Laboratory exerts an important role in Hiv infection contributing to evaluate this infection through some key variables of the immune response. Since 1981, there are several expansions of the knowledges about the role of basic immunology that have contributed to the area of immunologic investigations. Variables laboratory such as lymphocyte subsets, activation markers, Vbeta repertoire, chemokines and cytokines are very useful to establish the degree of Hiv disease and progression. These analyses have determined a sequential evolution of Hiv immunopathogenesis even hallmark of the infection (CD4 cells depletion) remains still unclear.

Today these variables are as follows:

HLA aplotype

Lymphocyte subsets

Activation markers

Chemokines

Cytokines

Recent reports have shown that MHC and their proteins (HLA molecules) play an important role in the evolution of Hiv infection. The risk of major progression seems related to particular HLA

TABELLA 1    MARCATORI IMMUNOLOGICI IN CORSO DI INFEZIONI DA HIV  SUBSETS linfocitari  CD+CD7+  CD4+CD45RA+  CD4+CD45RO+  CD8+CD38+  CITOCHINE   IL-2, IL-4, IL-10, gamma IFN, TNF  alfa  CHEMOCHINE    Rantes, MIP-1alfa, MIP-1 beta  .

aplotype. Naive T cells (CD4+CD45RA+) are implicated in the disease progression represent the major source of effector immune response while memory T cells (CD4+CD45RO+) have minor importance because are expression of redistribution from lymphoid tissue to peripheral blood. Chemokines and cytokines have an important pathogenetic role in the study of immunopathogenesis of Hiv infection. Several studies have shown that their expression is related to Hiv prognosis: TH 1 or proinflammatory cytokines are shifted to TH2 expression during the progression. Chemokines and their levels have an unclear role in determining the evolution of retroviral infection, but recent reports suggest that the increase of their levels is not protective. An important area of research is the evaluation of co-receptors such as fusin and CCRX5 in Hiv-infected individuals: mutations of receptor-related proteins seem associated to a major protection versus Hiv infection. In this regard, monitoring of immunology variables may play an important pathogenetic role in the evaluation of Hiv progression because the study of proinflammatory cytokines and chemokines may suggest information about both Hiv replication and cellular activation.

Anna D'Antonio Giuseppe Siciliano

Laboratorio di analisi e microbiologia Azienda Ospedaliera D. Cotugno

Napoli

 

   Leadership Medica^® 
  Mensile di scienza  medica e attualita` 
 Copyright 1997© All Rights Reserved