The human brain consumes more energy than any other organ in the body and it relies on an uninterrupted supply of energy in the form of adenosine triphosphate (ATP) to maintain normal cognitive function. This constant supply of energy is made available through an interdependent system of metabolic pathways in neurons, glia and endothelial cells that each have specialized roles in the delivery and metabolism of multiple energetic substrates. Perturbations in brain energy metabolism is associated with a number of different neurodegenerative conditions including impairments in cognition associated with infection by the Human Immunodeficiency Type 1 Virus (HIV-1). Adaptive changes in brain energy metabolism are apparent early following infection, do not fully normalize with the initiation of antiretroviral therapy (ART), and often worsen with length of infection and duration of anti-retroviral therapeutic use. There is now a considerable amount of cumulative evidence that suggests mild forms of cognitive impairments in people living with HIV-1 (PLWH) may be reversible and are associated with specific modifications in brain energy metabolism. In this review we discuss brain energy metabolism with an emphasis on adaptations that occur in response to HIV-1 infection. The potential for interventions that target brain energy metabolism to preserve or restore cognition in PLWH are also discussed.

中文翻译：

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对艾滋病毒感染的生物能适应。调节能量底物利用能否改善 HIV-1 感染者的大脑健康？


人脑比体内任何其他器官消耗更多的能量，并且依赖三磷酸腺苷（ATP）形式的不间断能量供应来维持正常的认知功能。这种持续的能量供应是通过神经元、神经胶质细胞和内皮细胞中相互依赖的代谢途径系统提供的，每个细胞在多种能量底物的输送和代谢中都具有专门的作用。大脑能量代谢的扰动与许多不同的神经退行性疾病有关，包括与 1 型人类免疫缺陷病毒 (HIV-1) 感染相关的认知障碍。脑能量代谢的适应性变化在感染后早期就很明显，在开始抗逆转录病毒治疗（ART）后并没有完全正常化，并且通常随着感染时间的延长和抗逆转录病毒治疗的持续时间而恶化。现在有大量累积证据表明，HIV-1 感染者 (PLWH) 的轻度认知障碍可能是可逆的，并且与大脑能量代谢的特定改变有关。在这篇综述中，我们讨论了大脑能量代谢，重点是针对 HIV-1 感染而发生的适应。还讨论了针对大脑能量代谢的干预措施以保持或恢复 PLWH 认知的潜力。