SERUM CYTOKINES AS PREDICTORS OF CLINICAL OUTCOME IN AIDS-RELATED INTESTINAL CRYPTOSPORIDIOSIS

Background Clinical variability in the natural course of cryptosporidi osis in patients affected by acquired immunodeficiency syndrome has be en correlated to rite degree of T-cell immunosuppression: however cryp tosporidiosis can occur as a self-limiting disease evert in patients w ith very low T-lymphocyte count,Aims, We tested the serum values of a panel of cytokines in AIDS patients with cryptosporidial enteritis in order to evaluate their role in predicting the clinical outcome of the disease. Patients and Methods. Thirty one HIV-positive patients with cryptosporidiosis and a CD4+ count of less than 100/mm(3) were studied Interleukin-2, Interleukin-4, Interleukin-10, Interferon-gamma, Inter leukin-12, Tumor Necrosis Factor a values were measured in serum at di agnosis. Results Interleukin-4 and Interleukin-10 concentration was si gnificantly lower in patients with mild disease whereas serum Interleu kin-2 and -12 was higher in this same group. The serum level of Interf eron-gamma did not differ in relation to the severity of the disease. Patients with self-limiting diarrhoea showed significantly lower level s of Tumor Necrosis Factor-alpha than subjects, who did not show any c linical improvement. Conclusions. In our study, it has been shown that cytokine levels in serum represent early predictive markers both for the severity of symptoms and the clinical outcome of cryptosporidial e nteritis in AIDS patients with a low CD4+ count.