( A multicenter clinical trial is bei...)Antibiotic might fight HIV-induced neurological problems

A multicenter clinical trial is being planned to test whether minocycline has the same effects in HIV-infected people as it does in SIV-infected monkeys, but it is not expected to start until sometime next year.

"It is too early to recommend minocycline for patients," emphasizes Ned Sacktor, M.D., an associate professor of neurology at the Johns Hopkins Bayview Medical Center who wasn't involved with the current study, but who is one of the physicians planning the clinical trial. "One needs to proceed with a clinical research trial first to prove its safety and efficacy against HIV-associated cognitive impairment."

SIV and HIV both affect the same tissues in the same way and use the same tricks to infect cells and outwit treatments, but SIV infects only non-human primates, and HIV only infects people. Antiretroviral drugs target and interfere with the viral proteins needed to accomplish this.

In contrast, minocycline doesn't target the virus or its proteins. While they're still working out the details, the researchers have shown that minocycline "calms down" as yet undefined biological pathways that involve two specific proteins -- MCP-1 and p38 -- implicated in damage in neurodegenerative diseases.

The MCP-1 protein, when secreted from brain cells under attack from HIV or SIV, attracts infection-fighting cells known as macrophages, which then enter the brain. The influx of these cells contributes to swelling and inflammation known as encephalitis. The other protein, p38, helps trigger a series of events that result in a cell's programmed death, called apoptosis.

Only one of the five treated monkeys showed any signs of encephalitis, and that monkey's condition was deemed mild by a set of standard measures. After the same amount of time -- 84 days after infection -- five of the six untreated monkeys had evidence of moderate or severe encephalitis and much more physical evidence of damage to brain cells, the researchers
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Source:Johns Hopkins