Calcium homeostasis change in CD4+ T lymphocytes from human peripheral blood during differentiation in vivo

Trends and Adaptive Optimal Set Points of CD4+ Count Clinical Covariates at Each Phase of the HIV Disease Progression

In response to invasion by the human immunodeficiency virus (HIV), the self-regulatory immune system attempts to restore the CD4+ count fluctuations. Consequently, many clinical covariates are bound to adapt too, but little is known about their corresponding new optimal set points. It has been reported that there exist few strongest clinical covariates of the CD4+ count. The objective of this study is to harness them for a streamlined application of multidimensional viewing lens (statistical models) to zoom into the behavioural patterns of the adaptive optimal set points. We further postulated that the optimal set points of some of the strongest covariates are possibly controlled by dietary conditions or otherwise to enhance the CD4+ count. This study investigated post-HIV infection (acute to therapy phases) records of 237 patients involving repeated measurements of 17 CD4+ count clinical covariates that were found to be the strongest. The overall trends showed either downwards, upwards, or irregular behaviour. Phase-specific trends were mostly different and unimaginable, with LDH and red blood cells producing the most complex CD4+ count behaviour. The approximate optimal set points for dietary-related covariates were total protein 60-100 g/L (acute phase), <85 g/L (early phase), <75 g/L (established phase), and >85 g/L (ART phase), whilst albumin approx. 30-50 g/L (acute), >45 g/L (early and established), and <37 g/L (ART). Sodium was desirable at approx. <45 mEq/L (acute and early), <132 mEq/L (established), and >134 mEq/L (ART). Overall, desirable approximates were albumin >42 g/L, total protein <75 g/L, and sodium <137 mEq/L. We conclude that the optimal set points of the strongest CD4+ count clinical covariates tended to drift and adapt to either new ranges or overlapped with the known reference ranges to positively influence the CD4+ cell counts. Recommendation for phase-specific CD4+ cell count influence in adaptation to HIV invasion includes monitoring of the strongest covariates related to dietary conditions (sodium, albumin, and total protein), tissue oxygenation (red blood cells and its haematocrit), and hormonal control (LDH and ALP).

An Evaluation to Determine the Strongest CD4 Count Covariates during HIV Disease Progression in Women in South Africa

INTRODUCTION

Past endeavours to deal with the obstacle of expensive Cluster of Difference 4 (CD4+) count diagnostics in resource-limited settings have left a long trail of suggested continuous CD4+ count clinical covariates that turned out to be a potentially important integral part of the human immunodeficiency virus (HIV) treatment process during disease progression. However, an evaluation to determine the strongest candidates among these CD4+ count covariates has not been well documented.

METHODS

The Centre for the AIDS Programme of Research in South Africa (CAPRISA) initially enrolled HIV-negative (phase 1) patients into different study cohorts. The patients who seroconverted (237) during follow-up care were enrolled again into a post-HIV infection cohort where they were further followed up with weekly to fortnightly visits up to 3 months (phase 2: acute infection), monthly visits from 3-12 months (phase 3: early infection) and quarterly visits thereafter (phase 4: established infection) until antiretroviral therapy (ART) initiation (phase 5). The CD4+ count and 46 covariates were repeatedly measured at each phase of the HIV disease progression. A multilevel partial least squares approach was applied as a variable reduction technique to determine the strongest CD4+ count covariates.

RESULTS

Only 18 of the 46 investigated clinical attributes were the strongest CD4+ count covariates and the top 8 were positively and independently associated with the CD4+ count. Besides the confirmatory lymphocytes, these were basophils, albumin, haematocrit, alkaline phosphatase (ALP), mean corpuscular volume (MCV), platelets, potassium and monocytes. Overall, electrolytes, proteins and red blood cells were the dominant categories for the strongest covariates.

CONCLUSION

Only a few of the many previously suggested continuous CD4+ count clinical covariates showed the potential to become an important integral part of the treatment process. Prolonging the pre-treatment period of the HIV disease progression by effectively incorporating and managing the covariates for long-term influence on the CD4+ cell response has the potential to delay challenges associated with ART side effects.

