Elevated soluble CD8 levels in sera of human immunodeficiency virus-infected populations

Successive emergence of two CD8 subsets in primary CMV infection of allograft recipients

Allograft recipients with cytomegalovirus (CMV) infection develop increased proportions of circulating CD8+ lymphocytes. A longitudinal study of 11 kidney and 5 liver allograft recipients with primary CMV infection but no other aetiological factor to explain graft dysfunction revealed selective imbalances in peripheral blood CD8+ T cell subsets. Initially, CMV viraemia was associated with elevated CD8+bright T cell numbers and T cell activation. Activation markers fell to normal when viral cultures became negative (before the end of the 1st month). During the 2nd-6th months, most (12/16) patients continued to have high CD8+ T cell counts (1050-2900 CD8+ cells/mm3), comprising an uncommon CD8+ T cell subset, as 45-73% of CD8+bright lymphocytes were CD3+ and TCRalphabeta+ but were not stained by anti-CD28, CD11b, CD16, CD56 and CD57 antibody. Unexpectedly, CD8+ CD57+ T cells, a hallmark of CMV infection, did not appear until the 2nd-6th months of primary CMV infection, and their numbers increased progressively thereafter. They became the predominant CD8+ T cell subset after about 6 months of infection and their persistence for several (up to 4) years was strongly correlated (r = 0.87) with expansion of CD8+ cells. Persistence of CD8 lymphocytosis was, thus, directly related to the rate of expansion of an uncommon CD8+ CD57- subset and its progressive replacement by CD8+ CD57+ T cells that were chronically elicited by CMV.

Pregnancy, HLA allogeneic challenge, and implications for AIDS etiology

Because of the large HLA genetic polymorphism, a human fetus usually has several paternal HLA antigens allogeneic to its mother. The maternal gamma-immunoglobulin (IgG) antibody response to fetal HLA alloantigens is noncytotoxic and associated with local suppression of maternal cell-mediated immunity (CMI) at the maternal-fetal interface. When mother and fetus are syngeneic for most HLA antigens, an increased risk exists for a maternal anti-placental cytotoxic CMI responses, compromising fetal survival. Local suppression of maternal CMI by an anti-HLA IgG response may have evolved to protect the fetoplacental unit from a maternal CMI cytotoxic reaction against expressed developmental neoantigens. A negative aspect of this adaptive response is that infectious organisms bearing HLA-homologous alloantigens (e.g. human immunodeficiency virus type 1, HIV-1) may generate a systemic IgG response suppressing CMI. Findings are reviewed suggesting this is an etiologic factor in the acquired immune deficiency syndrome (AIDS).

Opposite changes in serum soluble CD8 in patients at the active stages of Graves' and Hashimoto's diseases

Serum concentrations of soluble CD8 (sCD8) were examined by enzyme immunoassay in 154 patients with autoimmune thyroid diseases and 46 healthy controls. The numbers of peripheral CD8+ cells were also examined in the same subjects by flow cytometry. The serum concentrations of sCD8 were increased in patients with stimulative thyrotoxicosis caused by active Graves' disease, and decreased in patients with transient destructive thyrotoxicosis caused by the aggravation of Hashimoto's disease, and normal in euthyroid and hypothyroid patients with Graves' or Hashimoto's disease. The ratios of serum sCD8 levels to the numbers of CD8+ cells were increased in thyrotoxic patients with active Graves' disease, but not with active Hashimoto's disease, suggesting an increase in sCD8 production by CD8+ cells in active Graves' disease. The serum concentrations of sCD8 were correlated with the serum levels of thyrotropin receptor antibody (TRAb) and thyroid hormones in Graves' disease. These data indicate that serum sCD8 proteins change in opposite directions in the active stages of Graves' and Hashimoto's diseases, and may represent the disease activities.

