Abstract

Human immunodeficiency virus (HIV) is associated with neuroendocrine dysfunction which may contribute to co-morbid stress-sensitive disorders. The hypothalamic-pituitary-adrenal (HPA) or -gonadal (HPG) axes are perturbed in up to 50% of HIV patients. The mechanisms are not known, but we have found the HIV-1 trans-activator of transcription (Tat) protein to recapitulate the clinical phenotype in male mice. We hypothesized that HPA and/or HPG dysregulation contributes to Tat-mediated interactions with oxycodone, an opioid often prescribed to HIV patients, in females. Female mice that conditionally-expressed the Tat1–86 protein [Tat(+) mice] or their counterparts that did not [Tat(−) control mice] were exposed to forced swim stress (or not) and behaviorally-assessed for motor and anxiety-like behavior. Some mice had glucocorticoid receptors (GR) or corticotropin-releasing factor receptors (CRF-R) pharmacologically inhibited. Some mice were ovariectomized (OVX). As seen previously in males, Tat elevated basal corticosterone levels and potentiated oxycodone’s psychomotor activity in females. Unlike males, females did not demonstrate adrenal insufficiency and oxycodone potentiation was not regulated by GRs or CRF-Rs. Rather OVX attenuated Tat/oxycodone interactions. Either Tat or oxycodone increased anxiety-like behavior and their combination increased hypothalamic allopregnanolone. OVX increased basal hypothalamic allopregnanolone and obviated Tat or oxycodone-mediated fluctuations. Together, these data provide further evidence for Tat-mediated dysregulation of the HPA axis and reveal the importance of HPG axis regulation in females. HPA/HPG disruption may contribute vulnerability to affective and substance use disorders.

Highlights

  • Human immunodeficiency virus type 1 (HIV-1) infection remains a significant public health concern with ~1.1 million people living with HIV in the U.S The widespread use of combined antiretroviral therapeutics has largely increased life expectancy among

  • central nervous system (CNS) complications include neuropathic pain resulting in 8–52% of HIV-1 patients being prescribed opioids [7,8,9,10,11,12] which may interact with HIV-1 proteins, complicating outcomes

  • Disruption of mitochondrial activity in the CNS may contribute to neuroendocrine dysfunction observed in HIV+ patients given that mitochondria are the rate-limiting organelle necessary for steroidogenesis

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Summary

Introduction

HIV-infected patients; the inability of cART to target latent central nervous system (CNS) reservoirs including microglia and astrocytes [1], likely contributes to the persistence of central viremia and neurological symptomatology [2,3]. While the mechanisms that underlie neuroHIV remain the subject of intense investigation, neurotoxic HIV-1 proteins can persist within in the CNS where cART is poorly retained (indicated by the presence of viral proteins in cerebrospinal fluid [13,14]). Disruption of mitochondrial activity in the CNS may contribute to neuroendocrine dysfunction observed in HIV+ patients given that mitochondria are the rate-limiting organelle necessary for steroidogenesis

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