Jason J, Archibald L, McDonald L C, Hart W M, Rheanppumikankit S, Tansuphwaswadikul S, Byrd M G, Larned J, Han A, Green T A, Jarvis W R
Immunology Branch, Sexually Transmitted Diseases, and Tuberculosis Laboratory Research, National Center for Infectious Diseases Centers for Disease Control and Prevention, Public Health Service, Atlanta, Georgia 30333, USA.
Clin Diagn Lab Immunol. 1999 Jan;6(1):73-8. doi: 10.1128/CDLI.6.1.73-78.1999.
Opportunistic infections (OI) and the human immunodeficiency virus (HIV) cause significant morbidity and mortality in developing countries. Immune cell and cytokine profiles may be related to the type and course of OI and to the OI-HIV interaction. Examining cell-specific cytokine production ex vivo has only recently become feasible. In Thailand, 53 febrile, hospitalized adults were enrolled in a study of the immune correlates of bloodstream infections (BSI). On site, blood cells were stimulated ex vivo. Cell-surface antigens and eight intracellular cytokines were subsequently analyzed using flow cytometry to determine associations with mortality and the organism causing the BSI. By logistic regression analysis, the percentage of CD3(+) CD16/56(+) cells making tumor necrosis factor alpha (TNF-alpha) (P = 0.033) and the percentage of CD3(-) CD16/56(+) cells (NK) (P = 0.032) were related to HIV positivity. Lymph node enlargement with HIV infection and the percentage of CD3(+) CD16/56(+) making TNF-alpha were predictive of death. A lower percentage of CD3(+) CD8(+) lymphocytes making interleukin-8 (IL-8) (P = 0.005), fewer monocytes expressing CD14 (P = 0.009), and the percentage of CD3(+) CD8(+) cells producing gamma interferon (P = 0. 011) were associated with blood culture positivity and the causative organism. For every one point decrease in the percentage of CD3(+) CD8(+) cells making IL-8, the likelihood of a positive culture increased 23%; for every one point decrease in the percentage of monocytes expressing CD14, the likelihood of a positive culture increased by 5%. Only a few immune cell types and three of their related cytokines were significantly associated with HIV disease outcome or the BSI organism. These cell types did not include CD3(+) CD8(-) cells (a surrogate for CD4(+) cells), nor did they involve cytokines associated with a type I to type II cytokine shift, which might occur with advancing HIV infection. These associations support the premise that CD8(+) and CD16/56(+) lymphocytes play significant roles in HIV and type I infections.
机会性感染（OI）和人类免疫缺陷病毒（HIV）在发展中国家导致了严重的发病率和死亡率。免疫细胞和细胞因子谱可能与OI的类型和病程以及OI与HIV的相互作用有关。体外检测细胞特异性细胞因子的产生直到最近才变得可行。在泰国，53名发热的住院成年人参与了一项关于血流感染（BSI）免疫相关性的研究。在现场，对血细胞进行体外刺激。随后使用流式细胞术分析细胞表面抗原和八种细胞内细胞因子，以确定与死亡率和导致BSI的病原体之间的关联。通过逻辑回归分析，产生肿瘤坏死因子α（TNF-α）的CD3(+) CD16/56(+)细胞的百分比（P = 0.033）和CD3(-) CD16/56(+)细胞（自然杀伤细胞，NK）的百分比（P = 0.032）与HIV阳性相关。HIV感染伴有的淋巴结肿大以及产生TNF-α的CD3(+) CD16/56(+)细胞的百分比可预测死亡。产生白细胞介素-8（IL-8）的CD3(+) CD8(+)淋巴细胞的百分比降低（P = 0.005）、表达CD14的单核细胞减少（P = 0.009）以及产生γ干扰素的CD3(+) CD8(+)细胞的百分比（P = 0.011）与血培养阳性和病原体有关。产生IL-8的CD3(+) CD8(+)细胞百分比每降低1个百分点，培养阳性的可能性增加23%；表达CD14的单核细胞百分比每降低1个百分点，培养阳性的可能性增加5%。只有少数几种免疫细胞类型及其相关的三种细胞因子与HIV疾病结局或BSI病原体显著相关。这些细胞类型不包括CD3(+) CD8(-)细胞（CD4(+)细胞的替代物），也不涉及与随着HIV感染进展可能发生的I型到II型细胞因子转变相关的细胞因子。这些关联支持了CD8(+)和CD16/56(+)淋巴细胞在HIV和I型感染中起重要作用这一前提。