Evaluation of serum levels of soluble CD4, CD8 and beta 2-microglobulin in visceral human leishmaniasis

The levels of soluble CD4 (sCD4), sCD8 and beta 2-microglobulin (beta 2-M) were measured in sera from patients with visceral leishmaniasis during the course of infection. Levels of sCD4, sCD8 and beta 2-M were raised significantly above levels in normal sera and returned to the normal range after recovery. The decrease in the levels of sCD8 was related to a reduction of anaemia, leukopenia and thrombocytopenia. In contrast, sCD4 levels fluctuated during the period of infection. beta 2-M returned within normal range more rapidly than sCD8 secretion. Our results suggest that T cells are activated during infection, and that it is also possible that the raised levels of these soluble molecules play a role in the impairment of protective immunity.

CD8 lymphocytosis in primary cytomegalovirus (CMV) infection of allograft recipients: expansion of an uncommon CD8+ CD57- subset and its progressive replacement by CD8+ CD57+ T cells

Allograft recipients undergoing cytomegalovirus infection present increased proportions of circulating CD8+ lymphocytes. A longitudinal study of 11 kidney and five liver allograft recipients with primary CMV infection but no other etiological factor of graft dysfunction revealed selective imbalances of peripheral blood CD8+ T cell subsets. Initially, CMV viraemia is associated with elevated CD8+bright T cell numbers and T cell activation. Activation markers fall to normal when viral cultures become negative (before the end of the first month). During the second to sixth month, most (12/16) patients keep up high CD8+ T cell counts (1050-2900 CD8+ cells/mm3), comprising an uncommon CD8+ T cell subset, as 45-73% of CD8+bright lymphocytes were CD3+ and TCR alpha beta+, but were not stained by anti-CD28, CD11b, CD16, CD56, and CD57 antibody. Unexpectedly, CD8+CD57+ T cells, a hallmark of CMV infection, do not appear until the second to sixth month of primary CMV infection, and their numbers increase progressively thereafter. They become the predominant CD8+ T cell subset after 6 months of infection and their persistence for several (up to 4) years is strongly correlated (r = 0.87) with expansion of CD8+ cells. By analysis with MoAbs, there was no bias towards the use of particular TCR-V beta gene families at any time of primary CMV infection. Persistence of CD8 lymphocytosis is thus directly related to the rate of expansion of an uncommon CD8+CD57- subset and its progressive replacement by CD8+CD57+ T cells that are chronically elicited by CMV.

Soluble tumour necrosis factor receptors (sTNF-R) and HIV infection: correlation to CD8+ lymphocytes

The objective of this study was to determine sTNF-R, type I (p55) and type II (p75) in sera of HIV-infected male homosexuals and correlate them to T lymphocyte subpopulations and course of HIV infection. Serum samples were obtained from 39 HIV-1+ asymptomatic male homosexuals, 10 symptomatic (ARC and AIDS) male homosexuals and 44 HIV- non-homosexual healthy controls. sTNF-R levels were determined by ELISA with specific MoAbs and polyclonal antibodies to the sTNF-R proteins. sTNF-RI and II levels were significantly elevated in 72% and 74% respectively of HIV+ asymptomatic male homosexuals and in all of the symptomatic male homosexuals. In sequential studies a highly significant positive correlation was found between sTNF-RI and sTNF-RII (r = 0.8, P < 0.001) and between both sTNF-R and CD8+ lymphocyte counts (r = 0.6 and 0.92, respectively, P < 0.01-0.001) during the asymptomatic stage of the infection. All these correlations were lost, however, during the symptomatic phase of the disease. These results suggest that: (i) HIV infection is associated with elevation of sTNF-R serum levels; (ii) sTNF-R levels are strongly correlated to CD8+ lymphocytes during the asymptomatic stage of HIV infection.

