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Soluble versus cell-bound CD4, CD8 from bronchoalveolar lavage: correlation with pulmonary diagnoses in human
S K Willsie1, B L Herndon, L Miller
1University of Missouri-Kansas City School of Medicine 64108, USA.
Insights
Soluble CD8 (sCD8) levels in serum are elevated in HIV patients with fungal lung infections. This finding suggests sCD8 may indicate disease progression in this population.
Area of Science:
- Immunology
- Pulmonology
- Infectious Diseases
Background:
- Cellular analysis of bronchoalveolar lavage (BAL) aids disease monitoring in HIV patients.
- Soluble surface antigens offer potential for improved disease diagnosis and understanding.
Purpose of the Study:
- To evaluate soluble CD4 (sCD4) and CD8 (sCD8) in BAL and serum of HIV-infected individuals.
- To compare soluble markers with cell-bound CD4/CD8 quantified by flow cytometry.
- To correlate these markers with pulmonary diagnoses in HIV patients.
Main Methods:
- Collected BAL and serum from HIV-infected individuals undergoing bronchoscopy.
- Quantified soluble CD4 and CD8 in BAL and serum.
- Measured cell-bound CD4 and CD8 in BAL and peripheral blood via flow cytometry.
- Compared marker levels with patient pulmonary diagnoses (fungal, bacterial, Pneumocystis carinii).
Main Results:
- Serum sCD8 was significantly higher in patients with fungal infections compared to Pneumocystis carinii or bacterial infections (p=0.0001).
- The BAL sCD4/sCD8 ratio differed significantly between bacterial and fungal pulmonary infections (p=0.01).
Conclusions:
- Elevated serum sCD8 may serve as an important indicator of pulmonary fungal disease progression in HIV-positive patients.
- Soluble immune markers in BAL and serum show potential for diagnosing and monitoring pulmonary conditions in HIV.
Abstract:
Identification and assessment of cell populations in bronchoalveolar lavage (BAL) specimens may he used to follow the course of a disease state or response to specific therapy. Beyond cellular assessment, there are indications that the presence and quantity of soluble surface antigens released from activated cells may lead to improved understanding and facilitated diagnosis of a number of disease states. This study evaluated soluble markers (sCD4 and sCD8) in BAL and serum from HIV-infected individuals undergoing diagnostic bronchoscopy, and compared these values to flow cytometry-quantified BAL and peripheral blood cell CD4 and CD8. Patient pulmonary diagnosis (based on cytology and microbiology) was compared with patient blood and BAL-soluble and cell-bound CD4 and CD8 to determine the relationship of these markers to disease states in this population. Serum sCD8 in patients with fungal infections was significantly elevated above sCD8 in patients with Pneumocystis carinii or pulmonary bacterial infections, p = 0.0001. BAL sCD4/sCD8 ratio was also significantly different in patients with bacterial vs. fungal pulmonary infections, p = 0.01. These findings suggest that soluble markers, particularly elevated sCD8, may be an important indication of pulmonary disease progression in these HIV+ patients with fungal infections.
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