Morphometric analysis of the peripheral neuropathy of aids

Walter G Bradley, Paul Shapshak, Silvia Delgado, Isao Nagano, Renee Stewart, Beatriz Rocha

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

A morphometric study of the peripheral nervous system at autopsy was undertaken in 11 AIDS patients and 10 controls. The left L4, L5, and S1 dorsal root ganglia (DRG) and samples of the sciatic nerve at the buttock, tibial nerve at the knee, and sural nerve at the ankle were collected. Indices of neuronal/axonal degeneration and of segmental demyelination/remyelination were measured at each level. The small number of cases and evidence of neuropathy in a number of the control cases resulted in statistical significance for only a limited number of comparisons. Nodules of Nageotte in the DRG were increased fivefold in AIDS cases compared with controls, and axonal degeneration in single-teased nerve fibers was increased 9-fold in the sciatic nerve, 28-fold in the tibial nerve, and 12-fold in the sural nerve. The ratios of AIDS to controls for the density of remaining DRG neurons and large myelinated axons were reduced to 0.71 in the DRG, 0.84 in the sciatic nerve, 0.84 in the tibial nerve, and 0.66 in the sural nerve. Axonal regeneration in single-teased nerve fibers was increased threefold at the sciatic nerve level in AIDS, but was markedly reduced at distal levels. Acute segmental demyelination in single-teased nerve fibers was present to a greater extent than in controls at all levels of the peripheral nerves in the AIDS cases. Remyelinating fibers were increased compared with controls only in the proximal sciatic nerve. No case showed the changes of cytomegalovirus infection. In a parallel immunohistochemical study of these AIDS peripheral nerves, T-cell and macrophage infiltration, with cytokine expression, was demonstrated. The pathological process in the neuropathy of terminal AIDS appears to be a multifocal immunologically mediated inflammatory disease, with increased density of macrophages and T cells at all levels of the peripheral nervous system, producing segmental demyelination and axonal degeneration. Reparative processes (axonal regeneration and remyelination) occurred only at the most proximal levels of the nerves.

Original languageEnglish
Pages (from-to)1188-1195
Number of pages8
JournalMuscle and Nerve
Volume21
Issue number9
DOIs
StatePublished - Sep 1 1998

Fingerprint

Peripheral Nervous System Diseases
Acquired Immunodeficiency Syndrome
Sciatic Nerve
Spinal Ganglia
Tibial Nerve
Sural Nerve
Demyelinating Diseases
Nerve Fibers
Peripheral Nervous System
Peripheral Nerves
Regeneration
Macrophages
T-Lymphocytes
Neurons
Buttocks
Cytomegalovirus Infections
Pathologic Processes
Ankle
Axons
Autopsy

Keywords

  • AIDS
  • Axonal degeneration
  • HIV1
  • Pathophysiology
  • Peripheral neuropathy
  • Segmental demyelination

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Morphometric analysis of the peripheral neuropathy of aids. / Bradley, Walter G; Shapshak, Paul; Delgado, Silvia; Nagano, Isao; Stewart, Renee; Rocha, Beatriz.

In: Muscle and Nerve, Vol. 21, No. 9, 01.09.1998, p. 1188-1195.

Research output: Contribution to journalArticle

Bradley, Walter G ; Shapshak, Paul ; Delgado, Silvia ; Nagano, Isao ; Stewart, Renee ; Rocha, Beatriz. / Morphometric analysis of the peripheral neuropathy of aids. In: Muscle and Nerve. 1998 ; Vol. 21, No. 9. pp. 1188-1195.
@article{2a8372c8ee4048b6be089723bbbc0c2e,
title = "Morphometric analysis of the peripheral neuropathy of aids",
abstract = "A morphometric study of the peripheral nervous system at autopsy was undertaken in 11 AIDS patients and 10 controls. The left L4, L5, and S1 dorsal root ganglia (DRG) and samples of the sciatic nerve at the buttock, tibial nerve at the knee, and sural nerve at the ankle were collected. Indices of neuronal/axonal degeneration and of segmental demyelination/remyelination were measured at each level. The small number of cases and evidence of neuropathy in a number of the control cases resulted in statistical significance for only a limited number of comparisons. Nodules of Nageotte in the DRG were increased fivefold in AIDS cases compared with controls, and axonal degeneration in single-teased nerve fibers was increased 9-fold in the sciatic nerve, 28-fold in the tibial nerve, and 12-fold in the sural nerve. The ratios of AIDS to controls for the density of remaining DRG neurons and large myelinated axons were reduced to 0.71 in the DRG, 0.84 in the sciatic nerve, 0.84 in the tibial nerve, and 0.66 in the sural nerve. Axonal regeneration in single-teased nerve fibers was increased threefold at the sciatic nerve level in AIDS, but was markedly reduced at distal levels. Acute segmental demyelination in single-teased nerve fibers was present to a greater extent than in controls at all levels of the peripheral nerves in the AIDS cases. Remyelinating fibers were increased compared with controls only in the proximal sciatic nerve. No case showed the changes of cytomegalovirus infection. In a parallel immunohistochemical study of these AIDS peripheral nerves, T-cell and macrophage infiltration, with cytokine expression, was demonstrated. The pathological process in the neuropathy of terminal AIDS appears to be a multifocal immunologically mediated inflammatory disease, with increased density of macrophages and T cells at all levels of the peripheral nervous system, producing segmental demyelination and axonal degeneration. Reparative processes (axonal regeneration and remyelination) occurred only at the most proximal levels of the nerves.",
keywords = "AIDS, Axonal degeneration, HIV1, Pathophysiology, Peripheral neuropathy, Segmental demyelination",
author = "Bradley, {Walter G} and Paul Shapshak and Silvia Delgado and Isao Nagano and Renee Stewart and Beatriz Rocha",
year = "1998",
month = "9",
day = "1",
doi = "10.1002/(SICI)1097-4598(199809)21:9<1188::AID-MUS10>3.0.CO;2-O",
language = "English",
volume = "21",
pages = "1188--1195",
journal = "Muscle and Nerve",
issn = "0148-639X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - Morphometric analysis of the peripheral neuropathy of aids

