Investigators

Research Interest

Peripheral Nerve Laboratory

The peripheral nerve laboratory studies the physiologic and pathologic mechanisms of peripheral nerve disorders, applying clinical neurophysiologic, immunologic and immunopathologic methods. Its long-term goal is to enhance our understanding of the underlying mechanisms of peripheral neuropathies and apply these to the development of more effective specific treatment strategies. Under the Specialized Neuroscience Research Program (SNRP) we have established an effective collaborative program for the study of HIV-associated neuropathy.

Current Research

HIV Sensory Neuropathy: Age, Risk Factors and Immunopathology

Project Description:

With recent declines in the incidence rates of HIV-associated dementia, HIV-associated neuropathy (HIV-SN) is the commonest of the neurological disorders in AIDS. If affects up to 30% of patients and is associated with advanced HIV disease, and with dideoxynucleoside agents. To date, research efforts have focused on adult patients, and it is unclear whether children are vulnerable to this complication. The pathophysiological mechanisms which underlie HIV-SN remain undefined. Our underlying hypothesis is that symptomatic neuropathy in AIDS develops through the magnification of pre-existing nerve damage. HIV immune dysregulation with local macrophage activation plays a critical role. We are performing a prospective and longitudinal study of peripheral neuropathy in a Hispanic cohort of pediatric and adult HIV-infected patients to address these questions. The rationale of the study centers on the fact that there is very limited information about determinants of neuropathy in specific ages or ethnic and this information should permit the implementation of specific and effective therapeutic or preventive strategies. To accomplish the objectives of this project the following specific aims are being pursued:

1. To compare the incidence rates and determinants of sensory neuropathy in cohorts of HIV seropositive children and adults.
   
   
2. To determine the association between nucleoside analogue metabolism and peripheral neuropathy by measuring intracellular concentrations of phosphorylated nucleoside analogues in PBMCs.
   
   
3. To determine the relationship between macrophage dysregulation, immune activation and development of neuropathy.
   
   
4. To determine how patterns of immune activation and peripheral nerve damage affect the remodeling of the dorsal horn in the spinal cord and molecular pathways associated with pain in the dorsal root ganglia.
   
   

• Amiodarone-induced peripheral neuropathy: prevention and early diagnosis (with Ignacio Pita, MD, Neurology Resident)

Education

1977-1981: University of Puerto Rico, Rio Piedras, PR: B.S. Biology

1981-1985: Univ of PR School of Medicine, San Juan, PR: M.D. Medicine

1985-1986: NY Medical College Metropolitan Hospital, NY: Intern Medicine

1986-1989: Boston University, Boston City Hospital, MA: Resident Neurology

1989-1991: National Institutes of Health, Bethesda, MD: Fellow EMG/Clinical Neurophysiology

1996-1998: National Institutes of Health, Bethesda, MD: Post-Doc Neuromuscular Diseases

Experience

1991-1996: Acting Chief, EMG Section, NINDS, NIH

1990-1998: Command Consultant, National Naval Medical Center, Bethesda, MD

1996-1998: Associate Investigator, Neuromuscular Diseases Section, NINDS, NIH

1998-2000: Special Assistant to the Chancellor in Clinical Research, University of Puerto Rico, Medical Sciences, San Juan, PR

2000: Invited Participant, Human Immunodeficiency Virus and the Peripheral Nervous System Workshop, National Institute of Neurological Disorders and Stroke, NIH Arlington, VA

2000-2002: Assistant Director, RCMI - Clinical Research Center, University of Puerto Rico Medical Sciences, San Juan, PR

2002: Journal Article Referee for Muscle and Nerve

2002-present: Associate Director, RCMI - Clinical Research Center, University of Puerto Rico Medical Sciences, San Juan, PR

2003: Journal Article Referee for Muscle and Nerve

Publications

1. Luciano CA, Ebenezer G. Skolasky R, Ho-Fung V, Maldonado JC, Sanchez S, Castillo E, Ginebra T, Hauer P, Pardo C, McArthur JC. Distinctive Features of HIV Sensory Neuropathy in Children and Adolescents, Submitted to Neurology. 2009
   