Serum markers of T cell activation in relapses of Wegener's granulomatosis

Levels of soluble IL-2 receptor (sIL-2R), soluble CD4 (sCD4) and CD8 (sCD8) were measured by sandwich ELISA as markers for T cell activation in serial serum samples from 16 patients showing 18 histologically proven relapses of Wegener's granulomatosis (WG). Levels of sIL-2R increased from 1065 U/ml (median, range 373-2345 U/ml) 6 months before the relapse to 1684 U/ml (median, range 486-3404 U/ml) at the moment of relapse for the whole group (P = 0.10). The eight major relapses showed a profound rise in sIL-2R levels, from 1008 U/ml (median, range 686-1553 U/ml) 6 months before the relapse, to 1994 U/ml (median, range 1469-3404 U/ml) at the moment of relapse (P < 0.01). The levels of sIL-2R at the moment of relapse were significantly higher at the eight major relapses than at the time of the 10 minor relapses (P < 0.05). Minor relapses were not accompanied by a significant rise in sIL-2R levels. Titres of antineutrophil cytoplasmic antibodies (ANCA) rose by two or more titresteps or from negative to positive in 15/18 patients during the 6 months period before the relapse. In all seven cases with both a rise of the ANCA titre and an at least 25% increase in sIL-2R levels, the rise in ANCA preceded the rise in sIL-2R by at least 1 month. The level of sIL-2R at the moment of relapse correlated with the level of C-reactive protein (r = 0.488, P < 0.05) and with the disease activity score (r = 0.824, P < 0.002). There were no significant changes in levels of sCD4 or sCD8, although the levels of sCD4 tended to be higher at the time of major relapses. We conclude that major relapses of Wegener's granulomatosis are accompanied by systemic T cell activation. T cell activation, however, does not appear to precede the rise in ANCA titre.

Elevated levels of soluble CD54 (ICAM-1) in human immunodeficiency virus infection

Soluble CD54 levels in sera were quantitated in asymptomatic intravenous drug users, homosexuals, and patients with lymphadenopathy, AIDS-related complex, or acquired immunodeficiency syndrome. Soluble CD54 levels were elevated in human immunodeficiency virus (HIV)-seronegative asymptomatic intravenous drug users, reflecting infections like cytomegalovirus, Epstein-Barr virus, and hepatitis B virus. The sera of human immunodeficiency virus-seropositive groups of patients also had elevated levels of soluble CD54, reflecting infections like cytomegalovirus and human immunodeficiency virus infection.

Immunologic significance of increased soluble CD8/CD4 molecules in patients with active systemic lupus erythematosus

This study attempted to estimate soluble CD4(sCD4)/CD8(sCD8) molecules in active systemic lupus erythematosus (SLE) patients. Measurements were made by solid-phase enzyme-linked immunosorbent assay. sCD8 or sCD4 molecules were significantly increased in the patients as compared to control subjects. sCD8 correlated with the erythrocyte sedimentation rate. sCD4 correlated with the anti DNA antibody titer, the IgG concentration, and negatively with the complement titer. An association of these molecules with immunologic abnormalities and disease activity exists in SLE patients.

Serum soluble CD4, CD8 and IL-2R levels in adult acute myeloid leukemia in remission

We have measured the serum levels of soluble CD4, CD8 and IL-2R in 43 patients with AML in complete remission (AML-CR). The sCD8 levels of AML-CR patients (443.9 +/- 224.4 u/ml) were significantly high as compared to that of the normal controls (177.1 +/- 76.3 u/ml), p < 0.01. The sIL-2R levels of AML-CR patients were 715.0 +/- 646.3 u/ml, which significantly differed when compared to 322.1 +/- 65.7 u/ml for the normal controls, p < 0.01. However, the sCD4 levels of AML-CR patients were 9.6 +/- 4.7 u/ml, which did not differ from the 8.3 +/- 2.6 u/ml of the normal controls. The AML-CR patients showed significantly increased sCD8 and sIL-2R levels at all ranges during the remission from one to 188 months. The sCD8 levels and sIL-2R levels of the AML-CR patients showed a close correlation, p < 0.01. Further, the sCD8 levels and lymphokine activated killer cell cytotoxic activity showed a close correlation, p < 0.05. The presence of the activation of anti-tumor immunity may be related to the continuance of the remission in the AML-CR patients.

