Higher soluble CD14 levels are associated with lower visuospatial memory performance in youth with HIV
Higher soluble CD14 levels are associated with lower visuospatial memory performance in youth with HIV
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DOI：
10.1097/qad.0000000000002371
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发表时间：
2019-12-01
期刊：
影响因子：
3.8
通讯作者：
Sleasman, John W.
中科院分区：
文献类型：
--
作者：
Kim-Chang, Julie J.;Donovan, Kevin;Sleasman, John W.
目的：尽管早期抗逆转录病毒治疗（ART）和最佳的病毒抑制，艾滋病毒相关的神经认知障碍仍然存在。我们研究了由各种免疫激活途径驱动的免疫发病机制与HIV青年（YWH）离散神经认知表现域之间的关系。设计：观察性横断面研究。研究方法：使用ELISA/多重测定法评估入选青少年医学试验网络071/101的20-28岁的YWH的巨噬细胞、淋巴细胞活化和血管炎症的生物标志物。进行标准化的神经认知测试，并结合人口统计学调整的z分数，以形成注意力，运动，执行功能，言语和视觉空间记忆指数。对18种血浆炎症生物标志物与每个神经认知领域之间的关系进行了横断面分析。线性回归模型适用于对数转换的生物标志物值和神经认知领域评分的每种组合，并根据人口统计学、社会经济状况、物质使用、抑郁、CD 4（+）T细胞计数、HIV病毒载量和ART状态进行调整。结果：研究包括128名YWH [平均年龄23.8（SD 1.7）岁，86%男性，68%非裔美国人]。言语和视觉空间记忆域在队列中受损最显著（z分别为-1.59和-1.0）。较高的sCD 14与受损的视觉空间记忆相关，在调整其他生物标志物、人口统计学和HIV相关协变量后，视觉空间记忆仍然稳健。在血管炎症的生物标志物中，sICAM-1与言语记忆和注意力呈负相关，而sVCAM-1与执行功能和视觉空间记忆呈正相关。特定的神经认知领域与sCD 163、LPS或CCL 2水平无关。结论：青少年脑出血患者视觉空间记忆障碍与免疫激活有关，表现为sCD 14增高。
Objective: HIV-associated neurocognitive disorders persist despite early antiretroviral therapy (ART) and optimal viral suppression. We examined the relationship between immunopathogenesis driven by various pathways of immune activation and discrete neurocognitive performance domains in youth with HIV (YWH). Design: Observational cross-sectional study. Methods: YWH, ages 20-28 years, enrolled in Adolescent Medicine Trials Network 071/101 were assessed for biomarkers of macrophage, lymphocyte activation, and vascular inflammation using ELISA/multiplex assays. Standardized neurocognitive tests were performed, and demographically adjusted z-scores were combined to form indices of attention, motor, executive function, verbal, and visuospatial memory. Cross-sectional analysis of the relationship between 18 plasma inflammatory biomarkers and each neurocognitive domain was performed. Linear regression models were fit for each combination of log-transformed biomarker value and neurocognitive domain score, and were adjusted for demographics, socioeconomic status, substance use, depression, CD4(+) T-cell count, HIV viral load, and ART status. Results: Study included 128 YWH [mean age 23.8 (SD 1.7) years, 86% men, 68% African American]. Verbal and visuospatial memory domains were most significantly impaired in the cohort (z = -1.59 and -1.0, respectively). Higher sCD14 was associated with impaired visuospatial memory, which remained robust after adjusting for other biomarkers, demographics, and HIV-associated covariates. Among biomarkers of vascular inflammation, sICAM-1 was negatively associated with verbal memory and attention, whereas sVCAM-1 was positively associated with executive function and visuospatial memory. Specific neurocognitive domains were not associated with sCD163, LPS, or CCL2 levels. Conclusion: Impaired visuospatial memory in YWH is associated with immune activation, as reflected by higher sCD14.