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L M Clarke

Publications and source records attributed to L M Clarke.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Markers of human immunodeficiency virus infection in pediatric bronchoalveolar lavage samples.

Pulmonary cells and fluid obtained by bronchoalveolar lavage (BAL) from 19 pediatric acquired immunodeficiency syndrome (AIDS) patients with pneumonia were examined for markers of human immunodeficiency virus (HIV-1) infection. The HIV-1 DNA was detected in BAL cells by polymerase chain reaction (PCR) in 14 of 15 patients (93.3 percent). Immunostaining of cytocentrifuged cell preparations of six specimens revealed that HIV-1 antigen was associated with from five percent to 95 percent of the alveolar macrophages. Analysis of the 22 cell-free BAL fluids by enzyme immunoassay (EIA) showed that samples from three patients (15.8 percent) contained HIV-1 p24 antigen. One sample, with a dilution factor of 15.1 relative to serum, contained a markedly elevated antigen concentration (106 pg per ml) compared to the serum concentration (41.6 pg per ml). Antibodies to HIV-1 were present in the BAL fluids of six patients (31.6 percent) at levels detectable by EIA. By Western blot analysis, three samples yielded more intense gp120 bands compared to bands observed with matched serum samples. Our results suggest that HIV-1 and antibodies to this virus are frequently present in the lungs of children with AIDS and that the serum antigen and antibody profile of some patients does not reflect local pulmonary levels.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Characterization of cells, immunoglobulins, and immune complexes present in the bronchoalveolar lavage of pediatric AIDS patients.

The role of local immunity in relation to the frequent and heterogeneous pulmonary manifestations of HIV-1 infection in children is poorly understood. In order to examine lung immunity in pediatric AIDS patients, the cellular composition, immunoglobulin, and immune complex (IC) levels were evaluated in 23 samples of bronchoalveolar lavage (BAL) fluid and peripheral blood from 19 pediatric AIDS patients with acute pulmonary pathology. The patients were of two age groups: 4.0-21.5 months (N = 9) and 2.3-13.1 years (N = 10). In BAL, lymphocytes were elevated in 25-45% of samples, and neutrophils were elevated in 27-33%; BAL macrophages varied in percentage (28-99%) but had normal morphology. The blood differentials of pediatric AIDS patients undergoing BAL did not show significant differences when compared with a group of pediatric patients with tuberculosis, but leuko- and neutropenia was noted when compared with pediatric patients with pneumonia and no HIV disease. Of the immunoglobulins measured (IgG, IgM, IgA) only IgG was detectable in unconcentrated BAL fluid (1-37 mg/dl, equivalent to 12-630 mg/dl in the epithelial lining fluid after correction using urea as a marker of dilution). All patients were hypergammaglobulinemic and 83% had high levels of circulating IC (2-40 muEq/ml). Six BAL specimens (26%) also contained IC. The estimated level of IC in lung epithelial lining fluid (after correcting for dilution) was up to fivefold higher than IC concentration in corresponding sera. Specific antibodies to HIV-1 were demonstrated in 35% of the BAL samples by ELISA and in 65% by Western blotting.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