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Clinical and Diagnostic Laboratory Immunology, January 1999, p. 105-114, Vol. 6, No. 1
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Angiocentric CD3⁺ T-Cell Infiltrates in Human Immunodeficiency Virus Type 1-Associated Central Nervous System Disease in Children

Christos D. Katsetos,¹ John E. Fincke,¹ Agustin Legido,² Harold W. Lischner,³ Jean-Pierre de Chadarevian,⁴ Edward M. Kaye,² Chris D. Platsoucas,¹ and Emilia L. Oleszak^5,*

Department of Microbiology and Immunology¹ and Fels Institute for Cancer Research and Molecular Biology and Departments of Biochemistry and Neurology,⁵ Temple University School of Medicine, and Sections of Neurology² and Immunology,³ Department of Pediatrics, and Department of Anatomic Pathology,⁴ St. Christopher's Hospital for Children and Allegheny University of the Health Sciences, Philadelphia, Pennsylvania

Received 6 April 1998/Returned for modification 27 May 1998/Accepted 10 September 1998

A significant proportion of brain tissue specimens from children with AIDS show evidence of vascular inflammation in the form of transmural and/or perivascular mononuclear-cell infiltrates at autopsy. Previous studies have shown that in contrast to inflammatory lesions observed in human immunodeficiency virus type 1 (HIV-1) encephalitis, in which monocytes/macrophages are the prevailing mononuclear cells, these infiltrates consist mostly of lymphocytes. Perivascular mononuclear-cell infiltrates were found in brain tissue specimens collected at autopsy from five of six children with AIDS and consisted of CD3⁺ T cells and equal or greater proportions of CD68⁺ monocytes/macrophages. Transmural (including endothelial) mononuclear-cell infiltrates were evident in one patient and comprised predominantly CD3⁺ T cells and small or, in certain vessels, approximately equal proportions of CD68⁺ monocytes/macrophages. There was a clear preponderance of CD3⁺ CD8⁺ T cells on the endothelial side of transmural infiltrates. In active lesions of transmural vasculitis, CD3⁺ T-cell infiltrates exhibited a distinctive zonal distribution. The majority of CD3⁺ cells were also CD8⁺ and CD45RO⁺. Scattered perivascular monocytes/macrophages in foci of florid vasculitis were immunoreactive for the p24 core protein. In contrast to the perivascular space, the intervening brain neuropil was dominated by monocytes/macrophages, microglia, and reactive astrocytes, containing only scant CD3⁺ CD8⁺ cells. Five of six patients showed evidence of calcific vasculopathy, but only two exhibited HIV-1 encephalitis. One patient had multiple subacute cerebral and brainstem infarcts associated with a widespread, fulminant mononuclear-cell vasculitis. A second patient had an old brain infarct associated with fibrointimal thickening of large leptomeningeal vessels. These infiltrating CD3⁺ T cells may be responsible for HIV-1-associated CNS vasculitis and vasculopathy and for endothelial-cell injury and the opening of the blood-brain barrier in children with AIDS.

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^* Corresponding author. Mailing address: Fels Institute for Cancer Research and Molecular Biology, Temple University School of Medicine, 3309 N. Broad St., Philadelphia, PA 19140. Phone: (215) 707-7657. Fax: (215) 829-1320. E-mail: EOLESZAK{at}ASTRO.TEMPLE.EDU.

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Clinical and Diagnostic Laboratory Immunology, January 1999, p. 105-114, Vol. 6, No. 1
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

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