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Mononuclear Phagocytes 

Mononuclear Phagocytes
Mononuclear Phagocytes

Kenneth C. Williams

, William F. Hickey

, Tricia H. Burdo

, and Caroline Soulas

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date: 09 August 2020

Due to the presence of the blood-brain barrier, the central nervous system (CNS) had long been considered "immune privileged," that is, insulated with respect to the extra-CNS immune system. It is now clear that this privileging is relative, not absolute, and breaks down under a variety of circumstances. In fact, with respect to HIV-1 infection, it has been hypothesized that that latently infected immune cells may themselves provide the primary mechanism for infecting the brain. This has been hypothesized to occur via entry into the CNS of immune-activated mononuclear phagocyte (MP) cells that harbor HIV-1 provirus in their genomes (the "Trojan Horse" phenomenon). Furthermore, it is clear that immunocompetent cells of the MP system are the principal CNS cells infected by HIV-1. This chapter focuses on those MP activities and susceptibilities that may help explain the onset, maintenance, and propagation of HIV-1 infection in the CNS. Specific areas of focus are the heterogeneity of CNS MP cells, the turnover kinetics of these cells, their susceptibility to HIV-1 infection, and the spread of infection from outside to inside the CNS. The correlation of systemic (specifically, bone marrow) monocytic expansion with the clinical severity of HIV and SIV disease is also discussed, as is the composition of HIV- and SIV-encephalitis lesions from three cell groups of macrophage lineage.

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