Peripheral CD4+/CD8+ T-lymphocyte counts estimated by an immunocapture method in the normal healthy south Indian adults and HIV seropositive individuals

Effects of intracavitary administration of elemene combined with nedaplatin on malignant pleural effusion

AIM

To investigate the therapeutic effect of Elemene combined with Nedaplatin (ECN) on malignant pleural effusion (MPE) and its adverse reactions.

METHOD

A retrospective study was conducted, three hundred and fifty-two patients with MPE were divided into two groups according to different treatment methods. One hundred and eighty-nine patients were given intrathoracic injection of ECN and classified in ECN group; one hundred and sixty-three cases in the Nedaplatin group were given intrathoracic injection of nedaplatin. Routine treatments were used to prevent adverse reactions.

RESULT

The effective rate of the ECN group was 57.05%, and that of the Nedaplatin group was 23.08%. The comparison results of adverse reactions between the two groups showed that there was no significant difference in leukopenia, thrombopenia, anemia, vomitting and diarrhea, fever, hepatic damage and renal damage. The level of thoracalgia in the ECN group was higher than that in the Nedaplatin group. There was no significant change in the number of CD8+ T cells between the two groups after treatment. The number of CD4+T cells in the ECN group increased after treatment was higher than the Nedaplatin group after treatment.

CONCLUSION

ECN treatment can improve clinical control of MPE with no serious adverse reaction, can effectively reduce the immunosuppressive effect of nedaplatin and enhance the immune function of MPE patients which is worthy of clinical application.

Establishment of reference range of CD4 T-lymphocyte in healthy Nepalese adults

Objective

CD4 T lymphocytes are the most widely used cellular markers to assess the course of HIV infection, clinical staging and, monitoring the effect of antiretroviral therapy. The regional reference range for Eastern, Central and Western development region of Nepal had already been established whereas the same was still lacking in Mid-western and Far-western development region. The objective of this study was to establish reference range of CD4 T lymphocyte in the remaining two development regions and finally the national reference range using data from previous study.

Results

The average values (mean ± SD) of CD4 and CD3 T cell in present study was (819 ± 294) cells/μl and (1546 ± 532) cells/μl, respectively. The absolute CD4 T cell (914 ± 303) and CD3 T cell (1671 ± 560) count in female were significantly higher than those from male, CD4 (757 ± 270) and CD3 (1465 ± 499) (p value-0.000). National reference value of CD4 was determined to be (798 ± 335) cells/μl for healthy Nepalese adults.

Dynamic study of oral Candida infection and immune status in HIV infected patients during HAART

OBJECTIVE

To dynamically monitor oral Candida infection, CD4⁺ T lymphocyte counts, CD8⁺ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients during their first year of HAART and to preliminarily explore the relationships between them.

DESIGN

Forty-six patients with HIV/AIDS receiving HAART at the Infection Department of Chongqing Red Cross Hospital were followed for one year. At baseline and 3, 6, and 12 months after HAART initiation, oral rinses were collected and cultured to identify Candida species. Further, blood samples were collected to detect CD4⁺ T lymphocyte counts, CD8⁺ T lymphocyte counts and CD4/CD8 ratios.

RESULTS

The prevalence of OC decreased after HAART initiation (P ＜ 0.05), and Candida albicans was the dominant species isolated from the oral cavity (66/93). At 3, 6 and 12 months after HAART initiation, CD4⁺ T lymphocyte counts were 327.91 ± 138.82, 329.65 ± 142.66 and 319.98 ± 97.90 cells/mm³, respectively, which were significantly higher than the level at baseline (263.39 ± 126.01 cells/mm³) (P = 0.016, P = 0.014, and P = 0.035, respectively). During the first year of HAART, CD4/CD8 ratios increased gradually, and CD8⁺ T lymphocyte counts decreased continually. OC was associated with low CD4⁺ T lymphocyte counts and a low CD4/CD8 ratio. CD4⁺ T lymphocyte counts <200 cells/mm³ and Candida load ≥300 CFU/mL were risk factors for OC (P ＜ 0.05), and oral Candida load was negatively correlated with CD4⁺ T lymphocyte counts and the CD4/CD8 ratio.

CONCLUSION

OC might be a useful marker for the evaluation of immune status in patients with HIV/AIDS.

