Immunologic aspects of hyperimmunoglobulinemia E-like syndrome in patients with AIDS.
In this study we describe a series of nine patients affected by acquired immunodeficiency syndrome (AIDS) or AIDS-related complex who had hypereosinophilia and hyperimmunoglobulinemia E (hyper-IgE) with chronic dermatitis and recurrent staphylococcal infections. These patients had features similar to those present in hyper-IgE syndrome, a primary immunodeficiency disease. In addition, immunologic characterization of these patients with human immunodeficiency virus (HIV) infection, compared with 51 HIV-positive patients without hyper-IgE, both atopic and nonatopic, and three patients affected by the primary hyper-IgE syndrome, also revealed an increase in IgA and a severe decrease in B and CD4+ lymphocytes. Spontaneous in vitro synthesis of IgE by peripheral blood mononuclear cells was confirmed in both hyper-IgE conditions, together with increased levels of circulating eosinophil cationic protein. Serum-soluble CD23, usually increased in atopic conditions and hyper-IgE, was similar to that of normal control subjects in the HIV-positive patients with hyper-IgE. On the basis of our findings, we conclude that a hyper-IgE-like syndrome represents a distinct aspect of the clinical manifestations associated with HIV infection and that the immunologic mechanisms in this condition seem to differ from those known in primary hyper-IgE syndrome, because CD4+ TH2 type cells, which are currently believed to have a role in IgE production, are severely depleted in HIV-positive patients.
Paganelli
R
R
Department of Allergy and Clinical Immunology, University La Sapienza, Rome, Italy.
Scala
E
E
Mezzaroma
I
I
Pinter
E
E
D'Offizi
G
G
Fanales-Belasio
E
E
Rosso
R M
RM
Ansotegui
I J
IJ
Pandolfi
F
F
Aiuti
F
F
D000386:AIDS-Related Complex / Q000150:complications / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000276:immunology; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D047091:Eosinophil Granule Proteins; D004802:Eosinophilia; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood*; D007132:Immunoglobulin Isotypes / Q000097:blood; D007589:Job Syndrome / Q000276:immunology*; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D012260:Ribonucleases
D015703:Antigens, CD; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D006684:HLA-DR Antigens; D007132:Immunoglobulin Isotypes; D007073:Immunoglobulin E; D012260:Ribonucleases