New research from the University of Alberta may offer hope to HIV/AIDS patients suffering from poor memory and decision making as a result of their condition. The findings, published in the Journal of Neuroscience, show that insulin delivered intranasally has the ability to protect brain cells, while also suppressing HIV replication and preventing inflammation in the brain. The study showed that when researchers treated pre-clinical models of HIV-associated neurocognitive disorders (HAND) with insulin, neurological outcomes were noticeably better.
"Memory was improved, speed of function was improved, decision making was improved," says Christopher Power, senior author and professor of Neurology at the U of A's Faculty of Medicine & Dentistry. "We saw 25 per cent improvement in the various parameters. With that level of improvement it basically reversed the damaging effects of HIV on the brain," says Power.
In the study-funded by a Canadian Institutes of Health Research (CIHR) Team grant-the researchers treated preclinical models daily with insulin, delivered intranasally over a six-week period. Power, also a member of the U of A's Neuroscience and Mental Health Institute, says the findings were so consistently positive over the length of the study, the team now hopes to quickly move their work into humans.
Currently about one in four patients with HIV/AIDS will be affected by some form of neurocognitive impairment. Poor memory and concentration, impaired decision making, loss of fine motor control and slower speed of mental function are common symptoms.
"Because neurocognitive impairment is common and devastating for patients with HIV/AIDS, a new treatment would be a welcome option for affected patients," says Power. "Moreover, intranasal delivery would be easier for patients than taking more pills. Intranasal insulin treatment has also shown to be effective in Alzheimer's disease without any side-effects."
The team is now launching a randomized controlled trial in 2017, funded by CIHR, that will follow patients with HAND over a four month period. The patients will be split into three groups-one treated with a placebo, the rest being treated with insulin intranasally at two different doses. Power is optimistic the same positive results will carry over to human patients.
"We hope that our randomized control trial will yield sufficient data to move it forward to a larger phase three clinical trial, and eventually routine clinical use," says Power. "I know that many of my patients would really appreciate a new treatment for neurocognitive impairment. We believe we are on the right path."
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