Toxicological effects of nickel chloride on the cytokine mRNA expression and protein levels in intestinal mucosal immunity of broilers

The purpose of this study was to examine the toxicological effects of nickel chloride (NiCl2 ; 300, 600, and 900 mg kg(-1) diet) on the cytokine mRNA expression and protein levels in the intestinal mucosa and cecal tonsil, and on the ileac and cecal tonsil T cells in broilers by the methods of qRT-PCR, flow cytometry and ELISA for 42 days. Results showed that the IL-2, IL-6, IL-10, IL-17, IFN-γ, and TNF-α (LITAF) cytokine mRNA expression and protein levels were lower (P < 0.05 or P < 0.01) and the percentages of T-cell subsets were also lower in the 300, 600, and 900 mg kg(-1) groups than in the control group. It was concluded that dietary NiCl2 in excess of 300 mg kg(-1) could reduce cytokine mRNA expression and protein levels in the intestinal mucosa and cecal tonsil, and the percentages of ileac and cecal tonsil T-cell subsets. Decreasing in cytokine mRNA expression and protein levels of intestinal mucosa and cecal tonsil induced by NiCl2 was closely related to the reduction of T-cell population. Thus, the abnormal expression of these cytokines impacts the intestinal mucosal immune function by the pathways of reducing of lymphocyte population and activation. Also, this study first proved that NiCl2 at higher levels has the toxicological effects on intestinal mucosal immunity.

CD4+, CD8+, CD3+ cell counts and CD4+/CD8+ ratio among patients with mycobacterial diseases (leprosy, tuberculosis), HIV infections, and normal healthy adults: a comparative analysis of studies in different regions of India

In this study, we estimated the CD4+, CD8+, CD3+ cell counts and the CD4/CD8 ratio among normal healthy controls (adults and children), leprosy patients (without any complications and during reactional states), TB patients (with and without HIV), and HIV-positive patients (early infection and full-blown AIDS) and correlated the changes with disease progression. In our study, it was observed that among adults, CD4+ cell counts ranged from 518-1098, CD8+ from 312-952, whereas CD4/CD8 ratio from 0.75-2.30. Among children, both CD4+ and CD8+ cells were more and the CD4/CD8 ratio varied from 0.91-3.17. With regard to leprosy patients, we observed that CD4+ and CD8+ cell counts were lower among PB (pauci-bacillary) and MB (multi-bacillary) patients. CD4/CD8 ratio was 0.99 ± 0.28 among PB patients while the ratio was lower, 0.78 ± 0.20, among MB patients. CD4+ cell counts were raised during RR (reversal reactions) and ENL (erythema nodosum leprosum) among the PB and MB patients whereas the CD8+ cell counts were lower among PB and MB patients. CD4/CD8 ratio doubled during reactional episodes of RR and ENL. Among the HIV-negative tuberculosis (TB) patients, both the CD4+ and CD8+ cell counts were found to be less and the CD4/CD8 ratio varied between 0.53-1.75. Among the HIV-positive TB patients and HIV-positive patients, both the CD4+ and CD8+ cells were very less and ratio drops significantly. In the initial stages of infection, as CD4+ counts drop, an increase in the CD8+ cell counts was observed and the ratio declines. In full-blown cases, CD4+ cell counts were very low, 3-4 to 54 cells, CD8+ cells from 12-211 and the ratio drops too low. This study is the first of its kind in this region of the country and assumes importance since no other study has reported the values of CD4+ and CD8+ T-lymphocyte counts among patients with mycobacterial diseases (leprosy and TB), HIV infections along with normal healthy individuals of the region, and correlation with clinical presentations of patients.

