Cytokine profile of a long-term pediatric HIV survivor with hyper-IgE syndrome and a normal CD4+ T-cell count

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:104

Article

Seroogy, CM ; Wara, DW ; Bluth, MH ; Dorenbaum, A ; White, C ; Durkin, HG ; Elder, ME

关键词: HIV;    hyper-IgE syndrome;    anti-HIV IgE;    T-H1;    T-H2;    cytokine;   

DOI  :  10.1016/S0091-6749(99)70087-4

来源: Elsevier

【 摘 要 】

Background: An elevated IgE level and increased production of T-H2 cytokines are factors associated with poor prognosis in HIV infection. We report a pediatric long-term survivor of vertically acquired HIV infection with a normal CD4 count and a lon viral burden despite the lack of antiretroviral therapy and a phenotype resembling hyper-IgE syndrome. Objective: We sought to characterize the patient's T-H1 versus T-H2 cytokine profile and anti-HIV-specific immune responses, Methods: Supernatants collected from cultures of peripheral blood T cells stimulated with phorbol myristate acetate plus ionomycin were assayed for T-H1 and T-H2 cytokines by means of ELISA. Specific IgE antibodies were determined by immunoblot, HIV-specific cytotoxic T-lymphocyte responses were measured from cell lysis by fresh T cells of autologous B-lymphoblastoid cells expressing recombinant AIV proteins. Results: Patient CD4(+) T cells secreted significantly more T-H2 cytokines. IL-4 (P < .003) and IL-5 (P < .03), than HIV-infected and seronegative control cells. No difference was noted in T-H1 cytokine production. IgE specific for HIV gp160, p24, p17, and p66 proteins and,Aspergillus fumigatus was detected in patient sera. Despite predominance of T-H2 cytokines, HIV-specific cytotoxic T-lymphocyte activity was vigorous, Conclusions: The patient demonstrated predominantly T-H2 cytokine production in vitro. Unlike other patients with HIV who have hyper-IgE and increased T-H2 cytokine production, our patient has maintained HIV-specific immune responses, a low viral load, and a normal CD4 count without antiretroviral therapy. These findings support a diagnosis of primary hyper-IgE syndrome. Presence of anti-HIV-specific IgE may represent a protective mechanism against HIV replication in our patient.

【 授权许可】

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