   
2. Sorenson EJ, Windbank AJ, Mandrekar JN, Bamlet WR, Appel SH, Armon C, Barkhaus PE, Bosch P, Boylan K, David WS, Feldman E, Glass J, Gutmann L, Katz J, King W, Luciano CA, et. Al. ; Subcutaneous IGF-1 is not beneficial in 2 year ALS trial. Neurology 2008; 71: 1770- 1775
   
   
3. Luciano CA, Ho-Fung V, Sanchez S, Ebenezer G, Castillo E, Ginebra T, Ramirez L, Skolasky R, Hauer P, Pardo C, McArthur JC. Physiologic and Pathologic correlates of pediatric/adolescent HIV sensory neuropathy. Submitted to Annals of Neurology.
   
   
4. Keswani S, Luciano C, Pardo CA, Cherry KL, Ahmet H, McArthur JC. The spectrum of Peripheral Neuropathies in AIDS, in the "Neurology of AIDS", Gendelman H, Grant I, Everall IP, Lipton SA, Swindells S (Eds), Oxford University Press, 2005, pp 423-443
   
   
5. Luciano CA, Pardo C, McArthur JC. Recent developments in the HIV neuropathies. Current Opinion in Neurology, 16:403-409, 2003.
   
   
6. Luciano CA, Russell JW, Banerjee TK, Quirk J, Scott LJC, Dambrosia JM, Barton NW, Schiffmann R. Physiologic characterization of neuropathy in Fabry's disease. Muscle Nerve 26: 622-629, 2002.
   
   
7. Weiss MD, Luciano CA, Quarles RH. Nerve Conduction Abnormalities in aging mice deficient for myelin-associated glycoprotein. Muscle Nerve 24: 1380-1387, 2001
   
   
8. Syed NA, Sandrbrink F, Luciano CA, Altarescu G, Weibel T, Schiffmann R, Floeter MK. Cutaneous Silent Periods in Patients with Fabry Disease. Muscle Nerve 23: 1179-1186, 2000.
   
   
9. Luciano CA. Plasmaféresis, inmunoterapia y quimioterapia en las polineuropatías [Plasmapheresis, immunotherapy and chemotherapy in the polyneuropathies]. Rev Neurol (Spain), 1999; 29: 180-184.
   
   
10. Luciano CA. Aspectos importantes en el diagnóstico y manejo de las neuropatías periféricas [Important aspects in the diagnosis and management of peripheral neuropathies]. Rev Neurol (Spain), 1999; 29: 184-188.
    
    
11. Luciano CA. Neuropatías Crónicas Inflamatorias [Chronic Inflammatory neuropathies]. Rev Neurol (Spain), 1999; 29: 174-179.
    
    
12. Scott LJ, Griffin JW, Luciano C, Barton NW, Banerjee T, Crawford T, McArthur JC, Tournay A, Schiffmann R. Quantitative analysis of epidermal innervation in Fabry disease. Neurology 1999; 52: 1249-1254
    
    
13. Weiss MD, Luciano CA, Dalakas MC, Quarles R. Molecular mimicry in chronic inflammatory demyelinating polyneuropathy and melanoma. Neurology 1998; 51: 1738-1741
    
    
14. Samii A, Luciano CA, Hallett M. Central motor conduction time: reproducibility, variability, and discomfort of three different methods. Muscle Nerve 1998; 21: 1445-1450.
    
    
15. Floeter MK, Civitello LA, Everett C, Dambrosia J, Luciano CA: Peripheral neuropathy in children with HIV infection. Neurology 1997; 49:207-212.
    
