CELLULAR IMMUNE FUNCTION IN AIDS AND IN PRIMARY IMMUNE DEFICIENCIES

外周血T辅助细胞（Th）缺陷谱 无症状HIV血清阳性（HIV+）的血液白细胞（PBL） 现在已经发现一个人可以预测艾滋病的时间 诊断和死亡时间 Th缺陷的光谱似乎是 可归因于1型对2型的优势逆转 第二类功能优于第一类功能。 因此 可能是类型1功能是保护性的，而类型2不是。 的 个人和个人群体的人数 对HIV抗原具有有效的Th活性，但血清反应阴性 继续成长和扩张。 目前，在艾滋病毒暴露者中， 血清阴性个体的HIV特异性Th应答百分比 男同性恋者占63%，静脉注射毒品者占45%， 意外暴露的卫生保健工作者，75%;和新生儿的艾滋病毒- 感染的母亲，35%。 这些人中的大多数仍然 随访时血清反应阴性，但少数患者的HIV DNA PCR反应阳性。 的 上面总结的研究提出了细胞 由1型细胞介导的免疫是保护性的，但是体液性的。 免疫，由2型细胞介导的不是。 如果这些发现是正确的， 这表明艾滋病疫苗的开发应该针对 增强细胞免疫而不是体液免疫。 我们还注意到 白细胞介素-12（IL-12）在体外强烈增强了 HIV+个体的Th反应，包括HIV特异性反应。 这一发现提高了使用IL-12增强细胞免疫的可能性。 HIV+患者的免疫力。

The spectrum of T helper cell (Th) defects observed in the peripheral blood leukocytes (PBL) of asymptomatic HIV-seropositive (HIV+) individuals has now been found to be predictive for the time to AIDS diagnosis and time to death. The spectrum of Th defects appears to be attributable to a reversal from a predominance of Type 1 over Type 2 function to a predominance of Type 2 over Type 1 function. Thus, it may be that Type 1 function is protective whereas Type 2 is not. The numbers of individuals and of cohorts of individuals who exhibit potent Th activity against HIV antigens, but who are seronegative continue to grow and expand. At present, among HIV-exposed but seronegative individuals the percent of HIV-specific Th responsive individuals are: gay men, 63%; intravenous drug users, 45%; accidentally-exposed health care workers, 75%; and newborns of HIV- infected mothers, 35%. The majority of these individuals remains seronegative on follow-up although a few are PCR+ for HIV DNA. The studies summarized above raised the possibility that cellular immunity, mediated by Type 1 cells, is protective, but humoral immunity, mediated by Type 2 cells is not. If correct, these findings would indicate that AIDS vaccine development should be directed to augment cellular rather than humoral immunity. We have also observed that interleukin-12 (IL-12) strongly enhances the defective in vitro Th responses of HIV+ individuals, including HIV-specific responses. This finding raises the possibility of using IL-12 to enhance cellular immunity in HIV+ patients.