Background of study: HIV-infection leads to immunosuppression characterized by low CD4-cell counts and decreased production of cytokines after stimulation with different antigens. A similar situation may be encountered in patients under immunosuppressive therapy after solid organ transplantation.
Objective: Description of functional lymphocyte response to antigens ind HIV-Infection and drug induced immunosuppression.
Design: We compared 38 HIV-infected patients (HIV-pts; 37 ± 8 years) and 18 patients after heart transplantation (HTX-pts: 50 ± 15 years). Lymphocyte cultures were stimulated with pokeweed-mitogen (PWM), cytomegalovirus (CMV), tetanustoxoid (TeT) and tuberculin (TBC) for 72 hours. The concentration of Interleukin-2 (IL-2), Interleukin-10 (IL-10), Interferon-gamma (IFN-γ) and Tumor-Necrosis-Factor-alpha (TNF-α) in the supernatants was measured by ELISA-technique . Statistical significance was assumed with a p<0,05 in Wilcoxon-Mann-Whitney-U-Test.
Results: HIV-pts. had a lower mean CD4-cellcount than HTX-pts ( 394 ± 325 cells/µl vs. 818 ± 348 cells/µl). Mitogenic stimulation with PWM leads to a reduced production of IL-2 and IL-10 in HIV-pts (p<0,01), whereas the production of IFN-γ and TNF-α was not affected. After antigenic stimulation with CMV both patient groups showed similar response for all cytokines, the highest concentrations were achieved for IL-10 (HTX-pts: 312 ± 222 pg/ml, HIV-pts: 259 ± 156 pg/ml). TeT induces cytokine production in 30-50% in both patient-groups. HIV-pts achieved higher TNF-α concentrations after TeT stimulation (HTX-pts: 150 ± 61 pg/ml, HIV-pts: 288 ± 216 pg/ml). TBC leads to a cytokine production in 20-60% of the patients
without statistical significant difference between the groups.
Conclusion: When compared to patients under immunosuppressive therapy a marked reduction of CD4-cells in HIV-pts can be found, but the cytokine response after stimulation with CMV and TBC showed no difference. Only stimulation with TeT discloses a tendency to increased TNF-α levels and only mitogenic stimulation with PWM reveals IL-2 and IL-10 deficiency in HIV-pts.
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