Lewis D E, Minshall M, Wray N P, Paddock S W, Smith L C, Crane M M
Department of Microbiology, Baylor College of Medicine, Houston, TX 77030.
J Infect Dis. 1990 Dec;162(6):1373-8. doi: 10.1093/infdis/162.6.1373.
A central anomaly in the pathogenesis of AIDS is that few actively infected CD4+ cells (1 in 10(4)-10(5) have been detected in the peripheral blood, even though dramatic depletion (often greater than 90%) of CD4+ cells is the hallmark of disease progression. A sensitive, 35S-based human immunodeficiency virus (HIV) RNA in situ hybridization technique was coupled with a new detection method, confocal laser scanning microscopy, to examine transcriptionally active HIV-infected cells from individuals at different disease stages. In 35 symptomatic HIV-infected individuals (AIDS and AIDS related complex), an average of 1 in 350 mononuclear cells produced HIV RNA. In contrast, in an asymptomatic group of 30 individuals, an average of 1 in 2000 mononuclear cells produced HIV RNA. These data, obtained using this improved detection method, suggest there are more HIV RNA-producing cells in HIV-infected individuals than previously reported. In addition, increased numbers of HIV transcribing cells were found to correlate with declining clinical condition as assessed by Karnofsky performance score. These data suggest that viremia per se may account for the pathologic consequences in HIV infection.
艾滋病发病机制中的一个核心异常现象是，在外周血中很少能检测到活跃感染的CD4+细胞（每10⁴ - 10⁵个细胞中仅有1个），尽管CD4+细胞的显著耗竭（通常大于90%）是疾病进展的标志。一种基于³⁵S的敏感的人类免疫缺陷病毒（HIV）RNA原位杂交技术与一种新的检测方法——共聚焦激光扫描显微镜相结合，用于检测处于不同疾病阶段的个体中具有转录活性的HIV感染细胞。在35名有症状的HIV感染个体（艾滋病及艾滋病相关综合征）中，平均每350个单核细胞中有1个产生HIV RNA。相比之下，在30名无症状个体中，平均每2000个单核细胞中有1个产生HIV RNA。使用这种改进的检测方法获得的数据表明，HIV感染个体中产生HIV RNA的细胞比之前报道的更多。此外，通过卡诺夫斯基表现评分评估发现，HIV转录细胞数量的增加与临床状况的恶化相关。这些数据表明，病毒血症本身可能是HIV感染产生病理后果的原因。
