Document yrD99ypv6oEqZGaVgEjXaz5e4

p/\ Zoos' O N D F .M F I =>n m- A B N O R M A L HELPER b l PPRF.SbOR T-CLLL RATIO IN THE STAFF OF A PEDIATRIC HObPITAL To tht Editor A n inv crie d ratio o f helper to suppressor T cell> due to decreased n u m b ers of helper T cells is found in patients w ith A I D S ' J and in healths but high-risk p op ulation s * T h e ratio itself has been used as a d iag n ostic aid U 'c have found a reversed helper suppressor T-cell ratio with an unexpectedly high frequency among healthy staff m em bers of a p ed iatric chronic disease hospital None o f those studied were in a hieh-risk group A lth o ug h the hosoital specializes in omoIngN rh e u m a tic diseases im m u n i< rirli(iriicv <|is. rases. and ch ro nic p u lm o n ary diseases, there were nn rs|K>sures in A I D S lic lo rr or d u rin c the tim e of the study 1 h i m -lour full-tim e staff meml>rn> w ere studied I I f 1m m and J I w o m e n !; 13 w e ir p hvstcians. 13 nurses. -1 I.ite ra to rs let litm i.nis and 4 allied health professionals Aces rancerl from 22 to ti't sears (m ean r S l ) . 3 6 - KM Pcriph eral-hli*! m ononuclear cells wert isolated l>s F ic o ll- H v p a q u r grad ien t density t cttm lug .itton I o la l I cells, helper T cells, and suppressor I r rlls .w e re id e n tilic d it 1 fluorescein isothiocs anait--conjugated m onoclonal antibodies I.ru4. Leu-3a. and Leu-2a iB e c to n D ickin so n . M in im u m \ i r w . C a l i f ; , respectively T h e earliest determ inations were made visually w ith a fluo erstence micrtscope but most sam ples *err analy zed on a Huoerscence-actiy ateef cell sorter I F A O N I\ . Bre to n D ick in s o n I in te r faced w ith a consort 440 com puter system O n in itia l screening. 7 ol the 34 subjects had helper supp iesvor J cell ratios o f 0,9 or less, and 4 ol die <I had ratios u n der 0 H i i he m ean ratio ( r b . D ) a s l.7 = (J.0*J. ( I n a " n o r m a l" g ro up ol 8715 blood donors in o ur a re a ." the m ean ratio vs as 2.0 --0.7. and only I .9 per cent had values under 0.85.) O f the seven subjects w ith values of (J.9 or less, six ssere phs siria n s . and one vs as a lain ira tors te c h n ic ia n : five H ere m ale, and tw o fem ale; and lour w ere under 35 years ol ace. and three vs ere ov er 35. Persons w o rk in c in each o f the p ed iatric su bsp ecialties vs ere represented. A decrease in help er cells to less than 600 per cu b ic m illim e te r w as observ ed in one subject, and an increase in suppressor cells to more than 600 per cu b ic m illim eter vsas observed in four subiects. O n ly one subject had ab so lu te lvmp ho pem a at the tim e o f studs Fo u r subiects w ith in itia l ratios under 0.85 have un dercone re peated studies over periods ra n c m c Irom .3 to 3d m onths. In all Tour, valu es have re v e rtrd ( m ore than I 2 alter periods_ol sev eral m onths; one subieci had a cvchc second drop and rise w ith a periodicity of one sear. N one have had anv evidence of im m une deficiency. Ped ia tricia n s in p a rtic u la r and hospital staff in general arc pro!* ablv exposed to more infectious illnesses than a general p o p u latio n , and infections ran cause rev ersed help er suppressor T - c ril ra tio s ." H o vsrver. the reduced ratios persisted in these p ed iatric stall m em bers for longer periods than those p reviously reported. T h is suggests that more persistent im m un ologic s tim u li." perhaps related to (he specific chronic diseases dealt w ith , may have been involv ed in the altered ratios Palo A lto . C.A 94304 C a th erin e Som m a. M .D J ohn J M iller . IH . M .D . P h D E arl D Silv er m a n . M .D . M iciiaei P L in k . M .D C h ild re n 's H ospital at Stanford Stanford L'niversitv School of M ed icine 1. G onlieb M S . Schroff R . Schanker H.M. ci al Pnrumnrxsm connu pneumonia and mucosal candidiasis in previously health) homosexual men. e v i dence of a nc acquired cellular immunodcfKiencv N E n t i J M ed 19X1. 303 105-31 2. Vieira J . FranL E . Spira T J. Landcsm an S H Acquired immune dctiocncv in Haitians opportunistic infections in previously health) Hainan im m ifrants. N Engl J Sled 19X3. 30* 125-9 3 Curran JV. Lawrence D V Jafle H. ci al Acquired im m urxdcncicncv syndrome lA lD S i associated ith iransfuvKXW N Enpl J Med IVX4. 310.69- 75 4 Kornfeld H Siouw c R A V . Lance M Rrdd\ M M . Cricco M H T-lvm- phocvie subpopulanons in hom osC'ual men N Enel J Med 19X2. 3U~ 72V31 5 Pmchinp A J. M cM anus T J Jeffn cv D J. ci al Studies of cellular immunity in male homosexuals in London Lancet IV g i 2 126-30 6 Luban N L C . Kclleher JF Jr Rcamar- G H Altered disinhulion of T-Ivmpho evie subpopulaiioos in children and adolcwcm v with hzmi*philij Lancet 19*3. I 503 5 7 Landav A. Roon M -C . Aha T Stagno S Lu rie A Cooper V1 Im m unolog. c studies in a iv m p u 'r n a tii h e m o p h ilia p aiicm - J C lin In vest IVK.1 7| I5cxi- 4 * Lifson JD Finch S L . Sasaki DT Enck m an EG Venables aflrviiny' T Ivm phocvlc subsets in a volunteer b k **J donor population C lin Im m uni' 1 Im m unopalhol un p re l 9 De 9- aele M . Thtelemans C . \ an Camp B k G Charui vcnraiion of immu norr|.-ulalt>rv T cells in E B 1; -induced inftvtnHj mtnonuc Icon v hv mmvclonal aniihod.es N Enel J M ed I9 S I. ,V>a -h a s :