Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
Angiocentric CD3(+) T-cell infiltrates in human immunodeficiency virus type 1-associated central nervous system disease in children.
Clin Diagn Lab Immunol. 1999 Jan;6(1):105-14. Unique Identifier : AIDSLINE MED/99091889 Katsetos CD; Fincke JE; Legido A; Lischner HW; de Chadarevian JP; Kaye EM; Platsoucas CD; Oleszak EL; Department of Microbiology and Immunology, St. Christopher's; Hospital for Children and Allegheny University of the Health; Sciences, Philadelphia, Pennsylvania, USA.
Abstract:
A significant proportion of brain tissue specimens from children with AIDS show evidence of vascular inflammation in the form of transmural and/or perivascular mononuclear-cell infiltrates at autopsy. Previous studies have shown that in contrast to inflammatory lesions observed in human immunodeficiency virus type 1 (HIV-1) encephalitis, in which monocytes/macrophages are the prevailing mononuclear cells, these infiltrates consist mostly of lymphocytes. Perivascular mononuclear-cell infiltrates were found in brain tissue specimens collected at autopsy from five of six children with AIDS and consisted of CD3(+) T cells and equal or greater proportions of CD68(+) monocytes/macrophages. Transmural (including endothelial) mononuclear-cell infiltrates were evident in one patient and comprised predominantly CD3(+) T cells and small or, in certain vessels, approximately equal proportions of CD68(+) monocytes/macrophages. There was a clear preponderance of CD3(+) CD8(+) T cells on the endothelial side of transmural infiltrates. In active lesions of transmural vasculitis, CD3(+) T-cell infiltrates exhibited a distinctive zonal distribution. The majority of CD3(+) cells were also CD8(+) and CD45RO+. Scattered perivascular monocytes/macrophages in foci of florid vasculitis were immunoreactive for the p24 core protein. In contrast to the perivascular space, the intervening brain neuropil was dominated by monocytes/macrophages, microglia, and reactive astrocytes, containing only scant CD3(+) CD8(+) cells. Five of six patients showed evidence of calcific vasculopathy, but only two exhibited HIV-1 encephalitis. One patient had multiple subacute cerebral and brainstem infarcts associated with a widespread, fulminant mononuclear-cell vasculitis. A second patient had an old brain infarct associated with fibrointimal thickening of large leptomeningeal vessels. These infiltrating CD3(+) T cells may be responsible for HIV-1-associated CNS vasculitis and vasculopathy and for endothelial-cell injury and the opening of the blood-brain barrier in children with AIDS.
Keywords: JOURNAL ARTICLE Antigens, CD/METABOLISM Antigens, CD3/*METABOLISM Antigens, CD45/METABOLISM Antigens, CD8/METABOLISM Antigens, Differentiation, Myelomonocytic/METABOLISM AIDS Dementia Complex/*IMMUNOLOGY/*PATHOLOGY Blood-Brain Barrier/IMMUNOLOGY Brain/BLOOD SUPPLY/IMMUNOLOGY/PATHOLOGY Child Child, Preschool Human *HIV-1 Infant Male Support, Non-U.S. Gov't T-Lymphocyte Subsets/*IMMUNOLOGY/*PATHOLOGY Vasculitis/IMMUNOLOGY/PATHOLOGY 990530
A9950939
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Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