Increases in soluble CD8 antigen in plasma, and CD8+ and CD8+CD38+ cells in human immunodeficiency virus type-1 infection

Increases in plasma levels of soluble CD8 (SCD8) antigen and expansion of the CD8+ CD38+ lymphocyte compartment were early immunologic alterations frequently observed prior to detection of antibodies against human immunodeficiency virus type 1 (HIV-1) and diminution of CD4+ cells in subjects at risk to develop AIDS. These increases identified in the 49 seronegative homosexual men were manifest in all 164 homosexual subjects and 45 intravenous drug users (IVDU) positive for HIV-1 antibodies (HIV-1+), 19 patients with ARC, and 29 AIDS patients. Augmentation of plasma sCD8 antigen correlated with increases in both CD8+ and CD8+ CD38+ cells in HIV-1(-) homosexual men (r = 0.35, P less than 0.013; r = 0.48, P less than 0.0005; respectively) and the 258 HIV-1+ subjects (r = 0.25, P less than 0.0003; r = 0.33, P less than 0.0001, respectively). In vitro examination of unstimulated peripheral blood lymphocytes from HIV-1+ homosexuals and IVDU confirmed the fivefold higher constitutive levels of cellular release of sCD8 antigen in these subjects compared to heterosexual controls. Inclusion of radiolabeled amino acids during the 3-day culture period in the presence or absence of phytohemagglutinin resulted in negligible levels of radioactivity associated with the sCD8 antigen indicative of a lack of de novo synthesis. Throughout clinical progression to AIDS, sCD8 antigen levels continued to escalate relative to the numbers of CD8+ cells bearing CD38+ antigen. The data confirm the interrelationship between sCD8+ antigen and CD8+ and CD8+ CD38+ cells.

Increased soluble CD4 and decreased soluble CD8 molecules in patients with Sjögren's syndrome

PURPOSE

A new enzyme-linked immunosorbent assay for soluble CD4 (sCD4) and soluble CD8 (sCD8) molecules has been developed. We estimated the concentrations of these molecules in patients with Sjögren's syndrome and in patients with systemic lupus erythematosus (SLE) serving as a control population for non-Sjögren's inflammatory disease, since several findings suggestive of an aberration of immunocompetent cells have been reported in these autoimmune diseases.

PATIENTS AND METHODS

The study population consisted of 41 patients with Sjögren's syndrome (28 cases of the primary form and 13 cases of the secondary form), 66 patients with SLE, and 43 normal individuals. Serum samples and clinical and laboratory data were collected from each patient and control. Assays of the sCD4 and sCD8 molecules were performed using an enzyme-linked immunosorbent kit developed by T Cell Science Inc., Cambridge, MA.

RESULTS

The concentration of sCD4 was significantly increased in patients with both primary and secondary Sjögren's syndrome as compared with that in the control subjects. In contrast, sCD8 was significantly decreased in patients with primary disease but not in patients with secondary disease. A low or high concentration of sCD8 was significantly correlated with the presence of anti-SS-A antibody or hypocomplementemia, respectively. A similar significant correlation was noted between an increased sCD4 concentration and increased serum IgG level. In patients with SLE, the levels of both sCD4 and sCD8 were significantly increased.

CONCLUSION

These observations represent the first evidence of an increased level of the sCD4 molecule and a decreased level of the sCD8 molecule and an association with immunologic abnormalities in Sjögren's syndrome. The increased and decreased levels of these soluble molecules observed may play a pathologic role in patients with Sjögren's syndrome.

Immunological abnormalities in Kawasaki disease with coronary artery lesions

A review of our previous immunological studies on Kawasaki disease (KD) was undertaken. The results showed that peripheral blood macrophages/monocytes, T-cells and B-cells become activated during acute KD in terms of numerical changes in immunocompetent cells, expression of activated antigens on the cell surfaces and cytokine production. Also, during acute KD with coronary artery lesions (CALs) the numbers of macrophages/monocytes are increased. In addition, both the increased levels of tumor necrosis factor-alpha and shed intercellular adhesion molecule-1 in serum are more evident in KD patients with CALs than in those without. Our results further suggest that the main characteristics of the pathogenesis of KD are increased numbers of peripheral blood macrophages/monocytes with the secretion of monokines by these activated cells, and the expression of adhesion molecules on immunocompetent cells. These immune responses develop more vigorously in KD patients with CALs.

