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Biomedical subjects

I Blanca

Publications and source records attributed to I Blanca.

At least 19 recordsLinked to original sources

Effect of recombinant human erythropoietin on endothelial cell apoptosis.

BACKGROUND: Recombinant human erythropoietin (rHuEPO) induces endothelial cell growth and angiogenesis in vitro. The mechanisms are unknown. Because an increase in endothelial cell survival could play a role in this process, we examined the effect of rHuEPO on lipopolysaccharide (LPS)-induced apoptosis in bovine pulmonary artery endothelial cells (BPAECs). METHODS: Four groups of cells were studied. The first group was preincubated in serum-free medium followed by treatment with LPS. The second group was preincubated with rHuEPO followed by LPS. The third group was treated with only rHuEPO. Control cells were cultured in the absence of rHuEPO and LPS. Apoptosis was determined by flow cytometric DNA analysis, propidium iodide staining, cellular DNA fragmentation by ELISA, and gel electrophoresis. RESULTS: LPS-treated cells showed an increase in hypodiploid DNA (36.4 +/- 6.1%) compared with controls (9.8 +/- 3.3%, P < 0.001). Preincubation with rHuEPO decreased this effect to 14.7 +/- 5.1% (P < 0.001). Apoptosis determined by propidium iodide was observed in 33 +/- 8% of LPS-treated cells, but in only 9 +/- 3% of cells preincubated with rHuEPO cells (P < 0.001). Similarly, DNA fragmentation was decreased in rHuEPO pretreated cells compared with LPS alone (0.155 OD +/- 0.02 vs. 0.538 +/- 0.09 OD, P < 0.001). DNA breakdown was observed in only LPS-treated cells. CONCLUSIONS: These results suggest that rHuEPO prevents LPS-induced apoptosis in endothelial cells. This protective effect could be an important factor in the action of rHuEPO on vascular endothelium.

Animals↗

Expression of low-density lipoprotein receptors in peripheral blood and tonsil B lymphocytes.

B lymphocytes, purified from peripheral leucocytes from young normolipaemic humans, expressed and internalized low-density lipoprotein receptors (LDLR). The expression was assessed by a monoclonal anti-LDLR. The internalization of LDL was assessed by LDL labelled with 125I (125I-LDL) and 1,1'-dioctadecyl-3,3,3',3' tetramethyl-indocarboxycyanine perchlorate (LDL-DiI). The expression of LDLR, assessed by anti-LDLR, was: 38 +/- 8% (n = 5) for fresh purified cells, 60 +/- 10% (n = 12) for non-stimulated cells, 79 +/- 5% (n = 10) for IL-2 (100 U/ml)-stimulated cells and 95 +/- 5% (n = 8) for pokeweed mitogen (PWM) (1:200 dilution)-stimulated cells. The optimal concentrations of agonist were 100 U/ml of IL-2, and 1:200 dilution of PWM. IL-2 and PWM increased the internalization of LDL-DiI by 1.5-fold. The internalization of LDL-DiI was maximal at 60 microg of protein/ml (48 +/- 8%). Scatchard analysis revealed a Kd of 3.2 +/- 0.22 x 10(-8) M and 2180 +/- 190 binding sites in non-stimulated cells, a Kd of 7.73 +/- 0.36 x 10(-9) M and 12,500 +/- 430 binding sites for IL-2 (100 U/ml)-stimulated cells, and a Kd of 7.2 +/- 0.43 x 10(-9) M and 13,250 +/- 450 binding sites for PWM (1:200 dilution)-stimulated cells. Lineweaver-Burk analysis of LDL binding (LDL-DiI) revealed that the apparent Kd for non-stimulated cells was 1.3 +/- 0.11 x 10(-8) M, and 9.2 +/- 0.2 x 10(-9) M and 7.5 +/- 0.25 x 10(-9) M for IL-2- and PWM-stimulated cells, respectively. B lymphocytes from tonsils also showed a high expression of LDLR assessed with anti-LDLR (70 +/- 6%). The high expression of LDLR and the avid internalization of LDL suggest that LDL may be important for B cell physiological responses.

Adult↗

Characterization of local memory cells in stage-classified pulmonary tuberculosis: preliminary observations.

