Chest
Volume 105, Issue 5, May 1994, Pages 1324-1334
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Clinical Investigations
AIDS and Infection
Expression of Surface Markers on Alveolar Macrophages From Symptomatic Patients with HIV Infection as Detected by Flow Cytometry

https://doi.org/10.1378/chest.105.5.1324Get rights and content

Alveolar macrophages (AMs) harvested from 32 HIV-infected patients with respiratory problems (opportunistic pulmonary infections, n=12; other lung disease, n=20) and 13 healthy controls were stained with a panel of 15 monoclonal antibodies directed against surface antigens implicated in cell function. Antigen expression was quantified by flow cytometry and expressed as relative linear median fluorescence intensity (RLMFI). On AMs of patients, as compared with controls, there was a significant enhancement of HLA DP (12.1±1.5 vs 6.5±0.9, p=0.01, M±SEM, RLMFI units), CD11b (3.4±0.5 vs 1.7±0.4, p=0.014), CD11c (8.9±1.0 vs 4.8±0.8, p=0.0046), CD14 (2.1±0.3 vs 1.0±0.2, p=0.0009), and CD33 (1.7±0.1 vs 1.0±0.2, p=0.0093). No significant differences could be established for HLA-DR (36.9±5.8 vs 30.9±7.5, NS), HLA-DQ (3.4±0.3 vs 3.1±0.6, NS), CD54 (1.9±0.3 vs 1.2±0.1, NS), CD13 (2.5±0.6 vs 1.5±0.3, NS), CD36 (1.4±0.2 vs 0.9±0.3, NS), CD71 (10.3±1.9 vs 8.9±1.8, NS), CD25 (0.8±0.0 vs 0.9±0.1, NS), 27E10 (1.1±0.1 vs 0.8±0.3, NS), RM3/1 (1.9±0.4 vs 1.5±0.4, NS), and CD4 (1.5±0.3 vs 1.0±0.0, NS). The expression of CD14 and CD11b, but not of HLA class II antigens and CD71, was increased in the smaller cell population compared with the larger, thus suggesting monocyte recruitment. The increased expression of HLA-DP, CD11c, CD14, and CD33 on the patients' AMs was independent of smoking habits. The degree of immunodeficiency as indicated by the absolute peripheral CD4 count, the character of HIV-related pulmonary disease, and the prophylactic use of pentamidine or zidovudine did not significantly modify the antigen expression pattern. It is concluded that HIV infection may lead, most probably indirectly, to enhanced expression of surface antigens by local upregulation and/or recruitment of monocytes from the peripheral circulation. The functional significance of enhanced marker expression requires further clarification.

Section snippets

Patients and Controls

Bronchoalveolar lavage (BAL) fluid was obtained from a total of 32 consecutive nonselected HIV-infected patients presenting with respiratory symptoms (cough or mild dyspnea or both). Bronchoscopy, including lavage and transbronchial biopsy, was indicated to obtain a diagnosis of suspected infections or noninfectious pulmonary disease. Patients unwilling to undergo the procedure and those in whom the BAL recovery rate was less than 30 percent were excluded from the study. Pertinent clinical and

Patients

The majority of patients had AIDS (n=30, CDC IV C) (Table 1). Only two were in a pre-AIDS state of the disease. Twelve patients had Pneumocystis carinii pneumonia with additional opportunistic pathogens in three. Lung diseases other than opportunistic infection were diagnosed in 20 patients.

AM Surface Antigens

The expression of HLA-DP was enhanced substantially on AMs of HIV-infected patients (12.1±1.5 vs 6.5±0.9 for controls, p=0.01) (Table 3 and Fig 1). Neither HLA-DR, which had the highest relative surface

Discussion

The majority of the patients investigated in this study presented with advanced cellular immunodeficiency as evidenced by low peripheral CD4 lymphocyte counts and allocation to high WR and CDC classes. The BAL differentials yielded the pattern of “lymphocytic alveolitis” with a predominance of suppressor/cytotoxic T cells characteristic of this patient group.36

The results document that surface antigens on AMs taken from such HIV-infected individuals are expressed as normal or increased

Acknowledgments

The authors thank Prof. A. Radbruch and Ch. Göttlingen (Institut für Genetik, University of Cologne) for help with flow cytometry methodology.

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