Chest
Clinical InvestigationsAIDS and InfectionExpression of Surface Markers on Alveolar Macrophages From Symptomatic Patients with HIV Infection as Detected by Flow Cytometry
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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Part of this work was presented in abstract form at the 57th Annual Scientific Assembly of the American College of Chest Physicians, San Francisco, November 1991.
Revision accepted October 14.