Neuropsychiatric Disease and Treatment (Jan 2020)
The Role of Brain Derived Neurotrophic Factor in HIV-Associated Neurocognitive Disorder: From the Bench-Top to the Bedside
Abstract
Henry Michael,1 Thabisile Mpofana,2 Suvira Ramlall,3 Frasia Oosthuizen1 1Discipline of Pharmaceutical Sciences, School of Health Science, University of KwaZulu-Natal, Durban, South Africa; 2School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; 3Department of Psychiatry, University of KwaZulu-Natal, Durban, South AfricaCorrespondence: Henry MichaelDiscipline of Pharmaceutical Sciences, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban 4041, South AfricaTel +27 732770601Email [email protected]: Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remains prevalent in the anti-retroviral (ART) era. While there is a complex interplay of many factors in the neuropathogenesis of HAND, decreased neurotrophic synthesis has been shown to contribute to synaptic degeneration which is a hallmark of HAND neuropathology. Brain derived neurotrophic factor (BDNF) is the most abundant and synaptic-promoting neurotrophic factor in the brain and plays a critical role in both learning and memory. Reduced BDNF levels can worsen neurocognitive impairment in HIV-positive individuals across several domains. In this paper, we review the evidence from pre-clinical and clinical studies showing the neuroprotective roles of BDNF against viral proteins, effect on co-morbid mental health disorders, altered human microbiome and ART in HAND management. Potential applications of BDNF modulation in pharmacotherapeutic, cognitive and behavioral interventions in HAND are also discussed. Finally, research gaps and future research direction are identified with the aim of helping researchers to direct efforts to make these BDNF driven interventions improve the quality of life of patients living with HAND.Keywords: neurotrophins, neuroplasticity, HIV/AIDS, cognition, BDNF