Inhibitive effects of nickel chloride (NiCl₂) on thymocytes

The purpose of this study was to define the inhibitive effects of dietary nickel chloride (NiCl2) on thymocytes in broilers fed on diets supplemented with 0, 300, 600, and 900 mg/kg of NiCl2 for 42 days. We examined the changes of cell cycle phase, percentages of apoptotic cells, T cell subsets, cytokines, and mRNA expression of apoptotic proteins (bcl-2, bax, and caspase-3) in thymocytes by flow cytometry and quantitative real-time polymerase chain reaction (qRT-PCR). In the NiCl2-treated broilers, the percentages of thymocytes in G0/G1 phase were increased, whereas thymocytes in the S phase and the proliferation index were decreased. The percentages of apoptotic thymocytes were increased. Also, the mRNA expression levels of bax and caspase-3 were increased, and mRNA expression levels of bcl-2 were decreased. The percentages of CD3(+), CD3(+)CD4(+), and CD3(+)CD8(+) T lymphocytes in the thymus and peripheral blood were diminished. Concurrently, thymic cytokine (interleukin-1 beta (IL-1β), interleukin-2 (IL-2), interleukin-10 (IL-10), interleukin-12 p35 subunit (IL-12p35), interleukin-12 p40 subunit (IL-12p40), interleukin-21 (IL-21), interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), thymosin β4, thymosin β10, and thymosin β15) mRNA expression levels were decreased. The abovementioned results showed that dietary NiCl2 in excess of 300 mg/kg inhibited thymocyte growth by arresting cell cycle, increasing apoptosis percentage, altering apoptotic protein mRNA expression levels, and downregulating cytokine expression levels.

Effect of dietary nickel chloride on splenic immune function in broilers

This study was designed to evaluate the effects of dietary nickel chloride (NiCl2) on the splenic immunity in broilers by observing changes of cytokine mRNA expression and protein levels, immunoglobulin (IgA, IgG, and IgM) contents, and IgA+ B cell and T-cell numbers using the methods of qRT-PCR, flow cytometry (FCM), and ELISA. A total of 240 1-day-old avian broilers were equally allocated into four groups and fed on a corn-soybean basal diet as the control diet or the same diet supplemented with 300, 600, and 900 mg/kg NiCl2 for 42 days. The mRNA expression and protein levels of IL-2, IL-6, IL-10, IL-12, TNF-α/LITAF, IFN-γ, and IgA, IgG, and IgM contents were significantly decreased (p<0.05 or p<0.01) in the 300-, 600-, and 900-mg/kg NiCl2 groups when compared with those of the control group, which was consistent with the reduction of T-cell subset percentages and IgA+ B cell numbers in the 300-, 600-, and 900-mg/kg NiCl2 groups. The abovementioned results showed that dietary NiCl2 in excess of 300 mg/kg caused damage on splenocytes and splenic immune function. The results of the present study provided new experimental evidences for further study on the effect mechanism of NiCl2 on splenic immunity.

Effects of sodium selenite on aflatoxin B1-induced decrease of ileac T cell and the mRNA contents of IL-2, IL-6, and TNF-α in broilers

The aim of this work was to assess the protective effect of sodium selenite on the ileum mucosal immunologic toxicity induced by aflatoxin B1 (AFB1). One hundred and eighty one-day-old healthy male avian broilers were divided into four groups of three replicates and 15 birds per replicate and fed with basal diet (control group), 0.3 mg/kg AFB1 (AFB1 group), 0.4 mg/kg Se (+Se group), and 0.3 mg/kg AFB1+0.4 mg/kg Se (AFB1+Se group), respectively. The ileac T-cell subsets were determined by the methods of flow cytometry (FCM), and the mRNA contents of interleukin-2 (IL-2), interleukin-6(IL-6), and tumor necrosis factor-alpha (TNF-α) by quantitative real-time PCR. Compared with those in control group, the percentages of CD3+, CD3+CD4+, CD3+CD8+ intraepithelial lymphocytes (IELs) and LPLs, the CD4+/CD8+ ratio of IELs, and the mRNA contents of IL-2, IL-6, and TNF-α were decreased in AFB1 group. However, compared with those in AFB1 group, these parameters of AFB1+Se group were increased to be close to those in control group. It was concluded that 0.3 mg/kg AFB1 could reduce the cellular immune function of the ileum mucosa, but 0.4 mg/kg supplemented dietary selenium showed protective effects on AFB1-induced immunologic injury.

CD4 counts in laboratory monitoring of HIV disease--experience from western India

BACKGROUND

CD4 counts vary in different populations. The present study was conducted to determine CD4 counts in different World Health Organization (WHO) clinical stages in antiretroviral therapy naive individuals and to find out optimum CD4 cutoffs.

METHOD

Data of adult HIV seropositive patients who underwent CD4 count and total lymphocyte count (TLC) testing were included for analysis. The severity of immunosuppression was graded based on WHO criteria. To establish optimum CD4 cutoff values, receiver-operator characteristics (ROC) curves were generated.

