Expression of CCR-5/CXCR-4 in spinal cord of patients with AIDS

The discovery that chemokines and their receptors (in particular CXCR-4 and CCR-5) play a role in HIV infection challenges traditional views on the pa thogenesis of HIV infection in man and identifies new potential targets for therapeutic intervention. Several groups as well as our pilot study have f ound that increased numbers of CCR-5 positive macrophage/microglia correlat e with disease severity in brains of patients with AIDS. Among HIV-related disorders, vacuolar myelopathy (VM) is the most common spinal cord disorder in patients with AIDS. The purpose of this study was to investigate the po ssible relationship between the expression of CCR-5/CXCR-4 and spinal cord pathology in patients with AIDS. Thirty-four spinal cords (forming two grou ps: without and with VM) of patients with AIDS and 6 HIV-I-negative control s were investigated by routine histological examination and immunohistochem istry. Elevated expression of CXCR-4 was found in most AIDS cases with/with out neuropathological disorders (8/17 and 13/16, respectively). No CCR-5 ex pression was detected in HIV-1-negative controls. Among 34 cases with AIDS, expression of CCR-5 was detected in 1/16 HIV-1-positive normal spinal cord s and 5/18 with VM. Despite the lack of statistical significance between th e two groups (P=0.1019), our results suggest that CCR-5/CXCR-4 are present in spinal cord of patients with AIDS and that CCR-5 is more frequently foun d in association with VM.