Immunophenotype analysis and proliferative responses were investigated in bronchoalveolar lavage (BAL) cells from 21 patients with stage-classified tuberculosis: six with localized pulmonary infiltrate (LPI); seven with diffuse pulmonary infiltrate (DPI); and eight with pleural effusions (PE). Bronchoalveolar lavage cells from these patients contained a high number of cells/ml. The macrophage number was significantly lower in the DPI group (P < 0.05) compared to the LPI or PE groups. Conversely, neutrophils were markedly increased in DPI patients compared to LPI (P < 0.01) and PE (P < 0.01) patients. Lymphocyte infiltration (97.7 +/- 2.3% CD3+, > 83% alphabeta+ and CD4+ > CD8+) was observed in the three groups. A significant increase in the number of total lymphocytes (P < 0.01) and CD4+ cells (P < 0.05) was observed in the LPI group compared to the PE group. In the LPI group CD4+CD45RO+ cell infiltration was higher than CD4+CD45RA+ cells (P < 0.001), contrasting to similar numbers of these subpopulations in the DPI group. Lymphocytes from three out of three LPI patients (alphabeta+CD4+CD45RO+) responded against tuberculin purified protein derivative contrasting to the unresponsiveness of five patients with either DPI or PE. This impaired response was reverted in two out of five patients by using peripheral blood monocytes instead of alveolar macrophages. It is suggested that, in humans, alphabetaCD4+CD45RO cells are the main lymphocyte type involved in the initial local cell-mediated immune response against Mycobacterium tuberculosis.

Adolescent↗

Nitric oxide in different types of hypertension during pregnancy.

1. Serum nitric oxide (NO) levels (determined by its products of oxidation) were assessed in non-pregnant women, normal pregnant women and patients suffering from mild pre-eclampsia (MPE), severe pre-eclampsia (SPE), chronic hypertension (CHT) and CHT with pre-eclampsia (CHT + PE). The levels of NO products were significantly reduced during pregnancy in MPE (P < 0.001), CHT + PE (P < 0.01) and SPE (P < 0.05). Significant reductions of NO products were also observed in puerperium (P < 0.001) in all groups except CHT + PE (P < 0.05). 2. In normal pregnancy, three events were related to NO levels: (1) negative correlations were found between the levels of nitrite (r = -0.73, P = 0.0003), nitrate (r = -0.53, P = 0.017) and the number of weeks of gestation; (2) in the caesarean section group, the levels of NO at puerperium were significantly lower (P < 0.05) than those during pregnancy; and (3) there was a significant reduction in NO levels in the pregnant women carrying male fetuses as compared with female fetuses (P < 0.05). 3. In SPE, the patients with a family history of hypertension had lower levels of NO compared with the patients without such a history (P < 0.05). 4. A negative correlation was observed between systolic blood pressure, diastolic blood pressure and NO levels in MPE (r = -0.62, P = 0.013 and r = -0.68, P = 0.0049 respectively) and SPE (r = -0.72, P = 0.004 and r = -0.53, P = 0.037 respectively). 5. In SPE, positive correlations were observed between platelet count and nitrite (r = 0.67, P = 0.006) and nitrate levels (r = 0.56, P = 0.028). 6. In MPE, patients with anti-hypertensive treatment showed significantly (P < 0.05) higher levels of NO compared with the non-treated patients. 7. NO may be important in the physiopathology of hypertension during pregnancy, although several factors may affect its levels.

Adult↗

Low density lipoprotein receptor expression and function in human polymorphonuclear leucocytes.

Low density lipoprotein receptors (LDLR), capable of internalizing LDL, are expressed in polymorphonuclear neutrophils (PMN). The expression was assessed using anti-LDLR antibody by flow cytometry. The internalization of LDL was assessed by: (i) quantification of the uptake of labelled LDL with 1,1'-dioctadecyl-3,3,3',3' tetramethyl-indocarboxycyanine perchlorate (DiI) by flow cytometry; and (ii) the binding of LDL-125I. In fresh purified cells, Lineweaver Burk analysis of LDL binding (LDL-DiI) revealed that the calculated Kd (internalized LDL) for PMN (15.0 x 10(-9) M) is lower than the Kd for monocytes (1.1 x 10(-7) M) and the Kd for lymphocytes (3.2 x 10(-7) M). Scatchard analysis (LDL-125I) revealed 25,000 binding sites and a Kd of 9.6 x 10(-9) M for PMN. The interaction of LDL with its receptor caused a two-fold fast (peak at 1 min) and transient increase in the oxidative burst, measured by the formation of 2',7' dicholoflurescein (DCF) by flow cytometry. This effect was not observed in monocytes or lymphocytes, and it was blocked by anti-LDLR antibody. The stimulation of LDL was optimal at 10 microg of protein/ml. LDL was able to suppress DCF formation induced by phorbol myristate acetate (PMA) and PMA was unable to further stimulate LDL-treated cells, suggesting protein kinase-C (PKC) involvement in LDL effects. Using a PKC assay, LDL was shown to induce a two-fold increase in PKC translocation to the membrane. Thus, LDL increases PMN oxidative burst through a PKC-dependent pathway.

