Chavan S, Bennuri B, Kharbanda M, Chandrasekaran A, Bakshi S, Pahwa S
Immunology and Inflammation Center of Excellence, North Shore-Long Island Jewish Research Institute, Manhasset, NY 10030, USA.
J Infect Dis. 2001 May 15;183(10):1445-54. doi: 10.1086/320197. Epub 2001 Apr 13.
Immune reconstitution after antiretroviral therapy in human immunodeficiency virus (HIV)infected patients may result from the recovery of thymus function, peripheral redistribution, or decreased T cell destruction. This study investigated levels of T cell receptor gene rearrangement excision circles (TRECs) as a measure of recent thymic emigrant cells in peripheral blood lymphocytes of 50 HIV-infected infants and children who were followed-up for 40 months after the start or change of antiretroviral therapy. At baseline, patients exhibited fewer TRECs than did uninfected control subjects. The increase in TRECs after antiretroviral therapy was greater in infants than in older HIV-infected children. Of interest, patients who demonstrated discordant responses (i.e., increased CD4 T cell counts without significant virologic suppression) also had substantial gains in TRECs. Furthermore, TRECs correlated positively with the number of CD4 and naive T cells and negatively with age and virus load. Measurement of TRECs may serve as a useful tool for evaluating immune reconstitution in HIV-infected children receiving antiretroviral therapy.
人类免疫缺陷病毒（HIV）感染患者接受抗逆转录病毒治疗后的免疫重建可能源于胸腺功能的恢复、外周血重新分布或T细胞破坏减少。本研究调查了50名HIV感染婴幼儿外周血淋巴细胞中T细胞受体基因重排切除环（TRECs）的水平，这些患儿在开始或改变抗逆转录病毒治疗后接受了40个月的随访。基线时，患者的TRECs比未感染的对照受试者少。抗逆转录病毒治疗后，婴儿的TRECs增加幅度大于年龄较大的HIV感染儿童。有趣的是，表现出不一致反应（即CD4 T细胞计数增加但病毒学未得到显著抑制）的患者，其TRECs也有显著增加。此外，TRECs与CD4和初始T细胞数量呈正相关，与年龄和病毒载量呈负相关。检测TRECs可能是评估接受抗逆转录病毒治疗的HIV感染儿童免疫重建的有用工具。
