       Document 0697
 DOCN  M9630697
 TI    Loss of CD4 T lymphocytes in patients infected with human
       immunodeficiency virus type 1 is more pronounced in the duodenal mucosa
       than in the peripheral blood. Berlin Diarrhea/Wasting Syndrome Study
       Group.
 DT    9603
 AU    Schneider T; Jahn HU; Schmidt W; Riecken EO; Zeitz M; Ullrich R;
       Department of Medicine, Klinikum Benjamin Franklin, Free; University of
       Berlin.
 SO    Gut. 1995 Oct;37(4):524-9. Unique Identifier : AIDSLINE MED/96097882
 AB    Although changes in T lymphocyte subset distribution in the peripheral
       blood of patients infected with human immunodeficiency virus (HIV) are
       well defined it is not known whether these changes reflect changes in
       lymphoid compartments clearly involved in HIV related disease like the
       intestinal mucosa. This study analysed lymphocytes isolated
       simultaneously from the peripheral blood and duodenal biopsy specimens
       by three colour flow cytometry in eight asymptomatic HIV infected
       patients, 26 AIDS patients, and 23 controls. The proportion of CD4, CD8,
       CD4-CD8-, or gamma delta T cells did not correlate between circulating
       and duodenal T cells. CD4 T cells were reduced in the peripheral blood
       (7.5% (25th-75th percentile, 2-16%) v 52% (41-63%), p < 0.0005) and even
       more reduced in the duodenum (1% (1-2%) v 36% (23-57%), p < 0.0005) of
       AIDS patients compared with controls. Patients with asymptomatic HIV
       infection had intermediate CD4 T cells in the peripheral blood (24%
       (22-35%); p < 0.002 v controls; p < 0.01 v AIDS) but like AIDS patients
       very low CD4 T cells in the duodenum (3% (1-6%); p < 0.002 v controls).
       The ratio of duodenal to circulating CD4+ T cells was significantly
       reduced to 0.2 (0-1) in AIDS patients (p < 0.001) and even to 0.1
       (0.04-0.5) in asymptomatic HIV infected patients (p < 0.002) compared
       with 0.72 (0.44-0.95) in controls. These findings show an early and
       preferential loss of duodenal CD4 T cells in HIV infection.
       Immunological abnormalities in HIV infection are distinct between
       lymphoid compartments, and profound immunodeficiency may occur in the
       intestinal immune system although circulating T cells are largely
       preserved.
 DE    Acquired Immunodeficiency Syndrome/IMMUNOLOGY  Adult  Aged  Comparative
       Study  CD4 Lymphocyte Count  CD4-Positive T-Lymphocytes/*IMMUNOLOGY
       Duodenum/IMMUNOLOGY  Female  Flow Cytometry  Human  HIV
       Infections/*IMMUNOLOGY  *HIV-1  Immunophenotyping  Intestinal
       Mucosa/*IMMUNOLOGY  Male  Middle Age  Support, Non-U.S. Gov't  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