    
16. Luciano CA, Dalakas MC. Inclusion body myositis: no evidence for a neurogenic component. (Neurology 1997;48:29-33).
    
    
17. Luciano CA, Kumaraswamy S, Spector SA, Dalakas MC. Electrophysiologic and histologic studies in clinically unaffected muscles of patients with prior paralytic poliomyelitis. Muscle Nerve 1996;19: 1413-1420
    
    
18. Cupler E, Otero C, Hench K, Luciano C, Dalakas MC: Acetylcholine receptor antibodies as a marker of treatable fatigue in HIV-1 infected individuals. Muscle Nerve 1996; 19: 1186-1188
    
    
19. McKenzie R, Fried MW, Sallie R, Conjeevaram H, Di Bisceglie AM, Park Y, Savarese B, Kleiner D, Tsokos M, Luciano C, Pruett T, Stotka J, Straus SE, Hoofnagle JH. Hepatic failure and lactic acidosis due to fialuridine (FIAU), an investigational nucleoside analogue for chronic hepatitis B. N Engl J Med 1995; 333:1099-1105.
    
    
20. Luciano CA, Kumaraswamy S, Spector SA, Dalakas MC. Reinnervation in clinically unaffected muscles of patients with prior paralytic poliomyelitis: correlation between macro-EMG and histology. Ann NY Academy Sci 1995; 753: 394-396.
    
    
21. Luciano CA, Gilliatt RW, Conwit RA. Mixed nerve action potentials in acquired demyelinating polyneuropathy. Muscle Nerve 1995; 18:85-92.
    
    
22. Charnas LR, Luciano CA, Dalakas M, Gilliatt RW, Bernadini I, Ishak K, Cwik VA, Fraker D, Brushart TA, Gahl WA. Distal vacuolar myopathy in nephropathic cystinosis. Ann Neurol 1994; 35: 181-188.
    
    

Chapters

1. The spectrum of peripheralneuropathies in AIDS, S Keswani, C Luciano, C Pardo, K Cherry, A Hoke and J McArthur, In: The Neurology of AIDS, Second Edition, Edited by Howard Gendelman, Igor Grant, Ian P. Everall, Stuart Lipton and Susan Swindells.

Abstract Presentations

1. Luciano CA, Ginebra T, Castillo E, Hauer P, Pardo C, McArthur JC. Markers of HIV-Associated Neuropathy in a Hispanic Cohort. 3rd annual Conference of SNRP, Honolulu, Hawaii, May 2003
   
   
2. García R, Melendez M, Blanco R, Rosario O, Dávila S, Casiano D, Garciía H, Santana J, Luciano C, Rodríguez JF. Quantitation of intracellular d4T-TP and dT-TP in HIV-infected subjects using HPLC-MS/MS. 2nd IAS Conferenc on HIV Pathogenesisi and Treatment, Paris, France, July 2003.
   
   
3. Luciano CA, Ginebra T, Castillo E, Hauer P, McArthur JC. Electrophysiology Studies in Pediatric Human Immunodeficiency Virus Neuropathy. Muscle Nerve 2003; Suppl 12: S63-S64.
   
   
4. Luciano CA, Ginebra T, Castillo E, Hauer P, McArthur JC. Physiological and Morphological Abnormalities in HIV-infected Children. Annals of Neurology 2003; 54 (Suppl 7): S74
5. Luciano CA, Ho-Fung V, Sanchez S, Ginebra T, Gerena V, Castillo E. Sensitivity of various electrophysiological parameters in HIV-associated Neuropathy. Presented at the First Multidisciplinary Conference in Clinical Research and 4th Congress of Health Related Professions, San Juan, Puerto Rico, December 2004.
   
   
6. Luciano CA, Ho-Fung V, Sanchez S, Castillo E., Ginebra T, Gerena V, Rivera C, McArthur, JC. A Comparison of Soluble Immune Markers in Antiretroviral Toxic Neuropathy and HIV Distal Sensory Neuropathy. Neurology 2005; 64: A246. (Presented at the 57th annual meeting of the American Academy of Neurology, Miami Beach, Florida, April 2005.
   
   
7. Luciano CA, Ebenezer, G, Ho-Fung V, Sanchez S, Ginebra T, Castillo E., Hauer P, McArthur, JC. Increased Cutaneous Innervation in Pediatric/Adolescent HIV Sensory Neuropathy. Presented at the 5th annual Conference of Specialized Neuroscience Research Programs, College Park, Maryland, June 2005.