Role of HIV in the pathogenesis of distal symmetrical peripheral neuropathy

Nicolo Rizzuto, Tiziana Cavallaro, Salvatore Monaco, Michela Morbin, Bruno Bonetti, Sergio Ferrari, Sandra Galiazzo-Rizzuto, Giampietro Zanette, Laura Bertolasi

Research output: Contribution to journalArticle

Abstract

We report the results of a clinical, electrophysiological and pathological study conducted in 18 AIDS patients presenting a distal symmetrical predominantly sensory polyneuropathy (DSPN) characterized by painful dysesthesias as main complaint. Onset of the neuropathy was at CDC (Center for Disease Control) stage II in 2 patients, at CDC stage III in 5 patients and at CDC stage IV in the remainder. Electrophysiological investigation confirmed the presence of an axonal alteration in the sensory nerves, but also revealed motor involvement in all cases. The neuropathological features of sensory nerves were fiber loss and axonal degeneration with macrophagic activation. The expression of monocyte-macrophage markers and of major histocompatibily complex class II antigens appeared up-regulated in endoneurial ramified cells, while expression of CR3, a complement receptor involved in the process of phagocytosis, was down-regulated. In six nerve biopsy samples and in two out of five DSPN dorsal root ganglia we found HIV-related mRNA and protein located in scattered cells of the endoneurium which we presume to be macrophages. These data suggest that: (a) DSPN may occur early in the course of the disease and is not limited to later stages; (b) DSPN is not a ganglionitis but is actually a sensory-motor neuropathy; (c) the virus enters the peripheral nervous system and induces changes in the immunocompetent cell population with activation of macrophages. Storage of the virus inside macrophages may act both as a reservoir for the virus and as a putative cause of nerve damage, probably through release of cytotoxins and/or interaction with trophic factors.

Original languageEnglish
Pages (from-to)244-250
Number of pages7
JournalActa Neuropathologica
Volume90
Issue number3
DOIs
Publication statusPublished - Sep 1995

Keywords

  • Dorsal root ganglia
  • HIV infection
  • In situ hybridization
  • Painful neuropathy
  • Peripheral nerve biopsy

ASJC Scopus subject areas

  • Neuroscience(all)
  • Pathology and Forensic Medicine
  • Clinical Neurology

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  • Cite this

    Rizzuto, N., Cavallaro, T., Monaco, S., Morbin, M., Bonetti, B., Ferrari, S., Galiazzo-Rizzuto, S., Zanette, G., & Bertolasi, L. (1995). Role of HIV in the pathogenesis of distal symmetrical peripheral neuropathy. Acta Neuropathologica, 90(3), 244-250. https://doi.org/10.1007/BF00296507