# Pathogenesis of HIV-associated sensory neuropathy

> **NIH NIH R01** · UNIVERSITY OF TEXAS MED BR GALVESTON · 2024 · $400,000

## Abstract

PROJECT SUMMARY
Sensory neuropathy (SN) is the most common comorbidity in Human Immunodeficiency Virus-1(HIV-1)
infected-patients (hHIV-SN), which affects 60% of the 37.9 million HIV infected patients in this world. hHIV-SN
is particularly resistant to existing pain relief therapies and now there is no FDA approved HIV specific
analgesic available due to poorly understanding of the hHIV-SN pathogenesis. In order to develop disease-
specific and mechanism-based therapeutics for hHIV-SN, we must fully elucidate the underlying mechanisms.
Healthy skin is mainly innervated by nociceptors labeled by protein gene product 9.5 (PGP9.5+) to generate
nociception and the degeneration of PGP9.5+ nociceptor is a critical pathological mark of hHIV-SN. Growth
associated protein (GAP43) labels the newly sprouted nociceptor (GAP43+). PGP9.5+ and GAP43+ nociceptors
have distinctly neurotrophic dependency on glial cell line-derived neurotrophic factor (GDNF) and nerve growth
factor (NGF) respectively and the expression of GDNF and NGF are regulated by Wnt5a. Wnt5a is a secreted
signaling protein in the Wnt family that plays an important role in axonal remodeling and is also specifically up-
regulated in the spinal cord of HIV-SN patients with chronic pain. Our publication reported that gp120, an
envelope glycoprotein of HIV-1, plays a causative role in neuropathic pain occurred both in gp120-induced
mouse SN (mHIV-SN) and in hHIV-SN patients. The gp120-caused aberrant activation of neuronal Wnt5a in
sensory neuron and in spinal cord are intimately relevant with the development of SN-associated pain in
mouse and in HIV-infected patients as well. Importantly, our preliminary data have shown that Wnt5a-specific
antagonist, Box5, blocks mHIV-SN-associated pain and pathologies. Interestingly, in both of the mHIV-SN and
hHIV-SN, as PGP9.5+ nociceptor degeneration progresses, even close to the point of denervation, chronic pain
remains or worsens, instead of resolving. This phenomenon indicates that the chronic pain in HIV-SN must be
mediated by an alternate novel nociceptor, the sprouted GAP43+ nociceptor which specifically mediates the
HIV-Associated chronic pain. Our central hypothesis is: HIV-1 gp120 causes mHIV-SN by activation of Wnt5a-
NGF mediated sprouting of the GAP43+ nociceptor, which in turn specifically mediates HIV associated chronic
pain. We will test this hypothesis by using mHIV-SN mouse model in three Aims. In Aim #1, we will fully
investigate the interplay of the sprouting of GAP43+ nociceptors and the degenerating of PGP9.5+ nociceptor in
mHIV-SN by using multiple engineering mouse models. In Aim #2, we will determine that gp120-induced the
sprouting of GAP43+ nociceptor is mediated by Wnt5a-NGF pathway by pharmacological and genetic
approaches. In Aim #3, we will determine the therapeutic potential of antagonisms of Wnt5a by its antagonist,
Box5, NGF antagonism by tanezumab and GDNF to treat mHIV-SN in the gp120 mHIV-SN mouse model.
Results from this...

## Key facts

- **NIH application ID:** 10909241
- **Project number:** 5R01NS122571-04
- **Recipient organization:** UNIVERSITY OF TEXAS MED BR GALVESTON
- **Principal Investigator:** Subo Yuan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $400,000
- **Award type:** 5
- **Project period:** 2021-09-30 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10909241

## Citation

> US National Institutes of Health, RePORTER application 10909241, Pathogenesis of HIV-associated sensory neuropathy (5R01NS122571-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10909241. Licensed CC0.

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