Abstract
Chronic inflammation may contribute to neuropsychological impairments in individuals with HIV, and modulation of this inflammatory response by opiate receptor ligands is important in light of the prevalence of drug use in HIV populations. Exogenous MOR and KOR agonists have differential effects on central nervous system (CNS) immunity and, while some data suggest KOR agonists are immunosuppressive, the KOR agonist dynorphin has been shown to stimulate human monocyte chemotaxis. In this study, we examined mRNA levels of endogenous opioid receptors OPRK1 and OPRM1, prodynorphin (PDYN), macrophage scavenger receptor CD163, and microglia/macrophage marker CD68 in the caudate and anterior cingulate of postmortem brains from HIV-positive and HIV-negative subjects. Brain tissues of HIV-infected (n = 24) and control subjects (n = 15) were obtained from the Manhattan HIV Brain Bank. Quantification of the gene mRNA was performed using SYBR Green RT-PCR. CD68 and CD163 were increased in HIV-positive (HIV+) compared to HIV-negative (HIV-) individuals in both brain regions. There were higher OPRK1 (P <0.005), and lower PDYN mRNA (P <0.005) levels in the anterior cingulate of HIV+ compared to HIV- subjects. This difference between the clinical groups was not found in the caudate. There was no difference in the levels of OPRM1 mRNA between HIV+ and HIV- subjects. Using linear regression analysis, we examined the relationship of OPRK1 and PDYN mRNA levels in the HIV+ subjects with seven cognitive domain T scores of a neuropsychological test battery. Within the HIV+ subjects, there was a positive correlation between anterior cingulate PDYN mRNA levels and better T-scores in the motor domain. Within the HIV+ subjects there were also positive correlations of both OPRK1 and PDYN mRNA levels with the anti-inflammatory marker CD163, but not with proinflammatory CD68 levels. In this setting, decreased PDYN mRNA may reflect a homeostatic mechanism to reduce monocyte migration, accompanied by compensatory increases in the cognate receptor (KOR) to dampen pro-inflammatory responses. It is possible that enhanced neuroprotection and better motor performance are associated with higher levels of dynorphin and the recruitment of neuroprotective CD163-positive macrophages. Further studies are needed to test this hypothesis.
Highlights
Despite the availability of combination antiretroviral therapy (CART), which has successfully controlled HIV viremia and improved immune function in many treated HIV-infected patients, HIV-associated neurocognitive disorder (HAND) remains highly prevalent [1]
In order to investigate whether there is an impact of the Kappa opioid receptor (KOR)/PDYN system and Mu opioid receptor gene (OPRM1) on HIV-related neuropsychological impairment, we examined the postmortem brains of HIV-infected and control subjects to identify any changes in quantitatively measured levels of PDYN, Kappa opioid receptor gene (OPRK1) and OPRM1 as well levels of macrophage markers CD68 and Scavenger receptor (CD163) in the caudate and anterior cingulate
Expression of opioid receptor genes We have found significantly higher levels of OPRK1 mRNA in the anterior cingulate (P
Summary
Despite the availability of combination antiretroviral therapy (CART), which has successfully controlled HIV viremia and improved immune function in many treated HIV-infected patients, HIV-associated neurocognitive disorder (HAND) remains highly prevalent [1]. Despite numerous reports of effects of exogenous opiates, drugs of abuse, on replication of HIV, HIVassociated neurotoxicity and modulation of immune responses in cell culture, animal models, and AIDS pathology in humans, (for example, [7,8]) much less is known of the impact of the endogenous opioid system on HIV neuropathogenesis and HIV-associated neurocognitive impairment. In vivo and in vitro studies showed that stimulation of opioid receptors by exogenous MOP agonists like morphine leads to suppression of multiple components of the immune response including phagocytosis, natural killer cell activity, chemokine-induced chemotaxis, antibody response and cell-mediated immunity ( for review [10]). In humans and nonhuman primates, exogenous high-efficacy κ-opioid-receptor agonists have dose-dependent central nervous system (CNS)-mediated effects that include sedation (for example, unresponsiveness to environmental stimuli), dysphoria, anhedonia, depressive symptoms and psychotomimesis [16,17,18]
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have