RESULTS

Of 754 patients, 52.2% had CD4 counts <200 cells/mm3, but only 2.3% belonged to WHO stage IV. Newer CD4 cutoffs generated were 280, 120-280, <120 cells/mm3. Spearman rank correlation between CD4 counts and TLC was found to be weak (r = .32).

CONCLUSION

The cutoff values of CD4 counts for HIV disease may need to be revised for India. Regular CD4 count estimation is a must for monitoring disease progression in people living with HIV/AIDS.

Effect of dietary vanadium on the ileac T cells and contents of cytokines in broilers

The purpose of this 42-day study was to examine the effect of dietary vanadium on the ileac T cells and contents of cytokines including interleukin-2 (IL-2), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) in broilers by flow cytometry and enzyme-linked immunosorbent assay. A total of 420 one-day-old avian broilers were divided into six groups (seven replicates in each group and ten broilers in each replicate) and fed on control diet or the same diet supplemented with 5, 15, 30, 45, and 60 mg/kg vanadium in the form of ammonium metavanadate. The results showed that the percentages of CD3(+), CD3(+)CD4(+), and CD3(+)CD8(+) T cells in both ileac lamina propria lymphocytes (LPLs) and intraepithelial lymphocytes (IELs) were significantly lower (P < 0.05 or P < 0.01) in the 45- and 60-mg/kg groups than in the control group from 14 to 42 days of age. The CD4(+)/CD8(+) ratio was increased in ileac LPLs in the 60-mg/kg group at 28 days of age, and in ileac IELs in the 60-mg/kg group at 28 days of age and in the 45-mg/kg group at 42 days of age. Meanwhile, the ileac IL-2, IL-6 contents were decreased (P < 0.05 or P < 0.01) in the 60-mg/kg group from 14 to 42 days of age and in the 45-mg/kg group from 28 to 42 days of age in comparison with those of the control group. It was concluded that dietary vanadium in excess of 30 mg/kg reduced the ileac T cell population and percentages of T cell subsets, and IL-2, IL-6, and IFN-γ contents, implying that the immune function of local intestinal mucosa in broilers could be affected by the dietary vanadium.

Efficacy of a fish protein hydrolysate in malnourished children

Protein hydrolysates are good nutritional supplements as their bioactive ingredients can be easily absorbed and utilized for various metabolic activities. A fish protein hydrolysate (Amizate), prepared by a unique process of hydrolysis has the advantage of high di/tri peptide content (<10 kDa) along with essential and non essential amino acids, micronutrients and vitamins. The effect of Amizate on malnourished children (6-8 years, a total of 438) of Grade I and II (Gomez's classification) with respect to immunoglobulins, CD4/CD8 ratios and hemoglobin was examined. Measurement of these parameters during the user trial study (at the beginning and the end after 4 months) indicated that the levels of the immunological parameters were not significantly altered by the Amizate treatment. The values of immunoglobulins and CD4/CD8 ratios of malnourished children (India) are in the normal range and are in accordance with the reported values of various ethnic groups.

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (doi:10.1007/s12291-011-0145-z) contains supplementary material, which is available to authorized users.

A microchip CD4 counting method for HIV monitoring in resource-poor settings

BACKGROUND

More than 35 million people in developing countries are living with HIV infection. An enormous global effort is now underway to bring antiretroviral treatment to at least 3 million of those infected. While drug prices have dropped considerably, the cost and technical complexity of laboratory tests essential for the management of HIV disease, such as CD4 cell counts, remain prohibitive. New, simple, and affordable methods for measuring CD4 cells that can be implemented in resource-scarce settings are urgently needed.

METHODS AND FINDINGS

Here we describe the development of a prototype for a simple, rapid, and affordable method for counting CD4 lymphocytes. Microliter volumes of blood without further sample preparation are stained with fluorescent antibodies, captured on a membrane within a miniaturized flow cell and imaged through microscope optics with the type of charge-coupled device developed for digital camera technology. An associated computer algorithm converts the raw digital image into absolute CD4 counts and CD4 percentages in real time. The accuracy of this prototype system was validated through testing in the United States and Botswana, and showed close agreement with standard flow cytometry (r = 0.95) over a range of absolute CD4 counts, and the ability to discriminate clinically relevant CD4 count thresholds with high sensitivity and specificity.

