Elevated serum levels of tumor necrosis factor are associated with progressive encephalopathy in children with acquired immunodeficiency syndrome
M. Mintz, R. Rapaport, J. M. Oleske, E. M. Connor, M. R. Koenigsberger, T. Denny and L. G. Epstein
Department of Neurosciences, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark.
The cytokine tumor necrosis factor (TNF) was assayed in the sera (n = 31)
and cerebrospinal fluid (n = 26) of children with acquired immunodeficiency
syndrome, using a competitive radioimmunoassay. Elevated serum levels of
TNF were found in 15 (79%) of 19 patients with progressive encephalopathy
(PE), compared with 1 (8%) of 12 patients without neurologic involvement.
There was a significant association of PE with elevated serum TNF levels.
Conversely, of 16 patients with elevated serum TNF levels, 15 (94%) were
found to have PE, and of 8 patients with serum TNF levels greater than 100
pg/ml, all 8 (100%) had PE. No association was found between cerebrospinal
fluid levels of TNF and PE. Neither serum nor cerebrospinal fluid TNF
levels correlated with the degree of cachexia. These data suggest that
circulating TNF may be responsible for the myelin damage that occurs in
human immunodeficiency virus type 1-associated PE.
