An antibiotic commonly used to treat a variety of serious infections may also help prevent dementia in HIV patients, according to a test-tube study of human brain cells by Johns Hopkins University School of Medicine neurologist Jeffrey Rumbaugh, MD, Ph.D.
Results of the lab study with ceftriaxone are expected to be presented at the American Academy of Neurologys 58th annual meeting today in San Diego.
Rumbaugh added that, although ceftriaxone is FDA approved and could be used at any time by patients suffering from HIV dementia, there is not yet enough data to support doing so.
The study looked at two proteins, called Tat and gp120, that are part of the virus that causes HIV infection and that are implicated in the development of HIV dementia, according to Rumbaugh, the studys lead author. HIV is the only virus that makes Tat and gp120, which are produced during its normal life cycle, though other viruses make similar proteins. Dementia is a common side effect of long-term HIV infection, but there are no known specific treatments for this complication. According to Rumbaugh, Tat and gp120 are believed to cause dementia by reducing the expression of a brain chemical called EAAT-2 (excitatory amino acid transporter-2). EAAT-2 absorbs the neurotransmitter glutamate from the space between neurons (the synapse), thereby preventing excess neuronal excitation, which in turn can cause cell death and brain damage.
Ceftriaxone, used to treat pneumonias, sexually transmitted diseases, bacterial meningitis and other infections, is a known stimulator of EAAT-2 expression and protects against neuronal injury in mice with nervous system disorders. To test ceftriaxones potential in HIV, Rumbaugh and colleagues grew human neuronal cell cultures in a lab from existing human neuron cell lines, treated them with a range of doses of ceftriaxone, and exposed them to Tat or gp120. They found that the antibiotic protected the neurons against both HIV proteins. The dose of ceftriaxone needed for protection was well within the range currently used for treatment of bacterial infections.
These results indicated that this class of drugs may prove effective in treating HIV patients with dementia, Rumbaugh says.
About 500,000 people in the United States alone have HIV dementia. And although new cases of HIV dementia have declined over the last 10 years (due to the increased availability of effective HIV treatments), the prevalence of HIV dementia is on the rise since people are living longer with HIV.
We hope this research might help many patients with other forms of dementia, such as Alzheimers, and infections of the brain, like herpes encephalitis and West Nile encephalitis, says Rumbaugh. However, it will require a lot more development before drugs like these can be used even to treat patients with HIV dementia, let alone to treat patients with other neurological diseases.
Other researchers in this study include Jeffrey Rothstein, MD, PhD, and Avindra Nath, MD, both professors in the Department of Neurology at the Johns Hopkins University School of Medicine.
This study was supported by grants from the National Institutes of Health.
Source: Johns Hopkins
Dear Helpdesk: Working in a Toxic Health Care Environment
March 28th 2024Dear Helpdesk is your steadfast companion, offering life coaching and workplace advice from 2 seasoned IPs for some of your most challenging real-life situations. Let us help you navigate the intersection between work and life, guiding you to navigate the dynamic world of infection prevention with confidence and grace. This article is on handling a toxic health care environment.
Product Locator: Spring and Early Mother's Day Gift Guide for Infection Prevention Personnel
March 27th 2024Whether it's a spring holiday, birthdays, or no reason at all, infection prevention personnel love to give and receive gifts that help at the end of a stressful day. Infection Control Today® offers some gift ideas for infection prevention personnel and their families.
Catching Up With Vangie Dennis, AORN 2022-2023 President at AORN 2024
March 26th 2024Infection Control Today (ICT) had the privilege of catching up with Vangie Dennis, MSN, RN, CNOR, CMLSO, at the Association of periOperative Registered Nurses' (AORN’s) International Surgical Conference & Expo 2024. As the former president of AORN and an esteemed figure in perioperative services, Vangie Dennis shared insights into her recent endeavors and the exciting new chapter she's embarked upon.
How To Optimize Your Time Management Strategies for the Busy Infection Preventionist
March 25th 2024Is your calendar resembling a chaotic masterpiece of overlapping tasks? Join the club of infection preventionists striving to balance responsibilities. Dive into proven strategies from a fellow infection preventionist to reclaim control of your time, streamline tasks, and boost productivity effectively. This is an IP Lifeline article.