Abstract

BackgroundPeripheral neuropathy is currently the most common neurological complication in HIV-infected individuals, occurring in 35–50% of patients undergoing combination anti-retroviral therapy. Data have shown that distal symmetric polyneuropathy develops in mice by 6 weeks following infection with the LP-BM5 retrovirus mixture. Previous work from our laboratory has demonstrated that glial cells modulate antiviral T-cell effector responses through the programmed death (PD)-1: PD-L1 pathway, thereby limiting the deleterious consequences of unrestrained neuroinflammation.MethodsUsing the MouseMet electronic von Frey system, we assessed hind-paw mechanical hypersensitivity in LP-BM5-infected wild-type (WT) and PD-1 KO animals. Using multi-color flow cytometry, we quantitatively assessed cellular infiltration and microglial activation. Using real-time RT-PCR, we assessed viral load, expression of IFN-γ, iNOS, and MHC class II. Using western blotting, we measured protein nitrosylation within the lumbar spinal cord (LSC) and dorsal root ganglion (DRG). Histochemical staining was performed to analyze the presence of CD3, ionized calcium binding adaptor molecule (Iba)-1, MHCII, nitrotyrosine, isolectin B4 (IB4) binding, and neurofilament 200 (NF200). Statistical analyses were carried out using graphpad prism.ResultsHind-paw mechanical hypersensitivity observed in LP-BM5-infected animals was associated with significantly increased lymphocyte infiltration into the spinal cord and DRG. We also observed elevated expression of IFN-γ (in LSC and DRG) and MHC II (on resident microglia in LSC). We detected elevated levels of 3-nitrotyrosine within the LSC and DRG of LP-BM5-infected animals, an indicator of nitric oxide (NO)-induced protein damage. Moreover, we observed 3-nitrotyrosine in both small (IB4+) and large (NF200+) DRG sensory neurons. Additionally, infected PD-1 KO animals displayed significantly greater mechanical hypersensitivity than WT or uninfected mice at 4 weeks post-infection (p.i.). Accelerated onset of hind-paw hypersensitivity in PD-1 KO animals was associated with significantly increased infiltration of CD4+ and CD8+ T lymphocytes, macrophages, and microglial activation at early time points. Importantly, we also observed elevated levels of 3-nitrotyrosine and iNOS in infected PD-1 KO animals when compared with WT animals.ConclusionsResults reported here connect peripheral immune cell infiltration and reactive gliosis with nitrosative damage. These data may help elucidate how retroviral infection-induced neuroinflammatory networks contribute to nerve damage and neuropathic pain.

Highlights

  • Peripheral neuropathy is currently the most common neurological complication in Human Immunodeficiency virus (HIV)-infected individuals, occurring in 35–50% of patients undergoing combination anti-retroviral therapy

  • Increased CD4+ and CD8+ T-cell infiltration into the spinal cord and dorsal root ganglion (DRG) of murine-acquired immunodeficiency syndrome (MAIDS) mice with distal symmetrical polyneuropathy (DSP) We examined the infiltration of CD4+ and CD8+ T lymphocytes into the spinal cord of animals with DSP at 10 weeks p.i

  • Accelerated onset of hind-paw mechanical hypersensitivity in programmed death (PD)-1 KO animals infected with LP-BM5 and associated immune dysregulation To determine if LP-BM5 would induce signs of peripheral neuropathy in chronically infected PD-1 KO animals, we examined hind-paw mechanical hypersensitivity as described in the previous section

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Summary

Introduction

Peripheral neuropathy is currently the most common neurological complication in HIV-infected individuals, occurring in 35–50% of patients undergoing combination anti-retroviral therapy. Patients with distal symmetrical polyneuropathy (DSP), the most common peripheral neuropathy occurring with HIV infection, report debilitating effects on their quality of life such as painful, abnormal touch sensations (dysesthesias), burning, pins-and-needles sensations, and numbness which are often associated with mechanical allodynia [5]. These symptoms generally begin distally on the soles of the Chauhan et al Journal of Neuroinflammation (2018) 15:66 feet and are symmetrically distributed to legs, with upper extremities being affected later [6]. The urgent need to understand HIV-DSP pathogenesis, identify risk factors in addition to neurotoxic drugs, and develop effective preventative strategies will intensify as cART patients live longer

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