HIV感染者の病態進行と高IgE血症との関連の検討

Abstract

I have found that HIV-infected patients often show hyper-IgE immunog- lobulinemia in their clinical course. I compared serum IgE concentrations between 24 HIV -seropositive hemophiliacs and 13 HIV-seronegative hemophiliacs. The number of patients with hyper-IgE immunoglobulinemia over 1000 U/ml was larger in HIV-seropositive hemo- philiacs than HIV-seronegative hemophiliacs. I studied the relationship between serum IgE levels and clinical conditions of HIV infection in 32 HIV-infected patients (mean age : 33.4 years old, 29 males and 3 females; HIV-transmission: blood products 24 cases, sexual contact 8 cases). The number of patients who met the criteria of AIDS was significantly higher in patients with hyper-IgE immunoglobulinemia than in those with normal IgE levels. Counts of blood CD4-positive T cell were significantly decreased in patients with hyper-IgE immunoglobulinemia. These results suggest that HIV infection may alter serum IgE levels in HIV-infected patients and their hyper-IgE immunoglobulinemia may imply the progres- sion of HIV infection. Then I examined the expression of cytokine (IL-4, IL-10, IL-12, TNF-α and IFN-γ) mRNAs in peripheral blood mononuclear cells of 10 HIV-infected patients (mean age : 33.7 years old, 9 males and 1 female) using RT-PCR, and analyzed the relationship between serum IgE levels and cytokine profiles. The results showed that the expression of IL-4 mRNA was significantly increased in patients with hyper-IgE immunoglobulinemia (5 cases) compared to those with normal IgE levels (5 cases) (p＜0.05). These results showed that the exhanced expression of IL-4 mRNA might be related to the induction of hyper-IgE immunoglobulinemia in HIV-infected patients. According to recent data, s shift from Th1 to Th2 cytokine profile is likely to indicate a progression in the critical course of HIV infection. Moreover, hyper-IgE immunog- lobulinemia may be induced by IL-4, resulting in a more advanced critical stage of HIV infection. And I studied the relationship between the changes of serum IgE levels and HAART in 13 HIV-infected male patients (mean age : 36.8 years old). In patients with hyper-IgE immunoglobulinemia, some cases with an effective therapy had a tendency to decrease but serum IgE levels did not normalize during short observation. The monitoring of serum IgE levels is therefore of diagnostic value to monitor the progression of HIV infection in addition to the count of CD4-positive T cells.