Tumor necrosis factor-alpha in the retina in acquired immune deficiency syndrome

The presence of specific cytokines and the number and distribution of leukocytes were determined in the retinas of patients with acquired immune deficiency syndrome (AIDS). Using immunohistocytochemical techniques, three retinas from patients with AIDS had focal infiltration by T-lymphocytes and macrophages. These specimens stained positively for tumor necrosis factor-alpha (TNF-alpha) in cells identified morphologically as macrophages and glial cells and showed prominent reactive gliosis. The retinas from seven other affected patients had minimal leukocytic infiltration and no TNF-alpha reactivity; gliosis was present in only one. The retinas from clinically normal patients without human immunodeficiency virus (HIV) contained no TNF-alpha-positive cells. Using in situ hybridization for HIV, four of five patients with AIDS had rare positive cells. No interferon-gamma was detected in any of the retinal tissues tested. These data suggest a role for TNF-alpha in the development of AIDS-related retinal disease.