Thymopoiesis in HIV-infected adults after highly active antiretroviral therapy

被引:33
作者
Markert, ML
Alvarez-McLeod, AP
Sempowski, GD
Hale, LP
Horvatinovich, JM
Weinhold, KJ
Bartlett, JA
D'Amico, TA
Haynes, BF
机构
[1] Duke Univ, Med Ctr, Dept Pediat, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Immunol, Durham, NC 27710 USA
[3] Cobb Cty Board Hlth, HIV Clin, Marietta, GA 30008 USA
[4] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[5] Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA
关键词
D O I
10.1089/088922201753342040
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The thymus of HIV-seropositive patients can enlarge as CD4(+) T cell counts increase on highly active antiretroviral therapy (HAART). This may indicate development of new T cells or represent mature peripheral T cells recirculating to the thymus. To define the etiology of the enlargement, the thymuses of two HIV-infected individuals on HAART were biopsied. For more than 3 years before initiation of HAART, both patients (38 and 41 years of age) had documented CD4(+) T lymphopenia. Peripheral blood samples were obtained to assess circulating CD4(+)CD45RA(+)CD62L(+) T cells, which were thought to have recently developed in the thymus. Peripheral blood T cells from both patients and thymocytes from the second patient were also tested for levels of DNA episomes formed during T cell receptor gene rearrangement (T cell receptor rearrangement excision circles, TRECs). With HAART, peripheral blood CD4(+) T cell counts increased from approximately 60/mm(3) to 552/mm(3) and 750/mm(3) for patients 1 and 2, respectively. Thymic biopsies from both patients showed normal thymus histology with active thymopoiesis. Percentages of peripheral blood CD45RA(+)CD62L(+)CD4(+) T cells and quantitation of T cell TRECs also reflected active thymopoiesis in both patients. Thus, in these two HIV-seropositive adults examined after initiation of HAART, thymic enlargement represented active thymopoiesis. Thymopoiesis in adult AIDS patients may contribute to immune reconstitution even after prolonged CD4(+) T lymphopenia.
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页码:1635 / 1643
页数:9
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