Friday, January 25, 2008

Glucocorticoids, Neurotoxicity and Dementia

A prior post discusses the teaming up of cortisol and gp120 to induce apoptosis in lymphocytes. Another study, in addition, looks at the same phenomena among hippocampal neurons and suggests the potentially dire neurological consequences of the established medical practice of prescribing corticosteroids for the treatment of opportunistic infections in people with AIDS.

One of the most serious consequences of HIV infection is the frequent cases of Pneumocystis carinii pneumonia, and the current treatment of choice for serious cases involves administration of megadoses of synthetic GCs such as those used in this study (4448). Although the number of severe cases of Pneumocystis carinii pneumonia is declining, best estimates are that thousands of individuals are still treated annually in this megadose range (e.g., 160 mg of methylprednisolone per day for 7 days). The present findings suggest that any of these routes of exposure to elevated GC concentrations might have adverse neurological consequences; this possibility remains to be tested in a clinical setting.

The study also notes the elevated incidence of hypercortisolism in the immune depressed.

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