Cytolytic Response to HIV in Patients with HIV Disease Treated with Extracorporeal Photochemotherapy: Preliminary Study |
| |
Authors: | Joselyn Gonzalez Carole Berger Carolyn M Cottrill Alex Geller Joseph Schwartz Mark Palangio Albert S Klainer Emil Bisaccia |
| |
Institution: | Department of Internal Medicine, Morristown Memorial Hospital, Morristown, NJ, USA;Department of Photopheresis, Morristown Memorial Hospital, Morristown, NJ, USA;Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA;Department of Gastroenterology, Mayo Clinic, Rochester, MN, USA;Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA;Department of Dermatology, Columbia University College of Physicians and Surgeons, New York, NY, USA |
| |
Abstract: | Extracorporeal photochemotherapy (photopheresis), an immunomodulatory therapy that targets circulating T helper lymphocytes, has been applied to the management of human immunodeficiency virus (HIV) disease. Any therapy that exerts its actions on CD4+ T cells has the potential of exacerbating HIV infection. Therefore, it was necessary to observe immune function during treatment. Because cytotoxic T lymphocytes (CTL) and natural killer cells are thought to play an important role in the response against HIV infection, we examined the effect of photopheresis on HIV cytolytic activity. The study group consisted of seven patients with late-stage HIV disease who had not received any previous treatment for HIV infection. Patients were treated exclusively with photopheresis on two consecutive days each month for 14–32 months (average, 25 months). Peripheral lymphocytes, collected at various points during treatment, were used as effectors in a Wr release assay. Epstein-Barr virus (EBV)-transformed autologous B cell lines transfected with recombinant vaccinia vectors that expressed the HIV env (gp120, gp41) and gag (p24) proteins were used as target cells. All seven patients demonstrated relatively constant levels of cytolysis (>10% above controls) during treatment in the context of stable CD4+ T cell counts and a stable clinical status. These results suggest that extracorporeal photochemotherapy did not impair the cytolytic response to HIV infection and may have enhanced it in some patients. |
| |
Keywords: | |
|
|