Features of ‘CD4-exploders', HIV-positive patients with an optimal immune reconstitution after potent antiretroviral therapy
作者:
Cristina Mussini,
Marcello Pinti,
Vanni Borghi,
Milena Nasi,
Grazia Amorico,
Elena Monterastelli,
Laura Moretti,
Leonarda Troiano,
Roberto Esposito,
Andrea Cossarizza,
期刊:
AIDS
(OVID Available online 2002)
卷期:
Volume 16,
issue 12
页码: 1609-1616
ISSN:0269-9370
年代: 2002
出版商: OVID
关键词: HIV;T-cell receptor rearrangement excision circles;thymus;highly active antiretroviral therapy
数据来源: OVID
摘要:
ObjectiveTo identify crucial immunological characteristics of a group of patients, defined ‘CD4-exploders', who were able to fully reconstitute their immune system after receiving highly active antiretroviral therapy (HAART).PatientsAmong a population of 540 HIV-positive patients treated with HAART, six individuals were identified who experienced a nadir of less than 85 × 106CD4+ cells/l, had major opportunistic infections (four out of six), started HAART in 1996 or 1997, and showed a rapid and relevant CD4+ lymphocyte increase (mainly due to virgin cells), in some cases regardless of virological control.MethodsEnzyme-linked immunosorbent assay for the determination of interleukin (IL)-7 plasma levels; flow cytometry to analyse surface antigens and CD127 (IL-7 receptor α-chain) expression; quantitative-competitive (QC) PCR for detecting cells containing T-cell receptor rearrangement excision circles (TREC); chest-computed tomography (CT) to analyse thymus volume and content.ResultsIn ‘CD4-exploders', high levels of TREC+ lymphocytes were found among CD4+ T cells, which also contained a high percentage of naive cells. However, CT revealed a dramatic depletion of intrathymic lymphoid tissue. Plasma levels of IL-7 were significantly high. Most CD4+ and CD8+ T lymphocytes expressed CD127, whose level was similar to that of healthy donors. CD127 expression on CD8+ lymphocytes was markedly higher than in HIV-positive individuals treated with the same therapy or in patients with AIDS.ConclusionIn ‘CD4-exploders', HAART-induced reconstitution of the T-cell compartment is independent from thymus volume, and is favoured by the upregulation of the IL-7/IL-7 receptor system.
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