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Moar P, Linn K, Premeaux TA, Bowler S, Sardarni UK, Gopalan BP, Shwe EE, San T, Han H, Clements D, Hlaing CS, Kyu EH, Thair C, Mar YY, Nway N, Mannarino J, Bolzenius J, Mar S, Aye AMM, Tandon R, Paul R, Ndhlovu LC. Plasma galectin-9 relates to cognitive performance and inflammation among adolescents with vertically acquired HIV. AIDS 2024; 38:1460-1467. [PMID: 38608008 PMCID: PMC11239096 DOI: 10.1097/qad.0000000000003907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Adolescents with perinatally acquired HIV (AWH) are at an increased risk of poor cognitive development yet the underlying mechanisms remain unclear. Circulating galectin-9 (Gal-9) has been associated with increased inflammation and multimorbidity in adults with HIV despite antiretroviral therapy (ART); however, the relationship between Gal-9 in AWH and cognition remain unexplored. DESIGN A cross-sectional study of two independent age-matched cohorts from India [AWH on ART ( n = 15), ART-naive ( n = 15), and adolescents without HIV (AWOH; n = 10)] and Myanmar [AWH on ART ( n = 54) and AWOH ( n = 22)] were studied. Adolescents from Myanmar underwent standardized cognitive tests. METHODS Plasma Gal-9 and soluble mediators were measured by immunoassays and cellular immune markers by flow cytometry. We used Mann-Whitney U tests to determine group-wise differences, Spearman's correlation for associations and machine learning to identify a classifier of cognitive status (impaired vs. unimpaired) built from clinical (age, sex, HIV status) and immunological markers. RESULTS Gal-9 levels were elevated in ART-treated AWH compared with AWOH in both cohorts (all P < 0.05). Higher Gal-9 in AWH correlated with increased levels of inflammatory mediators (sCD14, TNFα, MCP-1, IP-10, IL-10) and activated CD8 + T cells (all P < 0.05). Irrespective of HIV status, higher Gal-9 levels correlated with lower cognitive test scores in multiple domains [verbal learning, visuospatial learning, memory, motor skills (all P < 0.05)]. ML classification identified Gal-9, CTLA-4, HVEM, and TIM-3 as significant predictors of cognitive deficits in adolescents [mean area under the curve (AUC) = 0.837]. CONCLUSION Our results highlight a potential role of Gal-9 as a biomarker of inflammation and cognitive health among adolescents with perinatally acquired HIV.
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Affiliation(s)
- Preeti Moar
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, USA
| | - Kyaw Linn
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Thomas A. Premeaux
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, USA
| | - Scott Bowler
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, USA
| | - Urvinder Kaur Sardarni
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, USA
| | - Bindu Parachalil Gopalan
- Division of infectious diseases, St. John's Research Institute, Bengaluru, India
- Sickle Thrombosis and Vascular Biology Lab, Sickle Cell Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, USA
| | - Ei E. Shwe
- Department of Pathology, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Thidar San
- Department of Pathology, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Haymar Han
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Danielle Clements
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Chaw S. Hlaing
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Ei H. Kyu
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Cho Thair
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Yi Y. Mar
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Nway Nway
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Julie Mannarino
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Jacob Bolzenius
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Soe Mar
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Aye Mya M. Aye
- Department of Pediatrics, Yangon Children's Hospital, University of Medicine 1, Yangon, Myanmar
| | - Ravi Tandon
- Laboratory of AIDS Research and Immunology, School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Lishomwa C. Ndhlovu
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, USA
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