Humans↗

Secretion of cytokines by natural killer cells primed with interleukin-2 and stimulated with different lipoproteins.

Natural killer (NK) cells were shown to secrete differentially interleukins (IL), IL-1 alpha, IL-1 beta, IL-2, IL-8, interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha), granulocyte-macrophage colony-stimulating factor (GM-CSF), and leukaemia inhibitory factor (LIF) upon stimulation with optimal concentrations of chylomicrons (CM), very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high-density lipoprotein (HDL) or acetyl-modified low-density lipoprotein (AcLDL). CM, VLDL, LDL and AcLDL induced LIF secretion which was absent in nonstimulated cells. CM, VLDL, and LDL did not affect IL-1 alpha secretion. CM stimulated IL-8 > TNF-alpha > IL-1 alpha > IL-2 = IFN-gamma, and decreased seventeen-fold GM-CSF secretion. VLDL stimulated IL-8 secretion > IL-1 alpha = IL-2 > IFN-gamma > TNF-alpha and decreased fivefold GM-CSF secretion. LDL stimulated IL-8 secretion > IL-1 alpha > IL-2 = IFN-gamma, it did not modify TNF-alpha and inhibited five hundred-fold GM-CSF secretion. HDL stimulated IL-2 secretion = IFN-gamma > IL-8, it decreased GM-CSF secretion > IL-1 alpha > IL-1 beta > TNF-alpha without affecting LIF. AcLDL stimulated IL-8 secretion > TNF-alpha > IL-1 alpha > IL-2 = IFN-gamma = IL-1 beta, and decreased GM-CSF secretion eightfold. When NK cells were primed with 10, 100 or 500 IU/ml of IL-2 before the addition of lipoproteins, a decrease in the secretion of cytokines was observed as compared with cells primed with IL-2 only. Differences in cytokine secretion were observed among the diverse type of lipoproteins used for cell stimulus. Thus, lipoproteins may condition NK cytokine secretion and cell activation.

Cell Culture Techniques↗

Expression and function of low-density lipoprotein receptors in CD3-CD16+CD56+ cells: effect of interleukin 2.

Low-density lipoprotein receptors (LDLR) have been shown to be expressed, internalized, and transcribed in CD3-CD16+CD56+ cells. Only a low percentage (up to 12%) of NK cells express LDLR. Interleukin 2 (IL-2) (1000 IU/ml) induced a threefold increase in the expression of LDLR on the cell surface that results from, at least in part, augmentation of LDLR turnover from the cytosol to the membrane. Scatchard analysis revealed that IL-2 decreased the Kd of LDLR binding for LDL from 7.53 to 4.33 nM with an increment in the number of binding sites from 2500 up to 5000. Both the proliferative response and cytotoxic functions of these cells are affected by LDL. Low concentrations of LDL induce an increase in the proliferative response (up to eightfold) and in the cytotoxic response of NK cells (up to fivefold). High concentration (more than 60 micrograms/ml) of LDL hampers both proliferative response and cytotoxic activity of NK cells. LDL did not affect the cytotoxic functions of IL-2-activated NK cells. Overall, we have shown that LDLR is expressed on the surface of NK cells and can be augmented by IL-2. Furthermore, we propose some insights into the mechanism responsible for the enhanced expression of LDLR on NK cell surface. In addition, our data clearly delineate that LDLR plays an important role in the regulation of proliferative responses and cytotoxic activity of these cells.

CD3 Complex↗

Regulatory effects of lipoprotein lipase on proliferative and cytotoxic activity of NK cells.

