Mitochondrial dysfunction in distal axons contributes to human immunodeficiency virus sensory neuropathy
Version of Record online: 8 NOV 2010
Copyright © 2010 American Neurological Association
Annals of Neurology
Volume 69, Issue 1, pages 100–110, January 2011
How to Cite
Lehmann, H. C., Chen, W., Borzan, J., Mankowski, J. L. and Höke, A. (2011), Mitochondrial dysfunction in distal axons contributes to human immunodeficiency virus sensory neuropathy. Ann Neurol., 69: 100–110. doi: 10.1002/ana.22150
- Issue online: 28 JAN 2011
- Version of Record online: 8 NOV 2010
- Manuscript Accepted: 2 JUL 2010
- Manuscript Revised: 13 JUN 2010
- Manuscript Received: 23 FEB 2010
- NIH grants. Grant Numbers: NS43991-07, NS43991-07S1, MH070306, NS055651
- German Research Foundation. Grant Number: Le2368/1-1)
Accumulation of mitochondrial DNA (mtDNA) damage has been associated with aging and abnormal oxidative metabolism. We hypothesized that in human immunodeficiency virus-associated sensory neuropathy (HIV-SN), damaged mtDNA accumulates in distal nerve segments, and that a spatial pattern of mitochondrial dysfunction contributes to the distal degeneration of sensory nerve fibers.
We measured levels of common deletion mutations in mtDNA and expression levels of mitochondrial respiratory chain complexes of matched proximal and distal nerve specimens from patients with and without HIV-SN. In mitochondria isolated from peripheral nerves of simian immunodeficiency virus (SIV)-infected macaques, a model of HIV-SN, we measured mitochondrial function and generation of reactive oxygen species.
We identified increased levels of mtDNA common deletion mutation in postmortem sural nerves of patients with HIV-SN as compared to uninfected patients or HIV patients without sensory neuropathy. Furthermore, we found that common deletion mutation in mtDNA was more prevalent in distal sural nerves compared to dorsal root ganglia. In a primate model of HIV-SN, freshly isolated mitochondria from sural nerves of macaques infected with a neurovirulent strain of SIV showed impaired mitochondrial function compared to mitochondria from proximal nerve segments.
Our findings suggest that mtDNA damage accumulates in distal mitochondria of long axons, especially in patients with HIV-SN, and that this may lead to reduced mitochondrial function in distal nerves relative to proximal segments. Although our findings are based on HIV-SN, if confirmed in other neuropathies, these observations could explain the length-dependent nature of most axonal peripheral neuropathies. ANN NEUROL 2010