Reduced Langerhans' Cell Ia Antigen and ATPase Activity in Patients with the Acquired Immunodeficiency Syndrome

• Published in: The New England journal of medicine Vol. 310; no. 20; pp. 1279 - 1282
• Main Authors: Belsito, Donald V, Sanchez, Miguel R, Baer, Rudolf L, Valentine, Fred, Thorbecke, G. Jeanette
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 17.05.1984
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - enzymology; Acquired Immunodeficiency Syndrome - immunology; Adenosine triphosphatase; Adenosine Triphosphatases - metabolism; Adolescent; Adult; AIDS; AIDS-related complex; AIDS/HIV; Antigen presentation; Antigen-presenting cells; Biological and medical sciences; Biopsy; Cell Count; Circumcision; Enumeration; Female; Gene expression; Histocompatibility Antigens Class II - analysis; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunodeficiency; Immunopathology; Infections; Kaposi's sarcoma; La antigen; Langerhans Cells - enzymology; Langerhans Cells - immunology; Light; Male; Medical sciences; Middle Aged; Patients; Skin; Stains & staining; Women; Human; Infection; Immunopathology; Kaposi sarcoma; Skin disease; Enzymatic activity; Langerhans cell; ATPase; AIDS; Skin; Ia-System
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM198405173102002

We investigated the possible role of a defect in antigen-presenting cells in the acquired immunodeficiency syndrome (AIDS), by enumeration of Langerhans' cells, the epidermal antigen-presenting cells. These cells were stained for the characteristic markers, surface la antigen and surface ATPase activity. A significant reduction was observed in the number of stained cells per square millimeter of body-surface area in 24 patients with AIDS and either opportunistic infections (la, 258±34, and ATPase, 274±46) or Kaposi's sarcoma (la, 378±100, and ATPase, 530±26), as compared with 38 appropriate controls (la, 721±13, and ATPase, 693±12). Examination of six patients with an "AIDS-related complex" revealed significantly reduced numbers of Langerhans' cells per square millimeter; this reduction was more pronounced in staining for la antigen (306±69) than in staining for ATPase activity (517±101). Given the known role of la expression in antigen presentation, we suggest that functional alterations in Langerhans' cells, and perhaps also in antigen-presenting cells in tissues other than skin, may be involved in the pathogenesis of AIDS. (N Engl J Med 1984; 310:1279–82.) ALTHOUGH it is known that patients with the acquired immunodeficiency syndrome (AIDS) have abnormally low numbers of OKT4+ cells in their peripheral blood, 1 , 2 it has not been established that this is the primary event in the disease. T-cell abnormalities may, for instance, be secondary to — or accentuated by — generalized B-cell activation, which is also present in such patients, 2 , 3 or may be brought about by defects in the antigen-presenting cell system. Langerhans' cells function as the antigen-presenting cells of the skin. 4 They are the only cells in the normal epidermis that have surface ATPase activity 5 and Ia antigen 6 ; . . .