Lipoprotein lipase (LPL) induced, in a dose-dependent fashion, a 2-fold and 11-fold increase in the proliferative response of peripheral blood lymphocytes (PBL) at 48 and 72 h, respectively; a 4- and 12-fold increase in natural killer (NK) cells, respectively; and a maximal 3-fold induction in interleukin-2 (IL-2)-treated NK cells at 72 h. T lymphocytes did not proliferate independently of the concentration of LPL used. LPL decreased the proliferative response of K562 and U937 cell lines. The effect on NK cells could be blocked by anti-LPL if it was added before LPL binding to the cell membrane. Contrary to its effects on NK proliferative response, LPL inhibited spontaneous cytotoxicity and lymphokine-activated killer activity (LAK). The effect was dose-dependent, target-dependent (U937 was more sensitive than K562 in LAK assays), but not LPL-binding time-dependent. Treatment of NK cells with heparinase overcame the inhibitory effect of LPL in spontaneous cytotoxicity. LPL binding to cell membranes, as assessed by flow cytometry, was as follows: K562 cells > monocytes > NK cells > LAK cells > U937 cells, absent in T lymphocytes and partially sensible to heparinase and IL-2 treatments. Protein kinase C translocation was observed upon treatment of NK cells with LPL. Three proteins in NK cell membrane (76, 57.2, and 27.2 kD), two in the cytosol (57.2 and 27.2 kD), and only one in ANA-1 cell membrane (76 kD) were precipitated with LPL-Sepharose. LPL receptors seem to be responsible for the proliferative and cytotoxic response observed in LPL-stimulated NK cells.

Cell Membrane↗

Effects of different lipoproteins on the proliferative response of interleukin-2-activated T lymphocytes and large granular lymphocytes.

1. T lymphocytes and large granular lymphocytes internalized chylomicrons, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein and acetyl modified low-density lipoprotein through different receptors as assessed by flow cytometry. The observed internalization ranged from 8% to 20%. 2. All lipoproteins induced proliferative responses in T lymphocytes and large granular lymphocytes at optimum concentrations (40 micrograms of protein/ml for all lipoproteins except high-density lipoprotein). Chylomicrons, very low-density lipoprotein and low-density lipoprotein increased T-lymphocyte proliferative response by fourfold while inducing respectively a seven-, nine- and sevenfold increment in large granular lymphocytes. Similarly, high-density lipoprotein and acetyl modified low-density lipoprotein respectively induced a nine- and sevenfold increment in T cells and a 17- and eightfold increment in large granular lymphocyte proliferative response. 3. Both cell types internalized more lipoprotein when they were stimulated with interleukin 2. Chylomicrons and low-density lipoprotein internalization was increased threefold and very low-density lipoprotein internalization twofold, while high-density lipoprotein internalization was unchanged in both cell types. Acetyl modified low-density lipoprotein internalization was fourfold higher in large granular lymphocytes only. 4. The proliferative response of interleukin-2 stimulated cells was different from that of unstimulated cells. Chylomicrons and very low-density lipoprotein induced a sixfold increment in T-cell proliferative response but only a fourfold increment in large granular lymphocytes. Low-density lipoprotein and acetyl modified low-density lipoprotein induced respectively a sevenfold and eightfold increment in T cells and a eightfold and threefold increment in large granular lymphocyte proliferative response. High-density lipoprotein did not affect T-lymphocyte proliferative response while inducing a twofold increase in large granular lymphocytes. 5. Lipoproteins are important in the proliferative response of unstimulated and interleukin-2-stimulated cells.

Adolescent↗

Decreased T-cell proliferative response to common environmental antigens could be an indicator of early human immunodeficiency virus-mediated lymphocyte lesions.

