Early brain effects of HIV in mouse model

ScienceDaily (Mar. 2, 2011) — A new mouse model closely resembles how the human body reacts to early HIV infection and is shedding light on nerve cell damage related to the disease, according to researchers funded by the National Institutes of Health.

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The study in the Journal of Neuroscience demonstrates that HIV infection of the nervous system leads to inflammatory responses, changes in brain cells, and damage to neurons. This is the first study to show such neuronal loss during initial stages of HIV infection in a mouse model.

The study was conducted by a team of scientists from the University of Nebraska Medical Center, Omaha, and the University of Rochester Medical Center, N.Y. It was supported by the National Institute on Drug Abuse (NIDA), the National Institute of Neurological Disorders and Stroke, the National Institute of Mental Health, and the National Center for Research Resources.

"This research breakthrough should help us move forward in learning more about how HIV affects important brain functioning in its initial stages, which in turn could lead us to better treatments that can be used early in the disease process," said Dr. Nora D. Volkow, director of NIDA.

"The work contained within this study is the culmination of a 20-year quest to develop a rodent model of the primary neurological complications of HIV infection in humans," said Dr. Howard Gendelman, one of the primary study authors. "Previously, the rhesus macaque was the only animal model for the study of early stages of HIV infection. However, its use was limited due to expense and issues with generalizing results across species. Relevant rodent models that mimic human disease have been sorely needed."

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Protein and calories can help lessen effects of severe traumatic brain injury, report says

ScienceDaily (Apr. 21, 2011) — To help alleviate the effects of severe traumatic brain injury (TBI), the U.S. Department of Defense should ensure that all military personnel with this type of injury receive adequate protein and calories immediately after the trauma and through the first two weeks of treatment, says a new report from the Institute of Medicine. Evidence from several studies of severely brain-injured patients shows that providing energy and protein to patients early reduces inflammation and improves their outcomes, said the committee of experts who wrote the report.

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This is the only nutrition-related approach to treating TBI that the committee recommended DOD implement at this time based on its review of the possible benefits of nutrients, dietary supplements, and specific diets to improve outcomes for TBI ranging from mild to severe. Several other nutritional approaches show potential for reducing the symptoms of brain injury, but there is not yet enough evidence about their effectiveness to recommend their adoption.

The committee identified the B vitamin choline, the amino acid-like compound creatine, n-3 fatty acids commonly known as EPA and DHA, and zinc as the most promising areas of investigation and recommended that DOD scientists and other researchers give them priority attention. These approaches are ones for which human clinical trials have been undertaken or are ongoing.

Other approaches, including antioxidants, flavonoids, ketogenic diets, and vitamin D, have less supporting evidence that has come solely from animal studies or from studies in people with different conditions. Although researchers must prioritize resources, DOD should continue to monitor the clinical literature for any new findings about the potential of these nutrients and diets in lessening brain injury effects, the report says.

The research priorities outlined in the report could generate information that provides health professionals with a fuller picture of which nutrients and dietary approaches work safely and most effectively. This information could also lead to new evidence-based clinical guidelines. There are few well-supported guidelines to inform health professionals' use of foods and dietary supplements to treat brain-injured patients, so clinicians employ a wide range of practices.

The IOM study focused on the potential role of nutrition in protecting against or treating the immediate and near-term effects of TBI. It did not evaluate the role of nutritional therapies in the rehabilitation phase or address long-term health effects associated with brain trauma, such as post-traumatic stress disorder, Alzheimer's disease, pain, and depression. A review of nutrition approaches to lessen long-term effects of TBI would be useful, the committee noted.

TBI is a significant cause of death and disability among personnel serving in the wars in Iraq and Afghanistan. It also contributes to nearly one-third of all injury-related deaths in the United States, making it a major health concern for the civilian population as well. According to recent estimates, between 1.6 million and 3.8 million sports-related TBIs occur annually, including those not treated by a health care provider.

The study was sponsored by the U.S. Army Medical Research and Materiel Command of the U.S. Department of Defense. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.

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