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Rapid progression of HIV-1 infection to AIDS.

Homosexually acquired human immunodeficiency virus type 1 infection is usually slowly progressive, and reports of its rapid progression to acquired immunodeficiency syndrome are rare. We present a case of acute human immunodeficiency virus type 1 and cytomegalovirus coinfection that progressed to acquired immunodeficiency syndrome and death in 7 months. The factors that determine the clinical outcome of human immunodeficiency virus type 1 infection are poorly defined; however, coinfection with other agents, such as cytomegalovirus, may influence its natural history.

AIDS-Related Opportunistic Infections↗

Chimeric CD7 monoclonal antibody therapy in rheumatoid arthritis.

Murine monoclonal antibody (Mab) therapy in patients with rheumatoid arthritis (RA) produces an antimouse immunoglobulin response by the recipient. We studied a chimeric (human/mouse) CD7 Mab, in a dose ranging tolerability study in 10 patients with RA. Modest improvements in disease activity occurred with frequent acute adverse effects of malaise, fever and nausea. After treatment, peripheral blood T lymphocyte numbers fell by 50% and CD7 expression fell by 97% for less than 7 days. Our study demonstrates chimeric Mab function in vivo and illustrates the influence of antibody isotype and patient characteristics on adverse effects.

Adult↗

Different distributions of lung and blood lymphocyte subsets in pediatric AIDS or tuberculosis.

Pulmonary immunity has not been studied in children with acquired immunodeficiency syndrome (AIDS) or tuberculosis (TB), even though lungs of both children and adults infected with human immunodeficiency virus (HIV-1) or Mycobacterium tuberculosis are affected frequently and severely. In the present studies, the distributions of T (CD3+, CD4+, CD8+) and B (CD19+) lymphocytes in bronchoalveolar lavage fluid (BALF) and blood of children with AIDS (N = 28) and children with pulmonary TB (N = 18) were determined using direct immunofluorescence (flow microfluorimetry). The distributions of lymphocyte subsets in BALF differed dramatically from those in blood. In pediatric AIDS, reduction of CD4/CD8 ratio was much more pronounced in BALF than in peripheral blood (0.15 +/- 0.04 vs. 0.43 +/- 0.11). This difference was due to selective depletion of BALF CD4+ lymphocytes, rather than to a great influx of CD8+ cells into the lung. In childhood TB, the CD4/CD8 ratio in BALF also was significantly decreased, despite its elevation in blood (1.02 +/- 0.26 vs. 1.96 +/- 0.32). The results show that (1) examination of peripheral blood lymphocytes does not reflect the kind and extent of changes observed in the distribution of pulmonary lymphocyte subsets, and (2) the profound decrease of the CD4/CD8 ratios in BALF of children with AIDS or TB is due to decreased percentages and absolute numbers of BALF CD4+ lymphocytes. The data suggest that analysis of BALF provides a more accurate evaluation of the patient pulmonary immune status than monitoring peripheral blood.

Acquired Immunodeficiency Syndrome↗

[Evaluation of immunological studies in patients with rheumatoid arthritis].

Immunological studies are widely applicable at a clinic in rheumatoid patients, despite the fact that their clinical value is still a disputable subject. Many authors are of opinion that the determination of individual immunological tests does not provide the estimation of immunological state in patients, and should be evaluated critically. The aim of the actual paper was to evaluate the immunological state of patients with rheumatoid arthritis by means of immunological profile index, which consists in performing concurrently many immunological tests involving both humoral immunology and cellular one. The results were referred to the duration of the disease, pathological process activity, the presence of rheumatoid factor, the advancement of osseous changes. The studies were carried out in patients, aged 16-69 years, 63 of them had RA and 9 were affected by ankylosing spondylitis. The control group comprised 16 normal subjects aged 28-61 years. It has been disclosed that the values of the immunological profile index in patients were statistically significantly lower than in the control group. The lowest values of immunological profile index were recorded in patients with extra-articular symptoms with recurrent infections of urinary and respiratory tracts, as well as in patients with active form of RA, and the presence of rheumatois factor. The patients with ankylosing spondylitis were found to reveal immunological disorders, but they were expressed less markedly than in RA patients. With the help of immunological profile it was possible to show that multifunctional immunological disorders appeared in patients with rheumatoid arthritis. The most sensitive immunological tests were: levels of immunoglobulins in blood serum, and the count of lymphocytes T and B. The immunological profile study in patients with rheumatoid inflammation of joints is an objective method of evaluating their immunological state.

Adolescent↗

[Quantitative assay of CD8+ (cytotoxic and suppressor) lymphocytes in patients with both asymptomatic and symptomatic HIV infection].