To evaluate CD4+/CD29+ cells and their responses to different antigens in polar stages of human immunodeficiency virus (HIV) infection, we studied 26 HIV-seropositive carriers (SPCs) and 15 patients with AIDS simultaneously with 20 healthy volunteers (HVs) and 10 seronegative homosexual and bisexual men (SNH). CD3, CD4, CD29, and CD45RA phenotypes were analyzed by two-color flow cytometry. Significant depletion of CD4+ T cells and both memory (CD4+/CD29+) and naive (CD4+/CD45RA+) T-cell subsets was found among SPCs and AIDS patients compared with the numbers of such cells in the HV and SNH groups. Responses to optimal doses of Candida albicans, streptokinase, and tetanus toxoid were explored in peripheral blood mononuclear cells and CD4(+)- and CD4+/CD29(+)-enriched cell populations. In SPCs, the response to C. albicans in peripheral blood mononuclear cells showed a statistically significant diminution compared with the response of HVs (15,308 versus 35,951 cpm). In addition, a significantly reduced response to streptokinase was evident only when cell preparations were CD4+/CD29+ enriched (3,048 versus 10,367 cpm). Furthermore, the SPC group comprised seven responders to at least one antigen and seven nonresponders to any of the selected specific antigens. Absence of a response in these latter patients was independent of the absolute counts of memory and naive T-cell populations. The response to tetanus toxoid, although diminished in SPCs, was not significantly different from that in controls. Our results suggest that defective responses to common environmental antigens, unrelated to the absolute number of CD4+/CD29+ cells, is probably an early indicator of an HIV-induced lymphocyte lesion.

Acquired Immunodeficiency Syndrome↗

Synthesis of bicyclic ketones in prostaglandins and their antimitotic activity.

The synthesis of a second ring in the prostaglandin structure, located at positions C-11 and C-13, has been accomplished starting from prostaglandin A2. Also an efficient enantioselectivity was obtained through the conjugate addition of carbanions at position C-11, together with the stereospecificity of a Claisen rearrangement at position C-13. Evaluation of the inhibitory effects on the proliferation of the K-562 cell line, in vitro, is presented. A structure-activity relationship indicated that alterations of the functional groups incorporated in the second ring of the prostaglandin structure affected their hydrophobicity. The antimitotic activity for prostanoids 7b, 7c and 7e have shown substantial improvements in their activities according to their ID50 values (12.5, 9.0 and 1.12 micrograms/ml), respectively). Attention is called to the importance of derivative 7a in terms of its high potency, determined by its ID50 values (0.35 micrograms/ml).

Antineoplastic Agents↗

Expression of different lipoprotein receptors in natural killer cells and their effect on natural killer proliferative and cytotoxic activity.

Natural killer (NK) cells take up chylomicrons (CM), very low density (VLDL), low density (LDL), high density (HDL) and acetyl-modified low density (AcLDL) lipoproteins through different receptors, VLDL being the lipoprotein with the highest uptake and HDL the lowest. The uptake of LDL can be selectively blocked by the anti-LDL receptor, which does not affect the uptake of CM, VLDL, HDL and AcLDL. Although the uptake of lipoproteins assessed by flow cytometry using DiI is not very high, the lipoproteins are able to induce an increase in proliferative responses, VLDL, AcLDL and HDL being the most important ones with 12- and 17-fold increments, respectively. CM, VLDL and LDL at low concentrations increase NK cytotoxic activity, while HDL and AcLDL inhibit, in a dose-dependent fashion, the killing of NK cells against K562. These results suggest the presence of four different receptors that are responsible for the cytotoxic and proliferative responses observed.

Acetylation↗

Synthesis of C(10)-halogenated prostaglandins.

The synthesis of halogenated prostaglandins at position C(10), starting from prostaglandin A2, has been accomplished, as well as an efficient regioselective hydroxylation of the upper chain of the prostanoid structure. Evaluation of the inhibitory effects on the proliferation of the K-562 cell line in vitro is presented. When the prostaglandin was modified in the upper chain, the antimitotic activity for bromo derivatives 4b, c and iodo derivative 5b had shown substantial improvements in their activities according to their ID50 values (28, 25, and 22 micrograms/mL, respectively). Attention is called to the significance of chloro derivative 3a in terms of its high potency, determined by its ID50 value (0.06 micrograms/mL).

Acetylation↗

Lipoprotein lipase expression in natural killer cells and its role in their cytotoxic activity.

