Fernández Fabrellas E, González Constán E, Marín González M, León P, Blanquer Olivas R
Servicio de Neumología, Hospital Dr. Peset Aleixandre, Valencia.
An Med Interna. 1999 Jan;16(1):21-4.
Cellular immunity disorder, showed by a decreased blood level of lymphocytes T CD4, is the main indicator of progression in HIV infection. The diminished level of these lymphocytes and CD4/CD8 ratio in pulmonary samples obtained by bronchoalveolar lavage (BAL) is known, so as the enhanced level of lymphocytes T CD8, while the pulmonary diseases high incidence in these patients could be due to a local immunity disorder or systemic one remains unknown. The aim of this study is to compare systemic immunity disorders, studied in blood samples, with local immunity replay, showed by BAL samples, in patients with HIV infection.
74 HIV patients were studied, all of them hospitalized due to acute respiratory disease, and undergone to fiberoptic bronchoscopy for diagnosing. Cellular and lymphocytic populations are compared and measured by flow cytometry in blood and BAL samples.
Percentage of total lymphocytes and CD4+ population were decreased in BAL samples, above all in patients with CD4 level minor than 25%.
Cellular immunity disorder of patients with HIV infection is bigger in lung than in blood. It's possible to foresee the lymphocytes T CD4+ pulmonary depletion from their blood levels.
细胞免疫紊乱表现为血液中T淋巴细胞CD4水平降低，是HIV感染进展的主要指标。通过支气管肺泡灌洗（BAL）获得的肺部样本中这些淋巴细胞水平及CD4/CD8比值降低，同时T淋巴细胞CD8水平升高，而这些患者肺部疾病高发的原因是局部免疫紊乱还是全身免疫紊乱尚不清楚。本研究的目的是比较HIV感染患者血液样本中研究的全身免疫紊乱与BAL样本显示的局部免疫反应。
研究了74例HIV患者，他们均因急性呼吸道疾病住院，并接受纤维支气管镜检查以进行诊断。通过流式细胞术对血液和BAL样本中的细胞和淋巴细胞群体进行比较和测量。
BAL样本中总淋巴细胞和CD4+群体的百分比降低，尤其是CD4水平低于25%的患者。
HIV感染患者的细胞免疫紊乱在肺部比在血液中更严重。可以根据血液水平预测肺部T淋巴细胞CD4+的耗竭情况。
