Study Shows Potential For Quelling AIDS Nerve Pain

September 10, 1998

A recent multicenter trial shows a natural factor that encourages nerve growth may bring relief from one of the more common effects of HIV infection: sensory neuropathy. The study, led by Johns Hopkins researchers, is supported by the AIDS Clinical Trials Group at the National Institutes of Health.

While not life-threatening, sensory neuropathy brings misery to thousands of HIV patients by producing burning, aching or tingling feelings as a result of injury to small sensation-bearing nerves. The injury comes from either the viral infection itself or the toxic effects of specific antiviral treatments. "Nearly a third of people with AIDS have these neuropathies, most often affecting the legs and feet," says neurologist Justin McArthur, MBBS, M.P.H., "Patients may be in constant pain and many have difficulty walking. It's quite a problem."

This spring, McArthur and a research team reported on a multicenter trial of 271 patients with HIV-related sensory neuropathy to evaluate genetically engineered nerve growth factor as a treatment. Nerve growth factor (NGF), found naturally in the body, is a small, potent molecule that helps maintain certain nerve cells. It also prods those nerve cells to grow and to communicate with other cells.

In the study, presented at this year's International AIDS Conference in Geneva, the patients got injections of either a moderate dose of lab-created NGF, a higher dose or a placebo. Throughout the 18-week trial, the team asked patients about improvements, had them rate their pain and took other neurological measures. The result, says McArthur, was that "patients said the intensity of pain was significantly lessened, and neurological exams showed improved sensation."

One offshoot of the study is that the researchers have verified precisely which nerves are involved in the injury -- something not done before. With a punch biopsy, a relatively painless technique little-used in neurology but common in dermatology, they removed small samples of the outer layers of skin. Under the microscope, the researchers found far fewer of the tiniest sensory nerves in the epidermis than normal. "We suspect other, larger nerves are recruited to take over the missing function," says John Griffin, M.D., head of neurology at Johns Hopkins. Those nerves are somehow more prone to produce pain.

As for the next step -- seeing if NGF triggers regrowth of patients' nerves -- that's under way, the researchers say. "For now," says McArthur, "we can measure the damage and treat the symptoms."

Currently, no existing treatment for HIV-related sensory neuropathy stops its degenerative path. Therapy has been limited to treating the pain by combining drugs such as tricyclic antidepressants, anti convulsants and/or painkillers, and using common-sense approaches like avoiding tight shoes.

Co-researchers on the study were Constantin Yiannoutsos of Harvard University, David Clifford of Washington University in St. Louis, Giovanni Schiffito of the University of Rochester, Betsy Smith of the NIAID, David Simpson at Mt. Sinai Hospital in New York City and research teams at 17 sites across the country.

The study was funded by grants from the National Institute of Neurological Disorders and Stroke (for grantholder David Clifford, M.D.) and by the National Institute of Allergy and Infectious Disease. It is under review for publication.

Media Contacts:
Karen Infeld (410)955-1534
Marjorie Centofanti (410)955-8725

Johns Hopkins Medicine

Related Aids Articles from Brightsurf:

Developing a new vaccination strategy against AIDS
Infection researchers from the German Primate Center (DPZ) -- Leibniz Institute for Primate Research have in cooperation with international colleagues tested a new vaccination strategy against the HIV-related simian immunodeficiency virus (SIV) in rhesus monkeys.

HIV-AIDS: Following your gut
Researchers find a way to reduce replication of the AIDS virus in the gastrointestinal tract.

A path toward ending AIDS in the US by 2025
Using prevention surveillance data to model rates of HIV incidence, prevalence and mortality, investigators at Brigham and Women's Hospital and Johns Hopkins Bloomberg School of Public Health set targets, specifically a decrease in new infections to 21,000 by 2020 and to 12,000 by 2025, that would mark a transition toward ending the HIV/AIDS epidemic.

What does it take for an AIDS virus to infect a person?
Researchers examined the characteristics of HIV-1 strains that were successful in traversing the genital mucosa that forms a boundary to entry by viruses and bacteria.

How AIDS conquered North America
A new technique that allowed researchers to analyze genetic material from serum samples of HIV patients taken before AIDS was known provides a glimpse of unprecedented detail into the beginnings of the AIDS epidemic in North America.

New research could help build better hearing aids
Scientists at Binghamton University, State University of New York want to improve sensor technology critical to billions of devices made every year.

NY State Department of Health AIDS Institute funds HIV/AIDS prevention in high-risk youth
NewYork-Presbyterian's Comprehensive Health Program and Project STAY, an initiative of the Harlem Heath Promotion Center (HHPC) at Columbia University's Mailman School of Public Health has received two grants totaling more than $3.75 million from the New York State Department of Health AIDS Institute for their continued efforts to prevent HIV/AIDS in at-risk youth.

A new way to nip AIDS in the bud
When new HIV particles bud from an infected cell, the enzyme protease activates to help the viruses infect more cells.

AIDS research prize for Warwick academic
A researcher at the University of Warwick has received international recognition for his contribution to AIDS research.

Insects inspire next generation of hearing aids
An insect-inspired microphone that can tackle the problem of locating sounds and eliminate background noise is set to revolutionize modern-day hearing aid systems.

Read More: Aids News and Aids Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to