS), and it provides large amounts of virus for detailed molecular and immunological analyses.
Journal ArticleDOI
The AIDS dementia complex: I. Clinical features.
TL;DR: In the most advanced stage of this AIDS dementia complex, patients exhibited a stereotyped picture of severe dementia, mutism, incontinence, paraplegia, and in some cases, myoclonus.