AU - Bradley, Walter G

AU - Shapshak, Paul

AU - Delgado, Silvia

AU - Nagano, Isao

AU - Stewart, Renee

AU - Rocha, Beatriz

PY - 1998/9/1

Y1 - 1998/9/1

N2 - A morphometric study of the peripheral nervous system at autopsy was undertaken in 11 AIDS patients and 10 controls. The left L4, L5, and S1 dorsal root ganglia (DRG) and samples of the sciatic nerve at the buttock, tibial nerve at the knee, and sural nerve at the ankle were collected. Indices of neuronal/axonal degeneration and of segmental demyelination/remyelination were measured at each level. The small number of cases and evidence of neuropathy in a number of the control cases resulted in statistical significance for only a limited number of comparisons. Nodules of Nageotte in the DRG were increased fivefold in AIDS cases compared with controls, and axonal degeneration in single-teased nerve fibers was increased 9-fold in the sciatic nerve, 28-fold in the tibial nerve, and 12-fold in the sural nerve. The ratios of AIDS to controls for the density of remaining DRG neurons and large myelinated axons were reduced to 0.71 in the DRG, 0.84 in the sciatic nerve, 0.84 in the tibial nerve, and 0.66 in the sural nerve. Axonal regeneration in single-teased nerve fibers was increased threefold at the sciatic nerve level in AIDS, but was markedly reduced at distal levels. Acute segmental demyelination in single-teased nerve fibers was present to a greater extent than in controls at all levels of the peripheral nerves in the AIDS cases. Remyelinating fibers were increased compared with controls only in the proximal sciatic nerve. No case showed the changes of cytomegalovirus infection. In a parallel immunohistochemical study of these AIDS peripheral nerves, T-cell and macrophage infiltration, with cytokine expression, was demonstrated. The pathological process in the neuropathy of terminal AIDS appears to be a multifocal immunologically mediated inflammatory disease, with increased density of macrophages and T cells at all levels of the peripheral nervous system, producing segmental demyelination and axonal degeneration. Reparative processes (axonal regeneration and remyelination) occurred only at the most proximal levels of the nerves.

AB - A morphometric study of the peripheral nervous system at autopsy was undertaken in 11 AIDS patients and 10 controls. The left L4, L5, and S1 dorsal root ganglia (DRG) and samples of the sciatic nerve at the buttock, tibial nerve at the knee, and sural nerve at the ankle were collected. Indices of neuronal/axonal degeneration and of segmental demyelination/remyelination were measured at each level. The small number of cases and evidence of neuropathy in a number of the control cases resulted in statistical significance for only a limited number of comparisons. Nodules of Nageotte in the DRG were increased fivefold in AIDS cases compared with controls, and axonal degeneration in single-teased nerve fibers was increased 9-fold in the sciatic nerve, 28-fold in the tibial nerve, and 12-fold in the sural nerve. The ratios of AIDS to controls for the density of remaining DRG neurons and large myelinated axons were reduced to 0.71 in the DRG, 0.84 in the sciatic nerve, 0.84 in the tibial nerve, and 0.66 in the sural nerve. Axonal regeneration in single-teased nerve fibers was increased threefold at the sciatic nerve level in AIDS, but was markedly reduced at distal levels. Acute segmental demyelination in single-teased nerve fibers was present to a greater extent than in controls at all levels of the peripheral nerves in the AIDS cases. Remyelinating fibers were increased compared with controls only in the proximal sciatic nerve. No case showed the changes of cytomegalovirus infection. In a parallel immunohistochemical study of these AIDS peripheral nerves, T-cell and macrophage infiltration, with cytokine expression, was demonstrated. The pathological process in the neuropathy of terminal AIDS appears to be a multifocal immunologically mediated inflammatory disease, with increased density of macrophages and T cells at all levels of the peripheral nervous system, producing segmental demyelination and axonal degeneration. Reparative processes (axonal regeneration and remyelination) occurred only at the most proximal levels of the nerves.

KW - AIDS

KW - Axonal degeneration

KW - HIV1

KW - Pathophysiology

KW - Peripheral neuropathy

KW - Segmental demyelination

UR - http://www.scopus.com/inward/record.url?scp=0031904353&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031904353&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1097-4598(199809)21:9<1188::AID-MUS10>3.0.CO;2-O

DO - 10.1002/(SICI)1097-4598(199809)21:9<1188::AID-MUS10>3.0.CO;2-O

M3 - Article

VL - 21

SP - 1188

EP - 1195

JO - Muscle and Nerve

JF - Muscle and Nerve

SN - 0148-639X

IS - 9

ER -