TY - JOUR
T1 - T-cell depletion in the colonic mucosa of patients with idiopathic CD4+ lymphopenia
AU - Kovacs, Stephen B.
AU - Sheikh, Virginia
AU - Thompson, William L.
AU - Morcock, David R.
AU - Perez-Diez, Ainhoa
AU - Yao, Michael D.
AU - Rupert, Adam W.
AU - Utay, Netanya S.
AU - Roby, Gregg
AU - Freeman, Alexandra F.
AU - Estes, Jacob D.
AU - Sereti, Irini
N1 - Funding Information:
Financial support. This work was supported by the National Cancer Institute (contract HHSN261200800001E) and the National Institute of Allergy and Infectious Diseases Intramural Research Program, NIH. Potential conflicts of interest. All authors: No reported conflicts.
PY - 2015/11/15
Y1 - 2015/11/15
N2 - Idiopathic CD4+ lymphopenia (ICL) is a rare syndrome characterized by low peripheral CD4+ T-cell counts that can lead to serious opportunistic infections. The pathogenesis of ICL remains unclear, and whether effector sites are also lymphopenic is unknown. In this study, rectosigmoid mucosal biopsy specimens from patients with ICL and healthy controls were evaluated. Significant T-cell lymphopenia was observed in the mucosal tissue of patients with ICL by flow cytometry and immunohistochemistry, compared with healthy controls. Functional capacity of T cells, assessed by production of interferon γ and interleukin 17, was preserved in the mucosa of patients with ICL. In contrast to T lymphocytes, the frequency of myeloid cells (neutrophils and macrophages) was elevated in the colonic mucosa of patients with ICL. Despite the observed mucosal abnormalities, plasma levels of intestinal fatty acid binding protein, a marker of enterocyte turnover and other inflammatory biomarkers, including interleukin 6, C-reactive protein, and tumor necrosis factor, were not elevated in patients with ICL, compared with healthy controls, whereas soluble CD14 levels were minimally elevated. These data suggest that patients with ICL, despite gut mucosal lymphopenia and local tissue inflammation, have preserved enterocyte turnover and T-helper type 17 cells with minimal systemic inflammation. These observations highlight differences from patients with human immunodeficiency virus infection, with or without AIDS, and may partially explain their distinct clinical prognosis.
AB - Idiopathic CD4+ lymphopenia (ICL) is a rare syndrome characterized by low peripheral CD4+ T-cell counts that can lead to serious opportunistic infections. The pathogenesis of ICL remains unclear, and whether effector sites are also lymphopenic is unknown. In this study, rectosigmoid mucosal biopsy specimens from patients with ICL and healthy controls were evaluated. Significant T-cell lymphopenia was observed in the mucosal tissue of patients with ICL by flow cytometry and immunohistochemistry, compared with healthy controls. Functional capacity of T cells, assessed by production of interferon γ and interleukin 17, was preserved in the mucosa of patients with ICL. In contrast to T lymphocytes, the frequency of myeloid cells (neutrophils and macrophages) was elevated in the colonic mucosa of patients with ICL. Despite the observed mucosal abnormalities, plasma levels of intestinal fatty acid binding protein, a marker of enterocyte turnover and other inflammatory biomarkers, including interleukin 6, C-reactive protein, and tumor necrosis factor, were not elevated in patients with ICL, compared with healthy controls, whereas soluble CD14 levels were minimally elevated. These data suggest that patients with ICL, despite gut mucosal lymphopenia and local tissue inflammation, have preserved enterocyte turnover and T-helper type 17 cells with minimal systemic inflammation. These observations highlight differences from patients with human immunodeficiency virus infection, with or without AIDS, and may partially explain their distinct clinical prognosis.
KW - Biomarkers
KW - HIV/AIDS
KW - Idiopathic CD4 lymphopenia
KW - Inflammation
KW - Mucosal immunity
UR - http://www.scopus.com/inward/record.url?scp=84977987888&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84977987888&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiv282
DO - 10.1093/infdis/jiv282
M3 - Article
C2 - 25995198
AN - SCOPUS:84977987888
SN - 0022-1899
VL - 212
SP - 1579
EP - 1587
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -