ANGIOCENTRIC
CD3+ T-CELL INFILTRATES IN HIV-1-ASSOCIATED CNS DISEASE IN
CHILDREN
C.D. Katsetos1, J.E. Fincke1, A. Legido2,
H.W. Lischner2, J.-P Chadarevian3, E.M. Kaye2, C.D. Platsoucas1,
and E.L.Oleszak4*. 1Department
Microbiology & Immunology, Fels Institute of Cancer Research
& Molecular Biology; 2Temple
University School of Medicine, Department of Pediatrics; 3Department
Anatomic Pathol. St. Christophers Hosp Children, Allegheny
University; 4Department Anatomy &
Cell Biology and Neurology, Temple University School of Medicine.
A substantial proportion of
brains examined at autopsy from children with AIDS show evidence
of mononuclear cell infiltration. Previous studies have shown
that these infiltrates are composed primarily of
monocytes/macrophages. We report here the presence of
angiocentric infiltrates comprised primarily of T cells in the
brains of children with AIDS. Perivascular infiltrates were found
in autopsy specimens from 5 of 6 children with AIDS and consisted
of CD3+ T-cells and in some cases, equal or greater proportions
of CD68+ monocytes/macrophages. Transmural mononuclear cell
infiltrates were found in one patient that consisted primarily of
CD3+ T cells, with an almost equal amount of CD68+ monocyte/
macrophages found only in certain vessels. There was a clear
majority of CD3+ T cells on the endothelial side of transmural
infiltrates. The majority of these cells were also CD8+ and
CD45R0+. The intervening brain neuropil, however, was dominated
by monocytes/macrophages/microglia, and reactive astrocytes with
very few CD3+/CD8+ cells present. Five of six patients showed
evidence of calcific vasculopathy, with only two exhibiting
HIV-1-encephalitis. One patient had multiple infarcts indicative
of a widespread mononuclear cell vasculitis. A second patient had
an old infarct associated with fibrointimal thickening of the
leptomeningeal vessels. These infiltrating T cells may be
responsible for HIV-1 associated CNS vasculitis and vasculopathy,
for endothelial cell injury, and for comprising the
blood-brain-barrier in children with AIDS.