Soluble CD4 and CD8 in the peripheral blood of patients with multiple sclerosis and HTLV-1-associated myelopathy

We evaluated the presence of soluble (s) CD4 and sCD8, released from activated T cells, in the sera of patients with multiple sclerosis (MS) and human T lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM) using an enzyme-linked immunosorbent assay (ELISA). In addition, peripheral blood T cell subsets in patients with MS and HAM were analyzed by single and two color flow cytometry. The serum level of sCD8 was significantly elevated in MS patients as compared with controls (p less than 0.001). Sera from patients with an exacerbation of acute relapsing MS showed a higher sCD8 level than the patients in remission or controls (p less than 0.01 and p less than 0.001, respectively). The serum levels of both sCD4 and sCD8 were also significantly elevated in patients with HAM (p less than 0.001 and p less than 0.001, respectively). In addition, a significantly increased serum level of soluble interleukin-2 receptor (sIL-2R) was found in patients with HAM as compared with that of controls (p less than 0.001). These observations suggest that CD8 cells may be activated in the peripheral blood of patients with MS and sCD8 may be related to clinical activity, but that both CD4 and CD8 cells may be activated in the peripheral blood of patients with HAM.

Raised serum levels of CD8, CD25 and beta 2-microglobulin in common variable immunodeficiency

Soluble CD8, soluble CD4, soluble CD25 (IL-2 receptor), beta 2-microglobulin and the cytokine tumour necrosis factor-alpha (TNF-alpha) were measured in sera from patients with common variable immunodeficiency (CVI). Levels of soluble CD8, soluble CD25 and beta 2-microglobulin but not of soluble CD4 and TNF-alpha were raised significantly above levels in normal sera. Sera from patients with X-linked agammaglobulinaemia, who are also antibody deficient, did not show this marked elevation. The raised levels of soluble CD8, soluble CD25 and beta 2-microglobulin in CVI, correlated with the extent of the defects in the B lymphocytes assessed in vitro, as well as with the clinical severity of the disease. The selective release of these molecules into sera may indicate that abnormal cellular activation occurs in most CVI patients. It is also possible that the raised levels of these soluble molecules play a part in the immunodeficiency.

Serum soluble CD4 and CD8 levels in Kawasaki disease

The levels of soluble CD4 (sCD4) and sCD8 in serum correlate with the T cell subset activation and may be important in monitoring and characterizing disease processes during immunological diseases. We compared acute Kawasaki disease (KD) with anaphylactoid purpura (AP) and acute febrile viral infections, such as measles and infectious mononucleosis (IM), in terms of serum sCD4 and sCD8 levels. The levels of serum sCD4 and sCD8 were measured by a sandwich enzyme immunoassay. In addition, peripheral blood mononuclear cell subsets were analysed by single and two-colour flow-cytometric analyses in KD and IM patients. The levels of serum sCD4 and sCD8 were significantly elevated in patients during acute stages of KD, measles and IM, but not AP. Peripheral blood CD4+, CD8+ and also HLA-DR+ T cells count did not increase during the acute stage of KD; however, peripheral blood CD8+ and HLA-DR+ T cell counts were increased during the acute stage of IM. Our results suggest that there is a low level of activation of peripheral blood T cells during acute KD, or that infiltrated T cells in some local tissues of KD patients contribute to the elevated levels of serum sCD4 and sCD8.

Evaluation of HIV P24 antigen, beta 2-microglobulin, neopterin, soluble CD4, soluble CD8, and soluble interleukin-2 receptor levels in patients with AIDS or AIDS-related complex treated with 2',3'-dideoxyinosine (ddI)

Circulating HIV P24 antigen, beta 2-microglobulin, neopterin, soluble CD4, soluble CD8, and soluble interleukin-2 receptor were measured in 13 zidovudine-intolerant patients (8 with ARC and 5 with AIDS) treated with dideoxyinosine (ddI). Measurements were made at baseline and at several intervals during therapy. Mean levels of HIV P24 antigen decreased early and significantly (P less than 0.01) after 2 weeks of ddI administration and remained low at weeks 8 and 12. In addition, mean SCD8 levels decreased late and significantly (P less than 0.02) after 16 weeks of ddI treatment and remained low at 24 weeks. In contrast, ddI administration had no substantial effect on mean levels of beta 2-microglobulin, neopterin, soluble CD4, and soluble interleukin-2 receptor. ddI administration appears to have been associated with early reduction of HIV P24 antigen levels and later reduction of SCD8 mean levels in these patients.

