GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR AND TUMOR-NECROSIS-FACTOR-ALPHA IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) TYPE-1INFECTION

Variations in cytokine production in patients with human immunodeficie ncy virus (HIV) infection could be involved in the physiopathology and in the progression of the disease. Therefore we studied the level of granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumor ne crosis factor alpha (TNFalpha) produced in patients with HIV infection at stage II (asymptomatic seropositives) and stage IV (AIDS) of the C DC classification, by using an enzyme amplified sensitivity immunoassa y. We measured the level of GM-CSF and TNFalpha in supernatant of phyt ohemagglutinin-activated peripheral blood mononuclear cells from patie nts and healthy individuals. In one out of 10 stage II patients and 4 out of 14 stage IV patients, we obtained higher levels of GM-CSF than the mean + 2 S.D. of controls, but in 3 stage IV patients with very lo w CD4+ lymphocyte counts (< 50/mm-3) compared to other patients, the G M-CSF values were very low. High levels of TNFalpha were detected in 3 out of 10 stage II and 6 out of 11 stage IV patients. The high values of TNFalpha were associated with high values of GM-CSF in stage II an d in most of AIDS patients except those with very low CD4+ T cell coun ts, who produced low levels of GM-CSF. Plasma levels of cytokines were evaluated in 10 stage II, 22 stage IV patients and 20 controls. Incre ased levels of GM-CSF (more than 9 pg/ml) were observed in the plasma from 8 out of 10 stage II patients and 17 out of 22 stage IV patients. The tendency that increased levels of GM-CSF were associated with inc reased levels of TNFalpha was observed in plasma from stage IV patient s. We report a disarray of GM-CSF production in patients with HIV infe ction that could be involved in clinical manifestations and progressio n of the disease.