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Evidence for Translocation of Microbial Products in Patients with Idiopathic CD4 Lymphocytopenia

Philip I. Lee, Emily J. Ciccone, Sarah W. Read, Ava Asher, Robert Pitts, Daniel C. Douek, Jason M. Brenchley and Irini Sereti
The Journal of Infectious Diseases
Vol. 199, No. 11 (Jun. 1, 2009), pp. 1664-1670
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/40254917
Page Count: 7
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Evidence for Translocation of Microbial Products in Patients with Idiopathic CD4 Lymphocytopenia
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Abstract

Translocation of microbial products has been described in chronic human immunodeficiency virus (HIV) infection and correlates with activation of the immune system. We investigated the potential ranslocation of microbial products in idiopathic CD4 lymphocytopenia (ICL), a rare disorder characterized by low CD4 T cell counts in the absence of HIV infection. Plasma lipopolysaccharide (LPS) levels and T cell activation were measured in a crosssectional cohort study of patients with ICL and HIV infection and healthy control subjects. Increases in CD4 T cell proliferation but not CD8 T cell proliferation were observed in patients with ICL. LPS levels were significantly elevated both in patients with ICL and in patients with HIV infection, and they were strongly correlated with the proportion of proliferating CD4 T cells in the cohort of patients with ICL (r = 0.88; P = .003). The proportions of T helper (Th) 17 and Thl CD4 cells in peripheral blood were similar between patients with ICL, patients with HIV infection, and control subjects. These findings suggest a potential association of translocation of microbial products with perturbed CD4 T cell homeostasis in individuals with CD4 lymphopenic states other than HIV infection.

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