RESUMEN
Blood leukocytes from 51 patients with acquired immune deficiency syndrome (AIDS) or AIDS-related syndrome (ARC) were immunophenotyped with the use of monoclonal antibodies and flow cytometry. The patients were placed into four clinically defined groups: HIV-positive asymptomatic (HIV+/A, 8); persistent generalized adenopathy (14); Kaposi's sarcoma (12); and opportunistic infections (17). Immunophenotypes were compared between groups. Statistically significant differences were seen in absolute lymphocyte counts, total T-cells, helper/inducer T-cells, the helper inducer subset of CD4+ lymphocytes, the suppressor inducer subset of CD4+ lymphocytes, activated helper T-cells, and natural killer cells. CD8+ cells and subsets were not statistically different between groups, possibly obscured by large ranges, but median values suggested differences. Results indicate a pattern of increasing or decreasing numbers of certain subpopulations as HIV infection progresses.
Asunto(s)
Complejo Relacionado con el SIDA/sangre , Síndrome de Inmunodeficiencia Adquirida/sangre , Seropositividad para VIH/sangre , Leucocitos/clasificación , Complejo Relacionado con el SIDA/patología , Síndrome de Inmunodeficiencia Adquirida/genética , Síndrome de Inmunodeficiencia Adquirida/patología , Adulto , Antígenos de Diferenciación de Linfocitos T/análisis , Seropositividad para VIH/patología , Humanos , Técnicas Inmunológicas , Recuento de Leucocitos , Leucocitos/patología , Activación de Linfocitos , Masculino , Fenotipo , Linfocitos T/clasificación , Linfocitos T/patología , Linfocitos T Colaboradores-Inductores/clasificaciónAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/inmunología , Complejo Relacionado con el SIDA/sangre , Complejo Relacionado con el SIDA/inmunología , Síndrome de Inmunodeficiencia Adquirida/sangre , Síndrome de Inmunodeficiencia Adquirida/terapia , Linfocitos B/inmunología , Humanos , Inmunoterapia , Células Asesinas Naturales/inmunología , Recuento de Leucocitos , Leucocitos/clasificación , Leucocitos/inmunología , Macrófagos/inmunología , Monocitos/inmunología , Linfocitos T/clasificación , Linfocitos T/inmunologíaRESUMEN
We have reviewed our experience with 271 B-cell lymphomas to determine the effectiveness of flow cytometry in the characterization of these malignancies. Flow cytometric immunophenotyping of the total lymphocyte and/or large lymphocyte populations confirmed the morphologic diagnosis of B-cell lymphoma in 92% of cases, which included 79% monoclonal and 13% surface immunoglobulin (SIg)-negative lymphomas. Light chain monoclonality was most frequent in low grade and follicular center cell (FCC) lymphomas, while SIg-negative cases were most common in high grade and non-FCC types. Low grade lymphomas of all histologic types had high median percentages of neoplastic cells and low T-cell percentages. Conversely, high grade lymphomas exhibited lower and less uniform median percentages of B-cells, with higher numbers of T-cells and lower CD4/CD8 ratios than low grade lymphomas. Several differences in B- and T-cells were observed between specific high grade histologic types. FCC lymphomas with a diffuse pattern had lower percentages of CD4+ cells and lower CD4/CD8 ratios than cases with a follicular pattern. Thus, immunophenotypic differences were observed between histologic types or groups with known differences in clinical course and prognosis. We conclude that flow cytometry provides reliable information on neoplastic and nonneoplastic cells in lymph nodes involved by B-cell lymphomas.
Asunto(s)
Linfocitos B/clasificación , Citometría de Flujo , Leucemia Linfocítica Crónica de Células B/clasificación , Antígenos de Diferenciación/análisis , Antígenos de Neoplasias/análisis , Linfocitos B/análisis , Linfocitos B/patología , Humanos , Hiperplasia/inmunología , Hiperplasia/patología , Leucemia Linfocítica Crónica de Células B/inmunología , Leucemia Linfocítica Crónica de Células B/patología , Linfoma Folicular/inmunología , Linfoma Folicular/patología , Neprilisina , Fenotipo , Receptores de Antígenos de Linfocitos B/análisis , Linfocitos T/análisis , Linfocitos T/clasificación , Linfocitos T/patologíaRESUMEN
Quantitative abnormalities of leukocyte subpopulations have been shown to correlate with clinical status in human immunodeficiency virus (HIV) infection. We have performed peripheral blood leukocyte phenotyping in 23 HIV-seropositive homosexual men, and correlated the results with clinical follow-up information. Individuals with CD4+ greater than 400/mm3 (Group 1) had less severe abnormalities in other mononuclear cell subpopulations than patients with CD4+ less than 400/mm3 (Group 2). Group 1 had decreased CD4+CDw29+ (B-cell inducer) cells, compared to HIV-seronegative homosexual controls, with normal CD4+CD45R+ (suppressor-inducer) cells, suggesting that CD4+ subpopulations are reduced at different rates. Group 2 had decreased counts for both CD4+CDw29+ and CD4+CD45R+ cells. Both groups had increased cytotoxic T cells (CD8+CD11b-), with decreased B cells and CD4+/CD8+ ratios, compared to HIV-seronegative homosexual controls. The Group 2 patients with subsequent clinical deterioration had particularly low CD4+ cells, CD4+CD45R+ cells, CD2+Ta1+ cells, and CD4+/CD8+ ratios and high CD8+CD11b- cells, compared to those with clinically stable illness. Our findings suggest that specific leukocyte subpopulations are altered differentially at various stages of HIV infection. However, the study involved only quantitative measurements of specific T- and B-cell subsets with no attempt to measure in vitro function. It is of course possible that normal numbers of cells in these subpopulations might be functionally deficient.
Asunto(s)
Antígenos de Diferenciación/análisis , Seropositividad para VIH/inmunología , Homosexualidad , Leucocitos Mononucleares/inmunología , Linfocitos B/inmunología , Humanos , Células Asesinas Naturales/inmunología , Recuento de Leucocitos , Leucocitos Mononucleares/clasificación , Activación de Linfocitos , Masculino , Linfocitos T/inmunologíaAsunto(s)
Conductos Biliares/cirugía , Colestasis/cirugía , Duodeno/cirugía , Drenaje , Humanos , Prótesis e ImplantesRESUMEN
The authors illustrate their experience with the fundoplication according to Nissen in the treatment of hiatal hernia and gastroesophageal reflux, and appraise its effectiveness in the light of the most modern diagnostical methods, among which chiefly the monitored pH-metry of distal oesophagus.