Elevated levels of soluble CD8 molecule in patients with lymphatic filariasis

The serum levels of soluble forms of suppressor/cytotoxic cells (sCD8) and interleukin-2 receptor (sCD25) were analyzed in 67 patients with lymphatic filariasis and 28 normal controls. Our results show that patients with lymphatic filariasis have significantly higher levels of sCD8 (p less than 0.05) than the control groups, whereas no such difference was observed for sCD25. Within the patient group, however, those in the chronic lymphatic obstruction (CP) had significantly higher levels of both sCD8 (491 +/- 52 U/ml, p less than 0.001) and sCD25 (293 +/- 36 U/ml; p less than 0.02) than those with asymptomatic microfilaremia (sCD8 344 +/- 32 U/ml; sCD25 190 +/- 10 U/ml, respectively). No statistically significant correlation was observed between the serological levels of sCD8 and the percentage of CD8 on peripheral blood T lymphocytes in any of the patient groups. Evaluation of the activation state of B lymphocyte did not reveal any difference in the cellular expression of B7, or serum levels of soluble CD23 in any of the groups studied. Thus the selective increase of sCD8 in patients with filariasis suggests a possible pathogenic role of the cells involved in the release of this molecule.

Immune activation markers to predict AIDS and survival in HIV-1 seropositives

Neopterin concentrations in body fluids of HIV-1 seropositives provide predictive information. In 1986, we examined serum and urine neopterin concentrations in 29 HIV-1 seropositives. Serum levels of soluble IL-2 receptor (sIL2R), soluble CD8 (sCD8), tumour necrosis factor alpha (TNF-alpha) and circulating immune complexes (CIC) were retrospectively analysed in 1989. All individuals had increased serum and urine neopterin, sIL2R and CIC concentrations, 27/29 had increased sCD8 concentrations, whereas all had normal TNF-alpha levels. During a 3-year follow-up, high urine and serum neopterin concentrations were significantly associated with progression to AIDS and with the occurrence of AIDS-associated death. Both neopterin variables were of similar predictive value (p less than 0.001, generalized Wilcoxon test). sIL2R concentrations were of borderline significance in predicting the onset of AIDS (p = 0.05). All other parameters lacked predictive information in our study. We conclude, that chronic immune activation is detectable in almost all HIV-1 seropositives. Chronic immune activation may be associated with HIV-1 replication and may contribute to the immunopathology of HIV-1 infection.

Beta 2-microglobulin and neopterin: predictive markers for human immunodeficiency virus type 1 infection in children?

The value of beta 2-microglobulin and neopterin concentrations in serum for early diagnosis of infants born to human immunodeficiency virus type 1 (HIV-1)-infected mothers was assessed. Concentrations of both markers were measured in serum samples from pediatric patients (Centers for Disease Control classifications P0, P1, and P2), as well as in age-matched normal subjects. Both beta 2-microglobulin and neopterin were significantly increased in HIV-1-infected symptomatic subjects (P2) compared to controls. Seventy-five percent of asymptomatic patients (P1) also had increased values. On the other hand, a significant overlap in concentrations of both markers in serum was found between controls and P0 patients. Thirty-eight percent of the P0 patients had values comparable to those of the P2 group. Persistently high concentrations of both markers in P0 patients may be indicative of HIV-1 infection.

