Phenotypic analysis of lymphocyte subsets in a diffuse infiltrative lymphocytosis syndrome (DILS) associated with HIV infection.

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

Phenotypic analysis of lymphocyte subsets in a diffuse infiltrative lymphocytosis syndrome (DILS) associated with HIV infection.

Int Conf AIDS. 1989 Jun 4-9;5:435 (abstract no. Th.B.P.116). Unique Identifier : AIDSLINE ICA5/00222489
Itescu S; Brancato J; Dalton J; Perdue R; Winchester R; Hospital for Joint Diseases, NYU Medical Center, New York, NY,; USA

Abstract: OBJECTIVE: To characterize a Sjogren's syndrome-like disorder in HIV-infected individuals with circulating and diffuse infiltrative CD8 lymphocytosis associated with HLA-DR5 (DILS) and to determine whether particular lymphocyte subsets are selectively expanded. METHODS: Patients were ascertained by referral for clinical evaluation to the Rheumatology Service at New York University. Analysis of peripheral blood lymphocyte populations was performed in patients with DILS, HIV-positive controls, and normal controls. Cells were stained with anti-CD4 and anti-CD8 antibodies, as well as directly conjugated anti-CDw29 and anti-CD45R antibodies. RESULTS: DILS is manifested clinically by generalized adenopathy, sicca symptoms, lymphocytic interstitial pneumonitis, and, less frequently, lymphocytic hepatitis and neurologic complications. Among 12 patients studied, only one instance of opportunistic infection has been found in up to 5 years of follow-up. Patients with DILS had significantly higher number of CD4+ cells than HIV-positive controls, mean 368 vs. 142/mm3 (p less than 0.05), a relative preservation of the CD4+CDw29+ subset when compared to normals, and a marked increase in the ratio of CD4+CDw29+to CD4+CD45R+ cells. Paralleling the massive increase in CD8+ cells, patients with DILS had significantly higher numbers of CD4-CDw29+ cells, 1089/mm3 vs. 323 for HIV controls and 371 for healthy controls (p less than 0.01). The degree of glandular and pulmonary lymphocytic infiltration correlated with the absolute numbers of both the circulating CD8+ and CD4-CDw29+ populations. CONCLUSION: Taken together with the HLA-DR5 association in DILS, these data would suggest that MHC-restricted antigen presentation activates the CD4+CDw29+helper-inducer lymphocyte subset leading to an expanded population of CD4-Cdw29+ cells. As CD4+CDW29+ cells are required for the differentiation of cytotoxic CD8 cells, the CD4-CDw29+ subset, which presumably defines the circulating CD8 population in DILS, is currently the subject of detailed characterization.

Keywords: Antigens, Differentiation/ANALYSIS CD4-Positive T-Lymphocytes Human HIV Infections/COMPLICATIONS/*IMMUNOLOGY Leukocyte Count Lung Diseases/COMPLICATIONS/IMMUNOLOGY Lymphocytosis/ETIOLOGY/*IMMUNOLOGY Phenotype Syndrome *T-Lymphocytes ABSTRACT
900930
M9094000

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