QUINOLINIC ACID IN THE CEREBROSPINAL-FLUID OF CHILDREN WITH SYMPTOMATIC HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 DISEASE - RELATIONSHIPS TO CLINICAL STATUS AND THERAPEUTIC RESPONSE
P. Brouwers et al., QUINOLINIC ACID IN THE CEREBROSPINAL-FLUID OF CHILDREN WITH SYMPTOMATIC HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 DISEASE - RELATIONSHIPS TO CLINICAL STATUS AND THERAPEUTIC RESPONSE, The Journal of infectious diseases, 168(6), 1993, pp. 1380-1386
Quinolinic acid (QUIN) is a neurotoxin implicated in the neurologic de
ficits associated with human immunodeficiency virus type 1 (HIV-1) inf
ection. Forty children with symptomatic HIV-1 disease had elevated (P
< .001) cerebrospinal fluid (CSF) QUIN levels (55.8 +/- 8.9 nM) compar
ed with controls (14.9 +/- 3.0 nM). Age-adjusted CSF QUIN concentratio
ns in HIV-1-infected children were predicted by the general index of m
ental abilities (GIMA, from an age-appropriate intelligence test; r =
-0.45, P < .01). Zidovudine therapy reduced CSF QUIN from 64.1 +/- 16.
3 to 19.7 +/- 5.2 nM (P < .01; N = 16) and increased GIMA from 76.8 +/
- 5.2 to 87.2 +/- 6.3 (P < .001). Encephalopathic HIV-1-infected patie
nts had higher CSF QUIN levels than patients without encephalopathy (7
9.6 +/- 16.1 vs. 32.7 +/- 6.7 nM, P < .01). CSF QUIN concentrations we
re also higher (P < .001) in patients who died less-than-or-equal-to 3
years after their baseline assessment, compared with those who were s
till alive. These results warrant further investigation of CSF QUIN in
HIV-infected children as a mediator of neurologic dysfunction and a s
upplemental marker of neurologic disease, particularly when combined w
ith measures of neurocognitive functioning.