Brain large artery inflammation associated with HIV and large artery remodeling.
Brain large artery inflammation associated with HIV and large artery remodeling.
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DOI：
10.1097/qad.0000000000000927
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发表时间：
2016-01-28
期刊：
影响因子：
--
通讯作者：
Morgello S
中科院分区：
文献类型：
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作者：
Gutierrez J;Menshawy K;Gonzalez M;Goldman J;Elkind MS;Marshall R;Morgello S
检验HIV阳性病例的脑动脉比HIV阴性病例的脑动脉具有更大程度的炎症，并且炎症与脑动脉重塑相关的假设。病例对照研究，横断面。系统分析了162例尸检病例（84例HIV感染者）的脑动脉内膜、中膜和外膜厚度，动脉粥样硬化和长扩张。用CD68+免疫组织化学评估炎症，并用反映数量和位置的半定量评分（即，动脉层）的活化巨噬细胞浸润动脉壁。用抗水痘带状疱疹病毒（VZV）基因63产物免疫组织化学方法检测VZV。所有病例均提供了人口统计学和临床变量，艾滋病毒感染病例中提供了关于CD4+细胞计数的纵向数据。多水平广义线性模型用于测试炎症和HIV之间的关联。与HIV阴性病例的动脉相比，HIV阳性病例的动脉具有更高的炎症评分（B = 0.36，P = 0.05），尽管在控制了人口统计学变量、血管危险因素和潜伏性VZV后，这种相关性减弱（B = 0.20，P = 0.18）。虽然内膜炎症在有和无HIV的病例中相似，但外膜炎症与HIV相关。内膜炎症与颅内动脉粥样硬化相关，与HIV状态无关，但外膜炎症与HIV相关的动脉中膜薄的长扩张相关。外膜炎症与HIV和不依赖于颅内动脉粥样硬化的扩张过长相关。这表明不同的炎症反应可能在颅内动脉粥样硬化和长颈扩张中起作用。
To test the hypothesis that brain arteries from HIV+ cases have a greater degree of inflammation than brain arteries from HIV− cases, and that inflammation is associated with brain arterial remodeling. Case–control study, cross-sectional. Brain arteries from 162 autopsy cases (84 with HIV) were systematically analyzed for thickness of the intima, media, and adventitia, and atherosclerosis and dolichoectasia. Inflammation was assessed with CD68+ immunohistochemistry, and measured with a semiquantitative score reflecting the number and location (i.e., arterial layer) of activated macrophages infiltrating the arterial wall. Latent varicella zoster virus (VZV) was assessed with anti-VZV gene 63 product immunohistochemistry. Demographic and clinical variables were available in all cases, and longitudinal data about CD4+ cell counts were available among cases with HIV. Multilevel generalized linear models were used to test the association between inflammation and HIV. Arteries from HIV+ cases had a higher inflammation score (B = 0.36, P = 0.05) compared with arteries from HIV− cases, although the association was attenuated after controlling for demographic variables, vascular risk factors, and latent VZV (B = 0.20, P = 0.18). Although intimal inflammation was similar in cases with and without HIV, adventitial inflammation was associated with HIV. Intimal inflammation was associated with intracranial atherosclerosis independent of HIV status, but adventitial inflammation was associated with HIV-associated dolichoectasia in arteries with a thin media. Adventitial inflammation is associated with HIV and dolichoectasia independent of intracranial atherosclerosis. This suggests that differential inflammatory responses may play a role in intracranial atherosclerosis and dolichoectasia.