NEUROPROTECTION WITH SELENIUM THERAPY IN HIV+ IDUS

硒疗法对 HIV 感染者的神经保护作用

• 批准号: 6175544
• 负责人: Gail Shor-Posner
• 金额: $ 5.1万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-08-05 至 2003-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6175544
• 关键词: AIDS dementia complex; AIDS therapy; HIV infections; chemoprevention; clinical research; cognition; diet therapy; dietary mineral; dietary supplements; human subject; intravenous drug abuse; mental disorder prevention; neural degeneration; neuroprotectants; neuropsychological tests; neuropsychology; nutrition related tag; oxidative stress; selenium

The major neuropsychiatric complication in HIV-disease is cognitive-motor impairment, with HIV-1 seropositive drug users reported to be at higher risk for the development of HIV-associated dementia and more rapid progression in neurologic disability. Oxidative stress, which can lead to neuronal degeneration, is increased in HIV-1 disease and appears to be potentiated by drugs of abuse. The primary objective of this ancillary study is to determine whether supplementation with selenium, a biologic antioxidant that is required for protecting cells from oxidative damage, can provide neuroprotection and help maintain cognitive function in HIV-l seropositive chronic drug users. Supplementation with selenium has been shown to improve oxidative defense systems in HIV/AIDS patients, and inhibit mental deterioration in neurologic patients. Our preliminary investigations in HIV- l infected drug users indicate that low levels of selenium are associated with decreased mental performance, and that short-term selenium supplementation results in a strong potential for improvement in mental function and mood state. These data suggest that administration of selenium may be an effective strategy to prevent loss of cognitive ability. We propose to extend our currently NIDA-funded, clinical trial, "Selenium Therapy to Slow Disease Progression in HIV+ IDUs", to compare the effects of selenium or placebo on neuropsychological function. Consented HIV-l infected drug users (n=120) will be enrolled at the baseline visit of the parent study, prior to supplementation, and administered a psychosocial and cognitive battery every 6 months for 30 months. Drug use, nutritional, immunologic, oxidative stress, and health status data will be collected by the parent study at the same visit as the cognitive and psychosocial battery, and made available for the proposed project. There is no direct scientific overlap between the two studies. The proposed collaborative and cost-effective research provides a unique opportunity to further our understanding of neuropsychological function in HIV-l seropositive men and women who abuse drugs, as well as provide important information necessary for the management of cognitive impairment in HIV-1 disease.

HIV-疾病中的主要神经精神并发症是认知运动障碍，HIV-1血清阳性药物使用者据报道对与HIV相关痴呆症的发展具有更高的风险，并且神经系统疾病的发展更快。 HIV-1疾病中会增加氧化应激，这可能导致神经元变性，并且似乎受滥用药物的增强。这项辅助研究的主要目的是确定补充硒是保护细胞免受氧化损伤所必需的生物学抗氧化剂的补充，可以提供神经保护并有助于维持HIV-L血清阳性慢性药物使用者的认知功能。已证明补充硒可改善艾滋病毒/艾滋病患者的氧化防御系统，并抑制神经系统患者的心理恶化。我们在艾滋病毒感染的药物使用者中进行的初步调查表明，低水平的硒与心理表现的降低有关，而短期硒补充剂则具有很强的改善心理功能和情绪状态的潜力。这些数据表明，硒的给药可能是防止认知能力丧失的有效策略。我们建议扩展当前NIDA资助的临床试验“硒疗法，以减缓HIV+ IDUS中的疾病进展”，以比较硒或安慰剂对神经心理学功能的影响。同意的HIV-L感染吸毒者（n = 120）将在父母研究的基线访问中招募，并在补充之前进行，并每6个月每6个月进行一次心理社会和认知电池进行管理。在与认知和社会心理电池相同的访问中，父母的研究将收集药物使用，营养，免疫学，氧化应激和健康状况数据，并可以用于拟议项目。两项研究之间没有直接的科学重叠。拟议的合作和成本效益的研究提供了一个独特的机会，可以进一步了解滥用药物的HIV-L血清阳性男性和女性的神经心理学功能，并提供了管理HIV-1疾病认知障碍所必需的重要信息。