ABSTRACT
HIV infection of the central nervous system (CNS) occurs in a majority of HIV-infected individuals. It causes HIV-
associated neurocognitive disorders (HAND) even in the era of combination antiretroviral therapy (cART). There are
currently no therapies for HAND. We have focused on HIV infection and pathogenesis in the CNS over the past 25 years.
Our studies have helped establish cell-free and cell-cell contact-mediated HIV infection of astrocytes and a critical role of
HIV Tat protein in HIV neuropathogenesis. The latter includes the creation of doxycycline-inducible brain-specific HIV
Tat transgenic mice (iTat) as an important surrogate HAND model. We have recently uncovered that activation of α7
nicotinic acetylcholine receptor (nAChR) by its positive allosteric modulator (PAM) PNU-120596 ameliorates HAND
neurology and neuropathology using the iTat model, suggesting the therapeutic potential of α7 nAChR PAM against
HAND. These studies are significant because Tat protein continues to be detected in the brain of HIV-infected individuals
treated with cART. In addition, we have shown that α7 nAChR PAM inhibits HIV replication and reactivation. These
findings undoubtedly call for further characterization of the mechanisms of α7 nAChR PAM-mediated neuroprotection
against Tat neurotoxicity and the mechanisms by which α7 nAChR PAM activation leads to inhibition of HIV replication
and reactivation. The central hypothesis for this proposal is that α7 nAChR PAM hold great promise as cART adjunctive
therapeutics to treat HIV neuropathogenesis and HAND. To test this hypothesis, we propose the following three
interrelated specific aims: (1) To further characterize the mechanisms of α7 nAChR/PAM-mediated neuroprotection
against Tat neurotoxicity; (2) To define the mechanisms of α7 nAChR/PAM-mediated inhibition of HIV replication and
latent HIV reactivation; and (3) To determine the in vivo effects of α7 nAChR/PAM activation on HIV neuropathogenesis
and HIV replication and latency in the CNS and periphery. We will use a combined molecular, cellular, biochemical, and
genetic approach, including the use of primary mouse and human cultures, iTat mice and α7 nAChR knockout mice, the
infectious and replication-competent EcoHIV model, and single nucleus advanced genomics technologies. The answers
sought have fundamental significance for our understanding of not only this critical and pervasive protein HIV Tat and its
role in HIV neuropathogenesis but also the molecular mechanisms of HIV transcription inhibition by α7 nAChR/PAM
activation. The findings from the proposed studies are expected to provide mechanistic and pre-clinical evidence to
support the use of α7 nAChR PAM as HAND therapeutics and inform a new intervention strategy for HIV
neuropathogenesis. The enormous amount of information available on HIV Tat, HIV infection and pathogenesis of the
CNS, and the roles of α7 nAChR/PAM in other neurodegenerative diseases, and the results obtained from our recent
studies make the accomplishment of these aims practical.