Stricker R B, Elswood B F, Goldberg B, Dumlao C, Van Elk J, Henry J, Winger E E, Epstein W L
HemaCare Corporation, San Francisco, CA 94108.
J Am Acad Dermatol. 1994 Sep;31(3 Pt 1):462-6. doi: 10.1016/s0190-9622(94)70212-8.
Promotion of cell-mediated immunity appears to be an important goal in the control of HIV infection. Topical dinitrochlorobenzene (DNCB) stimulates systemic cell-mediated immunity via the induction of cutaneous delayed-type hypersensitivity.
Our goal was to evaluate the clinical and immunologic effects of chronic DNCB application in a group of 24 HIV-infected patients.
We observed the patients for a mean of 28 months (range, 14 to 44 months). Of the 24 patients, 13 continued weekly DNCB application throughout the study (the compliant group), and 11 discontinued DNCB use after a mean of 10.9 months (the noncompliant group).
Two of the 13 compliant patients progressed to AIDS; none of these patients died. In contrast, AIDS developed in 5 of the 11 noncompliant patients and four of these patients died. Analysis of lymphocyte subsets revealed significant increases in natural killer cells and activated/cytotoxic CD8 T-cell subsets in the compliant group. In contrast, these cellular immune-related lymphocyte subsets decreased in the noncompliant subjects. Although CD4 T-cell levels decreased in both groups, there was a significantly greater drop in the noncompliant patients. CD8+CD38+ T cells increased significantly in both groups.
Chronic DNCB application appears to have a beneficial clinical and immunomodulatory effect in HIV-infected patients.
促进细胞介导的免疫似乎是控制HIV感染的一个重要目标。局部应用二硝基氯苯（DNCB）可通过诱导皮肤迟发型超敏反应来刺激全身细胞介导的免疫。
我们的目标是评估24例HIV感染患者长期应用DNCB的临床和免疫学效果。
我们对患者进行了平均28个月（范围为14至44个月）的观察。24例患者中，13例在整个研究过程中持续每周应用DNCB（依从组），11例在平均10.9个月后停止使用DNCB（不依从组）。
13例依从患者中有2例进展为艾滋病；这些患者均未死亡。相比之下，11例不依从患者中有5例发展为艾滋病，其中4例死亡。淋巴细胞亚群分析显示，依从组中自然杀伤细胞以及活化/细胞毒性CD8 T细胞亚群显著增加。相比之下，不依从患者中这些与细胞免疫相关的淋巴细胞亚群减少。尽管两组的CD4 T细胞水平均下降，但不依从患者的下降幅度明显更大。两组中CD8+CD38+ T细胞均显著增加。
长期应用DNCB似乎对HIV感染患者具有有益的临床和免疫调节作用。