Lymphocytes CD8+ have been assayed prospectively in 245 individuals infected with HIV. Percentage and number of CD8+ have been nearly two-fold higher in asymptomatic patients or patients with lymphadenopathy than those in the control group. The number of CD8+ lymphocytes has been rapidly decreasing parallel to the progression of HIV (ARC and AIDS), while their percentage has increased--however insignificantly. There has been a positive correlation between the number of CD4+ and CD8+ cells and all clinical stages of HIV infection.

Adolescent↗

T-cell alterations in immunoglobulin A nephropathy.

In the present paper are reported alterations of the cellular immunity found in 24 patients with immunoglobulin A nephropathy (IgAN). CD4+ and CD25+ cells were increased in patients in comparison with controls. The mean of interleukin-2 (IL-2) and interleukin-4 (IL-4) levels in sera were similar in patients and controls, but the levels of IL-2 in supernatants of stimulated peripheral blood mononuclear cells from patients were higher than those of controls. There were no correlations between renal function, serum IgA levels, urinary findings, cellular subsets, and IL-2 or IL-4 sera levels. These immunological data were also unrelated to the mode of clinical presentation. The results suggest a pivotal role of IL-2 in cellular immune response with regard to T-cell activation in patients with IgAN.

Adult↗

[Immune function and abdominal surgery in blood stasis syndrome in patients with gastrointestinal diseases].

52 Patients with Blood Stasis Syndrome (BSS) in abdominal surgical diseases were divided into 3 types according to their symptoms, signs and natures of diseases. Peripheral blood T lymphocyte subsets of these BSS patients and 12 healthy persons were studied with Flow Cytometry and monoclonal antibodies. The immunoglobulins and complements of these cases were also studied. There were no difference in T cell subsets, immunoglobulins and complements between Qizhi-BSS group and normal control. The Shire-BSS group showed that CD8 cell, IgG, IgM, and C1, C3c were increased. These results showed that the immune response increased in this type of BSS patients. In the Qixu-BSS group, the CD3 was nearly normal, and the CD4+, CD4+/CD8+ ratio, and CD16+ were statistically decreased. However, the CD8+ cells markedly increased, the IgG, IgM and IgD were also lowered significantly in this type. The marked morphologic abnormal changes in ultrastructures of T lymphocyte were found in 6 patients with Qixu-BSS group. These results showed that the Qixu type of Blood Stasis Syndrome patients were in the immuno-suppressive status.

Abdomen↗

[Investigation of interleukin 2 receptor and T cell subsets in the patients with tuberculous meningitis].

Interleukin 2 receptor (IL-2R) on lymphocyte and T cell subsets of peripheral blood(PB), defined by monoclonal antibodies, were studied in 25 patients with tuberculous meningitis. 25 staff members served as PB control. Dynamic changes of IL-2R positive cells and T cell subsets were observed in 10 of 25 patients at sixth week after chemotherapy. IL-2R positive cells showed higher percentages in the patients than in healthy controls. Percentages of CD5and CD4cells were lower than those of healthy control. With chemotherapy, the percentages of CD4cells raised. The results indicated that M. tuberculosis might stimulate T cell to express IL-2R. A lower cell mediated immunity function in the patients with tuberculous meningitis was characterized by CD4 lymphopenia.

Adult↗

[Treatment of infantile hepatitis syndrome with injection of yin zhi huang].

The infantile hepatitis syndrome is defined as a liver disease which occurs during the infantile period with the clinical manifestation of jaundice, hepatomegaly and hepatic dysfunction. The cause of disease is complex and the treatment is difficult. From March 1987 to June 1988, 55 patients (treatment group) were treated with injection of yin zhi huang, and 15 cases (control group) with injection of Inosine, vitamin C and glucose. The course of treatment lasted 15 days. At the beginning and the end of the treatment, serum bilirubin level, sALT level, duodenal juice bilirubin level, liver size and T cell subsets in peripheral blood had been detected separately. The results showed that among the treatment group, serum bilirubin level was significantly lower at the end of the treatment than that of the control group. The sALT, and hepatomegaly were also reduced or lessened, while the duodenal juice bilirubin level was increased. But there was no difference in T cell subsets between the two groups.

CD4-CD8 Ratio↗

[Experimental studies on the antitumor activity of glioma-infiltrating lymphocytes against autologous glioma].

In the present study, antitumor activity of glioma-infiltrating lymphocytes (GILs) was compared to that of lymphokine-activated killer (LAK) cells. Results suggested that killing activity of GILs against autologous glioma cells was significantly higher than that of LAK cells (P less than 0.05), but their activity against allogeneic glioma cells was not different from that of LAK cells (P greater than 0.05). Analysis of cell surface phenotypes showed that CD4+ cells were a main portion of LAK cells, and CD8+ were predominant in the GILs. In the beginning, growth of GILs was slower than that of LAK cells. As time went on, generation of GILs was faster than that of LAK cells. The results suggested that GILs were superior to LAK cells for adoptive immunotherapy in patients with brain glioma.

Brain Neoplasms↗