Interleukin-6 synthesis and IgE overproduction in children with perinatal human immunodeficiency virus-type 1 infection

Background: Unbalanced interleukin network and elevated IL-6 synthesis an s uggested mechanisms of immunoglobulin overproduction in children with perin atal human immunodeficiency virus-type 1 (HIV-1) infection. Objective: To investigate whether elevated IL-6 synthesis is a general mech anism of immunoglobulin overproduction in perinatal HIV-1 infection. Methods: In vitro spontaneous and phytohaemoagglutinin (PHA)-stimulated IL- 6 and IL-2 synthesis, serum IgE, IgG, IgA, and IgM levels, CD4(+) T-lymphoc yte counts, and HIV-1 RNA copy numbers were cross-sectionally determined in 31 children with perinatal HIV-1 infection. Children with immunoglobulin z -scores in the highest quartile were defined as children with high immunogl obulin level. Relationships between interleukin synthesis, high immunoglobu lin levels, and HIV-1 related disease were studied. Results: Children with high IEE levels had higher spontaneous IL-6 synthesi s (1337 +/- 138 pg/mL) compared with those without high IgE levels (861 +/- 194 pg/mL; P < .001). By contrast, spontaneous IL-6 synthesis was similar in children with or without high IgG, IgA, or IgM levels. Decreased PHA-sti mulated IL-2 synthesis, low CD4(+) lymphocyte counts, elevated HIV-1 RNA co py numbers, and severe disease correlated with high IEE (but not IgG, IgA, and IgM) levels. IgG, IgA, and ISM levels correlated with each other, but n ot with IgE levels. Conclusion: The increased IL-6 synthesis in HIV-1(+) children may affect Ig E rather than other immunoglobulin isotype levels. Overall results suggest that IgE and IgG, IgA, IgM overproduction have distinct underlying mechanis ms.