Document rx0j9zndY162Q2p9VXEZaRJmq

p7\ Zoos' O N D F .N IF l i 73 m A B N O R M A L H E L P E R b l P P R E S bO K T -C E L L R A T IO IN T H E ST IF F O F \ P E D IA T R IC H O S P IT A L To thr Ed itor A n inx c rie d ra tio o f h e lp e r to s u p p re s so r T ce lls due to decreased n u m b e rs of h elp er T cells is found in patients w ith A ID S ' 1 and in healths but hig h -risk pop u lation s * The ratio itself has been used as a d iag n o stic aid \ \ e haxe found a re x rrs rd helper su p p re s so r T -c e ll ra tio v 11h an u n e x p e c ie d lx h ig h frequenex am o n g healths stafi m em bers of a pediatric chronic disease hospital N one o f those stud ied w ere in a h ig h -risk g ro u p A h h o u g h the h o sp ita l s | r r ij| ir r ' in om ologN. r h r u m j iir dixe.isrs im m unnrlrhririu-\ dis. r j v i and tliro m r p ulm un ars diseases. there u r r r no r\|w isu rrs to A I D S Isclorc or d u rm c ih r tim e of the studs. T h irty - lo u r full-tim e s u iT m rm lsrrs w rrt studied ( I (> m rn an d J \ v o im c n i. 13 w e ir p h s s iria n s . 13 nurses. 4 l.ilx.rator\ u i l i m n . i ii s . and 4 allied health professionals Ages ra n c id Irom 22 to t'>s r.irs Im ra n ; S I)., 36-10). Peripheral-hit h*! niononuile.ir cells r r i tso latrd l>\ F ic o ll- H y p a q u e g rad ie n t d m s iis rn irifu g .iiin n I o ta l I cells, helper T cells, and suppressor I c r lK . x rr id e in ih e d m i l l fluorescein is o th io rx a n a ir--co n iu ca tc d m ono clo nal an tib o d ie s I.ru4. L e u - Ja . and L c u -2j t B e cto n D ick in s o n . M o u n ta in \ irxx. C a l i f .. respet ns els T h e earliest d e te rm in a tio n s sxrrr m ade v isu a lls w ith a Huoeesience micrtscope. but most sam ples err a n a lw .rd on a flu* oerseence-aem ated cell sorter I F A C S l\ . Breton Dickinson t in ter faced w ith a consort 440 com p uter sxstem O n in itia l screening. 7 ol the 34 t u r r e t s bad helper M iptnexsor T cell ratios o f 0 6 ..r less, and 4 ol ih r <1 had ratios u n d e r P M i. I he m ean ratio I ^ S . D . ) a s l . 7 * 0 o l t. ( I n a "n o rm a l g ro up ol 8 i l 3 blood donors in o ur area.* the m ean ratio w as 2 .0 * 0 .7 . an d o nly 1.9 per cent had valu es u n d e r O .fti.) O f the sr\ rn subjects w ith \ .slues o f 0.9 or less, six w ere pits siria n s . and one w as a lalm raio rs t r c h n ic ia n : fixe w ere m ale, and tw o fem ale: an d lou r w ere un der 33 y e ars o f age. and three w ere oxer 33. Persons w o rk in c in each o f the p e d ia tric su bsp ecialties w ere represen ted. A decrease in help er cells to less than 600 per cubic m illim e ter was observed in one subject, and an increase in suppressor cells to m ore than bOO per cu b ic m illim e te r was obserxed in four subjects. O n ly one subject had absolute ly m p h o p en ia at the lim e o f studs Fo u r s u b le ts w ith in itia l ratios under 0.83 haxe u n d e rg o n r re p ea trd studies oxer p eriods ra n c m c from i to .ltl_m o n th s. llL ^ lL tour. valu es liave re x e rtrd in m ore than I 2 alter p en o d s_o l scx_eral m o n th s: one su bject had a cy clic second d ro p and rise xxtth a p erio d icity o f one y ear. N o n e hax e had anx evid en ce o f im m u n e deficiency. Ped ia tricia n s in p a rtic u la r and hospital staff in general are probe ablx exposed to m ore infectio us illnesses than a general p o p u la tio n , and infrctionx can m use rexrrsed h elp ersun presso r T-Ccll ra tio s." "* H o w rv e r. the reduced ratios persisted in these pediatric stall m em bers for longer periods th a n those prex iouslx reported. T h is suggests that more persistent im m un olog ic s tim u li." perhaps related to the specific chronic diseases dealt w ith , max haxe been invo lve d in the altered ratios Pa lo A lto . C.A 94304 M.D.C a t h l r i s e S o m m a . J o h n J . M i l l e r . III. M.D.. Ph D. E a r l D. S i l v e r m a n . M.D. M i c i i a l i . P. L i n k . M.D. C h ild r e n 's H o s p ita l at S ta n fo rd Stanford L nixersnx School o f M e d ic in e I. Goetlicb M S . Schroff R. SchanLer H M . et ai f'/ iru m o o H ij r a n m i pneumo nia and mucosal candidiasis in previously healths homosexual men. e vi dence of a nc acquired cellular immunoderv.tencx N E n ti J M ed |9 K I; 303 1*23-31 2 Vieira J . Frani E . Spira T J. Landesman S H Acquired immune deficiency in Haitians opportunistic infections in prex sously healths Haitian immigrants N E n fi J Med 1983: 308 123 9 3 Curran J W Lawrence D V Ja fle H . et al Acquired imm ursiidcnocncs ss tsdrome i A ID S i assoctaied <ith tnnsfuxH*ns V EnpI J M ed 1984. 310 69- * 75 Komfetd H Siouwe R A V . Lance VI. Redds M M . G n cco M H T-lsmphocvie subpopulanons in homoxesual men \ Enel J Med 1982. 30~ 72931 5 Ptnchinc A l. M cM anus T J Jeffries 01. et al Studies of cellular immuntrs in male homosexuals in London Lancet |9 jj' 2 126-30 6 Lutsan N L C kcllcher I F Jr Rearr.ar. G H Altered disinhuison ol T-Is mpho- evie subpopulanons in children and a d o lcw cn o w.ih h .. rrK>philu L-irwct 1983. I 3 0 ' 3 }7 Landas A H n m M - C . Aha T Slagno S. L u n e V Crxpcr M D Immunologic siudies in assmpiomaiiv hcm iiphilu paiicnis J Clin Insest 198 7| I A.*- 4 8 Lifsoo ID Finch S L . Sasaki D T E n c k man E G v anahlex aflesimi: T Ismphocste subsets in xolumcer b lsO -do n.* population Clm lmmun<i' Imm unopjihol un pressi 9 De \laeie M Th elema ns C V n Camp B k G Choeos len/aiiun of immu norrpulaiors T cells in E B V -induced infs-vti*>u moehxsuc Icons hx monoclorsal antiNOiCs S' tn p l J Med I 98 I 3cu -7