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*
Unité dOncologie Virale, Département SIDA et Rétrovirus, Institut Pasteur, Paris, and
Service des Maladies Infectieuses et Tropicales, Hôpital Militaire Bégin, Saint Mandé, France
It has been proposed that HIV infection is associated with an
imbalance in Th1 and Th2 subsets. Recent reports indicate that Th1 and
Th2 effectors differ in their susceptibility to activation-induced
apoptosis. To determine whether increased T cell apoptosis in
HIV-infected patients contributes to alterations in cytokine synthesis,
we performed single-cell analysis of type 1 and type 2 cytokine
production by CD4 and CD8 T cells, simultaneously with detection of
apoptosis. We demonstrate that a differential alteration in
representation of Th1 subsets, rather than commitment of T cells to
secrete Th2 cytokines, occurs throughout HIV infection. A significant
decrease in the number of IL-2- or TNF-
-producing T cells was
observed, whereas those producing IFN-
remained preserved.
Furthermore, there is a gradient of susceptibility to
activation-induced apoptosis (IL-2 < IFN-
< TNF-
) among
the different Th1 subsets. This gradient was detected in both CD4 and
CD8 subsets, as well as in control donors and HIV-infected patients, in
whom the susceptibility to apoptosis of IL-2 and IFN-
producers was
increased compared with controls. This differential intrinsic apoptosis
susceptibility of Th1 effectors was found to be tightly regulated by
Bcl-2 expression. In HIV-infected persons, disappearance of
IL-2-producing T cells was a good indicator of disease progression and
was correlated with the progressive shrinkage of the
CD4+CD45RA+ T cell compartment and a
gradual increased susceptibility to activation-induced apoptosis of the
IL-2-producing subset. This close relationship between the
CD45RA/CD45R0 ratio, the level of type 1 cytokine production, and
susceptibility to apoptosis should be considered in HIV-infected
patients under antiviral or immune-based therapies.
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