Matsuda J
Department of Medicine, Teikyo University School of Medicine, Tokyo.
Rinsho Byori. 1991 Jul;39(7):743-7.
The present study was undertaken to discuss whether measurement of neopterin (NP) released into blood from monocytes/macrophage following activation of lymphocytes were useful tool to predict development of AIDS after HIV-1 infection. The subjects used for this study were eighty one cases of hemophilia, of whom 47 cases were HIV-1 antibody tested positive. Serum NP concentration (15.0 +/- 13.8 nmol/l) in anti-HIV-1 antibody-positive group was higher than in-negative group (5.7 +/- 3.3 nmol/l) (p less than 0.05), in which there was no case whose serum NP level amounted to more than 20 nmol/l. In anti-HIV-1 antibody-positive group, in which CD4/CD8 lymphocyte ratio was less than 0.4, serum NP level was significantly higher than in the group whose lymphocyte ratio was more than 0.5 (p less than 0.05). This result represents that there is a reverse correlation of NP concentration with the developing level of immunodeficiency. Furthermore, in eight cases who developed AIDS, serum NP levels turned to increase from several months or earlier until in all cases the levels were more than 30 nmol/l. In three cases of five who were dead, serum NP concentration had decreased to death since several months through one year. These findings reveal that measurement of serum NP concentration is correlated with clinical outcome after HIV-1 infection and it is useful as the marker for prediction of AIDS development. Also these findings represent that a parallel application of serum NP assay to CD4 lymphocyte counting, detection of anti-HIV-1 antibody, IgA, beta 2-microglobulin assays can predict the outcome of the HIV-1 infection more precisely.
本研究旨在探讨淋巴细胞激活后单核细胞/巨噬细胞释放到血液中的新蝶呤(NP)测量是否是预测HIV-1感染后艾滋病发展的有用工具。本研究的对象为81例血友病患者,其中47例HIV-1抗体检测呈阳性。抗HIV-1抗体阳性组的血清NP浓度(15.0±13.8 nmol/l)高于阴性组(5.7±3.3 nmol/l)(p<0.05),阴性组中血清NP水平无1例超过20 nmol/l。在抗HIV-1抗体阳性组中,CD4/CD8淋巴细胞比值小于0.4的患者,其血清NP水平显著高于淋巴细胞比值大于0.5的组(p<0.05)。这一结果表明NP浓度与免疫缺陷的发展程度呈负相关。此外,在8例发展为艾滋病的患者中,血清NP水平从数月或更早开始升高,直至所有病例的水平均超过30 nmol/l。在5例死亡患者中的3例中,血清NP浓度从数月至1年一直下降直至死亡。这些发现表明,血清NP浓度的测量与HIV-1感染后的临床结局相关,可作为预测艾滋病发展的标志物。这些发现还表明,将血清NP检测与CD4淋巴细胞计数、抗HIV-1抗体检测、IgA、β2-微球蛋白检测并行应用,可以更准确地预测HIV-1感染的结局。