Immunodeficit caused by lymphopenia T3 T4 (HIV -)

Martin jlm01 at mailclub-internet.fr
Sat Aug 9 13:48:10 EST 1997


Immunodeficit caused by lymphopenia T3 T4 (HIV -)

Summary :
great CD 8 deficit and impossibility to stimulate these cells
moderate CD 4 deficit
there is not doubt that these anomalies are the cause or predisposed to HPV
disease (important PS : HIV -)

Study of a clinical case

Female ,45 years old
Medical history :

1.	from her childhood epidermodysplasia verruca*, HPV8 bound
*epidermis dyspasia like warts
2.	30 years old : ocular toxoplasmosis
3.	36 years old : breast tumor, treated with surgery, radiotherapy,
chimiotherapy (6 treatments with Velbé + methotrexate + fluorouracile +
cortisone)
4.	44 years old : 
cervix uteri biopsy : HPV related to 31.35.39 (probably HPV 51)
vagina biopsy : HPV related to 31.35.39 and HPV related to 6.11.42
vulva biopsy : HPV related to 6.11.42

Conclusions of Immological studies

T Lymphocytes
			Results		Mean number	
			%	/mm3	/mm3	
Lymphocytes total	7	500	1000-4000	
CD 3+					800-2500	
CD 2+					800-2500	
CD 4+			56.5	280	500-2000	
CD 8+	1		4.5	70	250-1000	
				
Ratio CD 4+/CD 8+	3.9		1.5-3	

Lymphocyte phenotyping confirms great T lymphopenia (76.5 % CD 3 + cells,
say 310mm3); there is CD4 lymphopenia worthy of note : 62 %, say 250 CD 3+
+ CD 4+ cells/mm3 ; CD 8+ lymphopenia is great : 13 % CD 3+ + CD 8+ cells,
say 59/mm3. We found again a decrease of CD45RA cells among CD 3+ ones :
5.5 % (whereas 92% of CD 3 + cells are CD45RA).
Expression deficit of CD45RA is probably for its greater part on CD 4+
cells, since 30% of CD 8+ cells express CD45RA (we were not able to
determine these labels on CD 4, because we did not possess the anti-CD 4
antibody marked with proper fluorochrome.
Relating to activating labels, we found 18 % of CD 3+ cells with CD 25 and
20% of CD4 ones ; in the contrary CD25 expressing is very low on CD 8 +
cells 1 %. CD 69 molecule is not a constituent element of T cells (CD 4 or
CD 8).

We purified mononucleated  cells of Mrs X and cultivated them, during 18
hours without and with various otimuli. There is spontaneously for cells
cultivated without stimulus, cellular activation as 63.5 % of CD 4+ cells
express CD 69 molecule after 18 hours (compared to 20 % for normal cells),
when stimulated with PHA 90 % of CD 4 cells but 34 % of CD 8 express CD 69
(compared to 80-98 % on CD 8 normal cells). For cells stimulated with
anti-CD 3, CD 59 expressing is difficult to interpret because soluble CD 3
was more effective than fixed one. 

Conclusion : There is greater CD 8 lymphopenia, prevalence of memory cells
through CD 4 cells seems, this cells spontaneously activated. On the
contrary, there is probably insufficiency of CD 8+ cells activation.
The remainder of the study have not reveal specific anomaly. The amount of
gammaglobulins is normal : serum Ig G = 10 g/l ; normal Ig A, Ig M amounts
; normal serum complement. There is no autoantibody  (anti-nuclear, anti
DNA, anti-cardiolipin, rumatholoid factor) ; the intradermoreaction (10
units) is negative but Mrs X was not BCG-vaccinated ; blood count and
formula are normal except lymphopenia. There is not specific anormaly of
myelogram from spinal cord biopsy.
I have no explanation for this immunological deficit but its features are
compatible with specific decrease of anti-virus and anti-tumor defences.


Do you know a treatment for increasing the immunity of this patient ?
Do you know similar cases ?
Where to obtain further information ?

Answer to me.
 jlm01 at club-internet.fr

Best thanks.




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