Researchers will evaluate neurological complications particularly in those addicted to opioids.

NIDA awarded a three-year $3 million grant to Albert Einstein College of Medicine of Yeshiva University to establish a research center to study the neurological complications associated with HIV.

The new Einstein Proteomics Research Center will work to identify brain proteins responsible for these complications in people infected with HIV, particularly those who are also addicted to drugs. It will investigate the mechanism by which HIV infection causes neurological deficits and identify biomarkers that signal when these deficits begin and how they progress over time.

“We have developed a unique transgenic HIV mouse model that displays some features of neuro-AIDS,” says Harris Goldstein, M.D., director of the Einstein-Montefiore Center for AIDS Research and professor of pediatrics and of microbiology and immunology at Einstein. “By studying this mouse model in the proteomics center, we’ll be able to determine how HIV infection influences the proteins expressed in the brain.”

Several studies of autopsy tissue show that the neuro-AIDS process is worsened by drug abuse, particularly the use of opioids such as heroin, according to Albert Einstein College. “Therefore, the intersection between HIV infection and opioid use represents an especially important area of neuro-AIDS research on which our proteomics center will focus,” says Ruth Hogue Angeletti, Ph.D., who will direct the Einstein Proteomics Research Center for HIV-Associated Neurological Disorders and Substance Abuse. Dr. Hogue is professor of developmental and molecular biology and of biochemistry at Einstein.

Each project undertaken by the center will evaluate the neurological effects of buprenorphine, a reportedly less-addictive alternative to methadone. Compared with methadone, it can be given at higher doses with fewer adverse effects, the investigators report.

Buprenorphine, however, could conceivably contribute to neurological problems when used by drugs addicts who are infected with HIV. “The blood-brain barrier protects the brain from HIV-infected monocytes and other neuroinflammatory mediators, and we don’t yet know how buprenorphine affects this barrier,” says co-principal investigator Joan W. Berman, Ph.D., professor in the departments of pathology and microbiology and immunology at Einstein. “We need to understand buprenorphine’s neurological impact before use of the drug becomes widespread in this patient population.”

On the other hand, the center’s research may show that buprenorphine is a better alternative than methadone for people infected with HIV. “Because of its unique pharmacological properties, buprenorphine may provide neuropsychological benefits for HIV-infected people who are addicted to opioids,” says Julia H. Arnsten, M.D., the center’s other co-principal investigator and professor of medicine, of epidemiology and population health, and of psychiatry and behavioral sciences at Einstein.

As part of the study, Dr. Arnsten will recruit a cohort of HIV-infected patients who are undergoing treatment for drug addiction. These people will be monitored to see whether buprenorphine influences the development of neurological deficits.

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