title: Breast milk CD4+ T cells express high levels of C chemokine receptor 5 and CXC chemokine receptor 4 and are preserved in HIV-infected mothers receiving highly active antiretroviral therapy.
abstract: BACKGROUND
  Transmission of human immunodeficiency virus (HIV) to the infant through breast-feeding is a major problem worldwide; however, the biological circumstances of such transmission remain unclear. Little characterization of breast milk CD4(+) T lymphocytes has been done so far.
  
  
  METHODS
  We performed a detailed immunophenotypic analysis of T lymphocytes in the breast milk, compared with the blood, of HIV-uninfected (n=9) and HIV-infected (n=10) women receiving highly active antiretroviral therapy, by use of multiparameter flow cytometry. Descriptive statistics and nonparametric comparisons were performed using SAS software (version 9.1; SAS Institute).
  
  
  RESULTS
  In uninfected women, 44%-78% of breast milk CD4(+) T cells expressed the C chemokine receptor 5 (CCR5), whereas 26%-73% of cells coexpressed CCR5 and CXC chemokine receptor 4 (CXCR4). In contrast, only 7%-20% of peripheral blood CD4(+) T cells expressed CCR5 and 1%-20% coexpressed CCR5 and CXCR4. The level of CCR5 expression in CD4(+) T cells in breast milk was higher than in blood. In HIV-infected women, the high frequency of CD4(+)CCR5(+) T cells in breast milk was preserved.
  
  
  CONCLUSIONS
  A majority of CD4(+) T cells in breast milk express high levels of CCR5 and CXCR4. Unlike other mucosal immune sites, in which CD4(+)CCR5(+) T cells are rapidly eliminated by HIV, these cells are preserved in breast milk during HIV infection.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. apk3@cdc.gov
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.forename: Chris C
authors.initials: CC
authors.lastname: Ibegbu
authors.forename: Regan
authors.initials: R
authors.lastname: Theiler
authors.forename: Yong-Xian
authors.initials: YX
authors.lastname: Xu
authors.forename: Pooja
authors.initials: P
authors.lastname: Bansil
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Michael
authors.initials: M
authors.lastname: Lindsay
authors.forename: Salvatore
authors.initials: S
authors.lastname: Butera
authors.forename: Ann
authors.initials: A
authors.lastname: Duerr
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D016130:Immunophenotyping; D007231:Infant, Newborn; D008895:Milk, Human / Q000166:cytology*; D011247:Pregnancy; D019713:Receptors, CCR5 / Q000378:metabolism*; D019718:Receptors, CXCR4 / Q000378:metabolism*; D019562:Viral Load
chemical_list: D019713:Receptors, CCR5; D019718:Receptors, CXCR4