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Levels of IL‐6 and soluble IL‐6 receptor are increased in HIV patients with a history of immune restoration disease after HAART
Author(s) -
Stone SF,
Price P,
Keane NM,
Murray RJ,
French MA
Publication year - 2002
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1046/j.1464-2662.2001.00096.x
Subject(s) - medicine , peripheral blood mononuclear cell , immune system , asymptomatic , immunology , flow cytometry , immunopathology , biology , in vitro , biochemistry
Objectives We have previously described immune restoration diseases (IRD) associated with asymptomatic opportunistic infections presenting in immunodeficient HIV patients responding to highly active antiretroviral therapy (HAART). Here we address the question of whether patients with a history of IRD exhibit persistent immune activation, shown by elevated levels of interleukin‐(IL)‐6 and soluble IL‐6 receptor (sIL‐6R). Methods Peripheral blood mononuclear cells (PBMCs) and plasma were collected from HIV patients with nadir CD4 T cell counts of < 80/µL and who had achieved immune reconstitution after HAART with ( n =14) or without ( n =15) experiencing IRD, severely immunodeficient (SID) patients with < 80 CD4 T cells/µL ( n =8) and HIV seronegative controls ( n =15). PBMC production and plasma levels of IL‐6, sIL‐6R and interferon (IFN)‐γ (PBMC only) were measured by enzyme linked immunosorbent assay (ELISA). Intracellular flow cytometry was used to determine the predominant cellular source of IL‐6 in HIV patients and controls. Results Unstimulated PBMC from IRD patients produced significantly higher amounts of IL‐6 and sIL‐6R than non‐IRD patients and HIV seronegative controls. The sIL‐6R concentration was also significantly higher in supernatants from mitogen‐stimulated PBMC from IRD patients compared to non‐IRD patients. The production of IFN‐γ did not differ between IRD and non‐IRD patients. IRD patients had significantly higher plasma levels of IL‐6 compared to non‐IRD patients, SID patients and controls. Monocytes were the predominant source of IL‐6 in both HIV patients and controls. Conclusions Patients with a history of IRD after HAART have elevated levels of IL‐6 and sIL‐6R.