title: Changes to alveolar macrophage phenotype in HIV infected individuals with normal CD4 counts and no respiratory disease.
abstract: BACKGROUND
  It has previously been shown that HIV infected individuals with pneumonitis have identifiable abnormalities in alveolar macrophages obtained by bronchoalveolar lavage (BAL). In particular, alterations in the expression of alveolar macrophage surface antigens associated with macrophage function have been reported. To determine whether these changes reflect HIV infection or the respiratory episode itself, a population of HIV infected patients with no respiratory disease was studied.
  
  
  METHODS
  Twenty two HIV antibody positive individuals with a peripheral blood CD4 count of > 400/microliters and 10 healthy volunteer controls underwent bronchoscopy and BAL. Cytospin preparations from the recovered cells were stained using immunoperoxidase and double immunofluorescence techniques with monoclonal antibodies RFD1, RFD7, EBM11/CD68 (mature macrophages), UCHM1/CD14 (monocyte marker), and HLA-DR (RFDR1). Differential cell counts were also performed.
  
  
  RESULTS
  There was an increase in overall alveolar macrophage HLA-DR expression in the HIV population. This was not reflected in a change in the percentage of cells staining CD14 (monocytes) or CD68 (mature macrophages) positive. The relative proportions of cells staining RFD1 + RFD7- (inducer cells), RFD1 - RFD7+ (effector cells), and RFD1 + RFD7+ (suppressive cells) were unchanged between HIV and control groups.
  
  
  CONCLUSIONS
  In a population of HIV infected individuals with normal CD4 counts and no respiratory disease there was an increase in overall alveolar macrophage HLA-DR expression which occurred independently of any alteration in the relative proportions of alveolar macrophage subpopulations.
authors.affiliation: Department of Clinical Immunology, Royal Free Hospital and School of Medicine, London, UK.
authors.forename: M C
authors.initials: MC
authors.lastname: Lipman
authors.forename: M A
authors.initials: MA
authors.lastname: Johnson
authors.forename: D H
authors.initials: DH
authors.lastname: Bray
authors.forename: L H
authors.initials: LH
authors.lastname: Poulter
mesh_terms: D000386:AIDS-Related Complex / Q000150:complications; D000328:Adult; D000938:Antigen-Presenting Cells; D018791:CD4 Lymphocyte Count; D002452:Cell Count; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology*; D006801:Humans; D018655:Lymphocyte Count; D016676:Macrophages, Alveolar / Q000276:immunology*; D008297:Male; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D006684:HLA-DR Antigens; D001613:beta 2-Microglobulin