Covariate random effects on the CD4 count variation during HIV disease progression in women

Purpose: To investigate the variation in CD4 count between HIV positive patients due to clinical covariates at each phase of the HIV disease progression. Patients and methods: The Centre for the AIDS Programme of Research in South Africa (CAPRISA) conducted different studies in which female patients were initially enrolled in HIV negative cohorts (phase 1). Seroconverts were further followed-up weekly to fortnightly visits up to 3 months (phase 2: acute infection), monthly visits from 3 to 12 months (phase 3: early infection), quarterly visits thereafter (phase 4: established infection) until antiretroviral therapy (ART) initiation (phase 5). Results: Eighteen out of the 46 CD4 count covariates investigated were significant. Low average CD4 counts at acute and early phase entry improved at a faster rate than entries at higher average CD4 count. During therapy, all the 18 covariates induced significantly different patients' average CD4 counts. The rate of change of CD4 count greatly varied in response to lactate dehydrogenase during the acute phase. Red blood cells increase resulted in the patients' CD4 counts approaching a common higher level during the early phase. During therapy, the already high CD4 counts improved faster than lower ones in response to the red blood cells increase. As the monocytes increased, patients with lower average CD4 counts became worse than those with higher average CD4 counts. Conclusion: Changes in the covariates measurements either induced no variation effects in certain phases or improved the CD4 count at a faster rate for those patients whose average CD4 was already high or worsen the CD4 level which was already low or caused the patients' CD4 counts to approach the same level - higher or lower than the general cohort. The studied covariates induced wide variations in the CD4 count between HIV positive patients during the ART phase.

Environment and T regulatory cells in allergy

The central role of T regulatory cells in the responses against harmless environmental antigens has been confirmed by many studies. Impaired T regulatory cell function is implicated in many pathological conditions, particularly allergic diseases. The "hygiene hypothesis" suggests that infections and infestations may play a protective role for allergy, whereas environmental pollutants favor the development of allergic diseases. Developing countries suffer from a variety of infections and are also facing an increasing diffusion of environmental pollutants. In these countries allergies increase in relation to the spreading use of xenobiotics (pesticides, herbicides, pollution, etc.) with a rate similar to those of developed countries, overcoming the protective effects of infections. We review here the main mechanisms of non-self tolerance, with particular regard to relations between T regulatory cell activity, infections and infestations such as helminthiasis, and exposure to environmental xenobiotics with relevant diffusion in developing countries.

Role of extracellular calcium ions at early stages of human T-lymphocyte polyclonal activation in vitro

In this work we comparatively analyzed interleukin-2 (IL-2) and interferon gamma production (IFN-gamma) and also CD69 and CD25 expression by activated T-cells depending on extracellular calcium concentration ([Ca2+]e), which was varied with EGTA. The expression of CD69 molecules on the surface of T-cells depended only on the presence of phorbol myristate acetate, occurred at [Ca2+]e higher than 0.2 mM, and did not require the presence of ionomycin. The increase in [Ca2+]e by itself cannot induce expression of CD25 and CD69 molecules by activated cells. The values of [Ca2+]e, at which maximal fractions of CD3+CD69+(IL-2)+, CD3+CD69+(IFN-gamma)+, and CD3+CD25+ activated T-cells were reached, never coincided with mean values of [Ca2+]e for healthy donors and were different from each other. So, there is different [Ca2+]e dependence for initial stages of activated T-cells differentiation. The relation between T-cells activation parameters and their differentiation is discussed.

The lupus-related Lmb3 locus contains a disease-suppressing Coronin-1A gene mutation

Here, we show that a lupus-suppressing locus is caused by a nonsense mutation of the filamentous actin-inhibiting Coronin-1A gene. This mutation was associated with developmental and functional alterations in T cells including reduced migration, survival, activation, and Ca2+ flux. T-dependent humoral responses were impaired, but no intrinsic B cell defects were detected. By transfer of T cells, it was shown that suppression of autoimmunity could be accounted for by the presence of the Coro1a(Lmb3) mutation in T cells. Our results demonstrate that Coronin-1A is required for the development of systemic lupus and identify actin-cytoskeleton regulatory proteins as potential targets for modulating autoimmune diseases.