Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
IMMUNOPATHOGENESIS, IMMUNE RESPONSE, AND IMMUNOLOGIC RECONSTITUTION IN AIDS AND HIV INFECTION
Vaccines 87. Modern Approaches to New Vaccines: Prevention of AIDS and Other Viral, Bacterial, and Parasitic Diseases. Chanock RM et al, eds. New York, Cold Spring Harbor Laboratory, p. 164-7, 1987.. Unique Identifier : AIDSLINE ICDB/88647972 Fauci AS; Lane HC; Lab. of Immunoregulation, NIAID, NIH, Bethesda, MD 20892
Abstract:
It is now widely recognized that the underlying immunopathogenic event in acquired immune deficiency syndrome (AIDS) is a defect in cell-mediated immunity due to infection of the helper/inducer (T4) subset of T lymphocytes with the etiologic retrovirus, the human immunodeficiency virus (HIV). Only recently has the host's immune response to the virus begun to be delineated. The various aspects of the immunopathogenesis of AIDS are discussed, and the authors' recent data are described relating to the immune response to HIV infection. In addition, the ongoing approaches to reconstitution of the immune response in AIDS patients (pts) are outlined. Given the paucity of cells that have been clearly demonstrated to be infected with the AIDS virus at any given time, a number of alternative suggestions concerning the mechanisms of T4-cell depletion have been raised in addition to a direct cytopathic effect of the virus on each and every depleted T4 cell: (1) direct cytopathic effect of HIV on T4 lymphocytes; (2) selective depletion of a subset of T4 lymphocytes or a T4+ nonlymphoid cell critical to the propagation of the entire T-cell pool, resulting indirectly in attrition of the pool; (3) induction by HIV of soluble substances with toxic effects on T4 lymphocytes; (4) autoimmune phenomena; and (5) high level of HIV env gene expression in infected T4 cells with induction of syncytia formation and cell death in other neighboring T4 cells not directly infected with the virus. It has been demonstrated that sera of infected individuals contain antibodies that can effectively mediate antibody-dependent cellular cytotoxicity against virus-infected targets. HLA-restricted T-cell-mediated cytotoxicity against HIV-infected targets can be demonstrated under certain circumstances. Immunologic reconstitution has been achieved in an AIDS pt by combining the antiretrovirus agent suramin and bone marrow transplantation with syngeneic lymphocyte transfusions from the pt's healthy seronegative twin brother. The pt remained immunologically reconstituted 12 mo after the procedure. (4 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*IMMUNOLOGY Antibodies, Viral/*ANALYSIS Antibody Specificity *Cytopathogenic Effect, Viral Human HIV/*IMMUNOLOGY Macrophages/IMMUNOLOGY Monocytes/IMMUNOLOGY Neutralization Tests T-Lymphocytes, Helper-Inducer/IMMUNOLOGY MEETING PAPER
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Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