Elevated levels of CD4 antigen in sera of human immunodeficiency virus-infected populations

CD4 antigen levels in sera from asymptomatic intravenous drug users and homosexuals and patients with lymphadenopathy, acquired immunodeficiency syndrome-related complex, or acquired immunodeficiency syndrome were quantitated. Like soluble CD8, CD4 antigen levels were elevated in human immunodeficiency virus-seronegative asymptomatic intravenous drug users and homosexuals, probably reflecting infections such as cytomegalovirus, Epstein-Barr virus, and hepatitis B virus infections. The sera from human immunodeficiency virus-seropositive groups of patients with human immunodeficiency virus infection also had elevated levels of CD4 antigen, presumably reflecting infections like cytomegalovirus and human immunodeficiency virus infections.

Expression of serum IL-2, IL-2R, and CD8 levels during hyposensitization in house-dust-sensitive asthmatics

In this study, we used the enzyme-linked immunosorbent assay (ELISA) to evaluate the changes of serum interleukin-2 (IL-2), interleukin-2 receptor (IL-2R), and suppressor/cytotoxicity factor (CD8) in house dust-sensitive asthmatic children during hyposensitization. Patients before immunotherapy presented significantly higher serum levels of IL-2 and IL-2R than normal subjects (p less than 0.001), but these levels became normal after three years of hyposensitization. No significant difference of serum CD8 level was noted between pretreated patients and normal controls. Although the serum CD8 level in treated patients also decreased after three years of immunotherapy, this decrease was not significant compared with the pretreated patients (p greater than 0.05). This study suggests that serum IL-2 and IL-2R markers might be helpful in analyzing allergic states associated with immune activation and in evaluating the therapeutic effects of hyposensitization.

Effect of azidothymidine (AZT) on HIV P24 antigen, beta 2-microglobulin, neopterin, soluble CD8, soluble interleukin-2 receptor and tumor necrosis factor alpha levels in patients with AIDS-related complex or AIDS

Circulating HIV P24 antigen, beta 2-microglobulin, neopterin, soluble CD8, soluble interleukin-2 receptor and TNF alpha levels were measured in 20 patients (9 with ARC and 11 with AIDS) treated with azidothymidine (AZT) and in 12 patients (3 with ARC and 9 with AIDS) who were in a placebo group. Mean levels of HIV P24 antigen, beta 2-microglobulin, neopterin and SCD8 decreased significantly (P less than 0.05) after 12 to 16 weeks of AZT administration. SIL-2R and TNF alpha serum levels did not appear to change in association with AZT therapy. No changes were observed in the placebo group except that TNF alpha levels appeared to increase after 12 to 16 weeks. These results suggest that AZT administration may have led to reduced HIV P24 antigen, beta 2-microglobulin, neopterin and SCD8 mean levels in these patients.

Elevated levels of circulating immune complexes in human immunodeficiency virus infection

Circulating immune complexes were quantitated in asymptomatic intravenous drug abusers (IVDA), male homosexuals, and patients with lymphadenopathy or acquired immunodeficiency syndrome (AIDS) by two different methods. Circulating immune complexes were elevated in HIV-seronegative IVDAs and male homosexuals, probably reflecting viral infections such as cytomegalovirus (CMV). Circulating immune complexes were also elevated in HIV-seropositive IVDAs and male homosexuals and in patients with lymphadenopathy or AIDS, reflecting infections such as CMV and HIV.

Neopterin and alpha and beta interleukin-1 levels in sera of patients with human immunodeficiency virus infection

Levels of neopterin and alpha and beta interleukin-1 (IL-1) in sera of normal controls, asymptomatic intravenous drug abusers, homosexuals, and patients with lymphadenopathy or acquired immunodeficiency syndrome were measured. Neopterin levels were elevated in the sera of human immunodeficiency virus (HIV)-seronegative intravenous drug abusers and homosexuals, as well as in the sera of HIV-seropositive patients. Alpha IL-1 was the most predominant form of IL-1 found in the sera of all groups, and its level in HIV-seronegative intravenous drug abusers was elevated compared with the level in controls, whereas its levels in asymptomatic HIV-seropositive intravenous drug abusers and asymptomatic HIV-seronegative and HIV-seropositive homosexuals were decreased relative to the level in controls. Beta IL-1 levels in sera in all groups were not significantly different from the control value, except for the HIV-seropositive homosexual group; in this group the beta IL-1 level was significantly decreased compared with the control value.