CONCLUSION

Advances in the adaptation of new technologies to biomedical detection systems, such as the one described here, promise to make complex diagnostics for HIV and other infectious diseases a practical global reality.

Normal values of CD4 and CD8 lymphocyte subsets in healthy indian adults and the effects of sex, age, ethnicity, and smoking

BACKGROUND

Information on lymphocyte populations (T, B, and natural killer cells) and subpopulations (CD4 and CD8) in India is generally lacking. Measurement of T-cell subsets is important in India for evaluating disease stage and progression in individuals with the human immunodeficiency virus (HIV). Hence, this study was conducted to provide normal ranges of absolute and percentage values of CD4 and CD8 T-lymphocyte subsets and the ratio of CD4 to CD8 in normal Indian adults.

METHODS

Flow cytometric analysis (EPICS-XL) was used to determine the range of T-lymphocyte subpopulations in normal Indian blood donors at Command Hospital and the Armed Forces Medical College, Pune, India. The reference population consisted of 94 healthy HIV-seronegative blood donors. T-lymphocyte subsets were analyzed with two-color immunophenotyping of peripheral blood lymphocytes with the use of a lysed whole-blood technique and enumerated.

RESULTS

For normal values of various blood components, we found mean values of 2114 cells/microl for total lymphocytes, 865 cells/microl (40.2%) for CD4(+) lymphocytes, 552 cells/microl (31.3%) for CD8(+) lymphocytes, and 1.7 for the CD4:CD8 ratio. The 95% confidence intervals for the same parameters were 1115-4009 cells/microl, 430-1740 cells/microl (30.75-49.60%), 218-1396 cells/microl (20.06-42.52%), and 0.39-3.02 respectively. Females had significantly higher CD4 counts (P < 0.05), percentage of CD4 lymphocytes (P < 0.01), and CD4:CD8 ratio (P < 0.01). Males had a significantly higher percentage of CD8 lymphocytes (P < 0.01). They also had higher CD8 counts that did not reach significance. Age, ethnicity (Dravidian versus Aryan), smoking, alcohol consumption, and the interval between drawing the blood sample and its analysis were factors that did not produce statistically significant differences in the T-cell subsets studied.

CONCLUSIONS

When compared with other published series, the CD4 and CD8 values in healthy Indians were no different from those reported in the West. These observations have important clinical implications for the use of T-lymphocyte subset measurements in India, especially in the management of HIV infection. The normal ranges established by this study can be used as a reference for decisions made in clinical practice.

Correlation of CD4(+) T-Cell counts estimated by an immunocapture technique (Capcellia) with viral loads in human immunodeficiency virus-seropositive individuals

As antiretroviral therapy becomes more affordable, valid, reliable, and inexpensive laboratory tests are also needed to monitor the progression of disease in people with human immunodeficiency virus (HIV) infection. The CD4(+) T-cell counts estimated by Capcellia, an immunocapture method, and flow cytometry were compared and were correlated with HIV type 1 (HIV-1) load. There was a significant negative correlation between the HIV-1 load and CD4(+) T-cell counts estimated by flow cytometry (r = -0.63, P = <0.001) as well as between the HIV-1 load and CD4(+) T-cell counts estimated by Capcellia (r = -0.61, P = <0.001). Capcellia is a cost-effective, user-friendly assay that correlated well with HIV-1 load determinations for individuals both with and without treatment.

Molecular confirmation of human immunodeficiency virus (HIV) type 2 in HIV-seropositive subjects in south India

Nested PCRs for human immunodeficiency virus type 1 (HIV-1) and HIV-2 were compared with immunoblot test results. Twelve of 13 immunoblot-positive HIV-2 samples were positive by PCR. There were five INNO-LIA (Innogenetics, Zwijnaarde, Belgium) and/or HIVBLOT 2.2 (Genelabs, Singapore) samples that tested positive for dual infection. HIV-1 PCR was positive in all samples, while HIV-2 PCR was positive in two and RIBA (Chiron Corporation, San Diego, Calif.) was positive for HIV-2 in three samples. Thus the prevalence of HIV-2 is accurately estimated by the use of immunoblotting, but that of HIV-1 and -2 dual infection may be overestimated.