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NCIRE-The Veterans Health Research Institute is the leading private nonprofit institute devoted to Veterans health research in the United States. Our mission is to advance Veterans health through research.

We support the work of some of the nation's foremost physicians and scientists at the San Francisco Veterans Affairs Medical Center, the premier biomedical research facility in the VA system. All have faculty appointments at the University of California, San Francisco, which has its own proud traditions of research and patient care. We also partner with the U.S. Department of Defense to support health research on behalf of our men and women in the Armed Forces.

Those who have served in uniform have given their best for their country. In return, we believe that they deserve nothing less than the best health care research we can provide.

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Lynn Pulliam, MS, PhD

Chief of Microbiology, SFVAHCS
Professor of Laboratory Medicine and Medicine, UCSF

Email: lynn.pulliam@ucsf.edu

Immune Dysfunction and Cognitive Impairment in HIV and/or HCV infections

Dr. Pulliam's laboratory was the first to show that blood monocytes (white blood cells) from individuals with HIV release toxins that kill or damage neural cells, thus demonstrating that HIV dementia is not caused by direct HIV infection of brain cells but by the immune cells themselves. With successful antiretroviral therapy, most subjects no longer have HIV dementia but about 35% will continue to have neurocognitive impairment.  Her lab is interested in finding blood monocyte biomarkers to identify chronic activation, which puts subjects at risk for different co-morbid pathologies, as well as determine how the immune system affects cognition.  A recent study found that the immune monocyte profile correlated with a decrease in neurons by neuroimaging.  Further studies in the Pulliam lab found evidence that Tat, a protein secreted by HIV, inhibits neprilysin, the major protein that degrades amyloid beta.  Amyloid accumulation is associated with Alzheimer's disease. This suggests that while individuals with HIV now live longer, they run an increased risk of developing cognitive impairment. The Pulliam lab reported that individuals co-infected with HIV and HCV have much higher incidence of cognitive impairment than treated HIV infection alone.   The Pulliam lab is investigating how activated blood monocytes in HIV infection and coinfection with HCV can shed exosomes that contain miRNA that can enter neural cells and cause dysfunction. This may explain the continued cognitive impairment in spite of adequate HIV therapy.

 

To see Dr. Pulliam on Pub Med, click here.