Lipoprotein lipase (LPL) is the key enzyme in the metabolism of triglyceride-rich lipoproteins. The patterns of LPL mRNA expression and secretion of the enzyme have not yet been established in natural killer (NK) cells. We show in the present communication that CD3- CD16+ cells (NK cells) transcribe LPL mRNA, express LPL on the surface and secrete the enzyme. In contrast, there is no LPL expression on the surface of highly purified B and T lymphocytes. Stimulation of NK cells with interleukin-2 (IL-2) reduced the expression of LPL on their surface and augmented the secretion of LPL by the cells. The addition of anti-LPL antibodies to NK cells in culture led to a complete abrogation of cytotoxicity of NK cells against the K562 tumour cell line. Furthermore, IL-2 stimulation of effector cells reversed the anti-LPL antibody-induced inhibition of cytotoxic activity. Overall, these findings suggest that LPL plays a key role in the cytotoxic activity of NK cells.

Base Sequence↗

Bone marrow and peripheral blood natural killer cell activity in lymphomas. Its response to IL-2.

Natural killer (NK) cytotoxic activity was simultaneously investigated in bone marrow mononuclear cells (BMMC) and peripheral blood lymphocytes (PBL) from nine Hodgkin's disease (HD) and 15 non-Hodgkin lymphoma (NHL) untreated patients. Twenty-five PBL samples and seven bone marrow specimens from healthy individuals were also included as control group (C). NK cell activity was evaluated in basal condition and post-stimulation with human recombinant IL-2 (rIL-2). Data were expressed in K values (number of BMMC or PBL needed to lyse 50% of the target cells). In basal condition, both HD and NHL patients showed a NK cell activity comparable to the C group, both in BMMC (HD, K = 2.48 +/- 1.3; NHL, K = 3.8 +/- 2.0; C, K = 3.2 +/- 0.7) and PBL (HD, K = 2.0 +/- 1.0; NHL, K = 2.3 +/- 1.0; C, K = 2.2 +/- 0.2). Stimulation with rIL-2 induced a significant and comparable enhancement of the NK activity in PBL from HD, NHL and C while the response to rIL-2 of the BMMC in most of the HD and NHL patients was significantly greater than the C group. Responder cells were characterized by negative selection with specific MoAb plus complement as a CD3-, CD16+, CD56+ cytotoxic cell and further confirmed by flow cytometry. We postulate that IL-2 activation of bone marrow NK cell precursors, in addition to enhancing the activity of circulating NK, may be of value for the therapeutic rationale of IL-2 in patients with lymphoma.

Adolescent↗

Cellular immunity in current active pulmonary tuberculosis.

A group of 10 patients with recently diagnosed pulmonary TB were studied and compared to 10 bacillus Calmette-Guérin (BCG) immunized healthy individuals. Cellular immune mechanisms were explored in vitro utilizing fresh and precultured peripheral blood mononuclear cells exposed to PHA, PPD, and recall antigens (SK/SD and CA). Proliferative assays were also carried out in the presence of either each patient's serum (autologous serum) or cocultured with CD3(+)-depleted adherent cells. Serum measurements of soluble interleukin-2 (IL-2) receptor and synthesis of IL-2 generated by mononuclear cells stimulated with PPD and SK/SD were also performed. Patient sera were able to inhibit autologous as well as allogeneic cell responses, and a significant adherent cell suppressive effect was observed. As a whole the group of patients showed decreased blast transformation to PPD, preserved proliferative responses to other recall antigens, and a low PPD-induced generation of IL-2. Furthermore, as possible evidence of preactivated T cells, these patients demonstrated high soluble IL-2 receptor serum levels. Early compromise of specific cell-mediated immunity, including IL-2 abnormalities, may be of significance in newly diagnosed pulmonary TB.

Adult↗

Immunopathogenic aspects of infection by the human immunodeficiency virus in Venezuela.

A study of the immunopathogenic characteristics of HIV infection was begun in 1984 at the National Reference Center on Clinical Immunology (CNRIC) in Caracas, Venezuela, on 240 individuals with a variety of clinical manifestations. The most important findings were depletion of the CD4 cells in HIV-infected individuals, including asymptomatic carriers; significant reduction of the CD3-, CD16+ large granular lymphocytes (LGL) in AIDS cases; decrease in LGL cytotoxic activity in infected persons versus controls, along with increased lytic function induced by stimulation with recombinant interleukin-2 in both groups; and reduction of the CD4 population in AIDS patients, independent of the presence or absence of free serum antigen. Such research is helping to clarify the immunopathogenic mechanisms of HIV and possible geographic and demographic variations.

Acquired Immunodeficiency Syndrome↗