VIRUSMYTH HOMEPAGE


DISPUTING THE CD4 CELL THEORY
"Evidence suggests decrease in CD4 + T cells is not a death sentence"


Jim Kling (jkling@nasw.org) interviewed Louis J. Picker, associate director of the Vaccine and Gene Therapy Institute at the Oregon Health Sciences University, about his "Hot Paper" published in Nature Medicine (1). The interview was published in The Scientist on 14 May 2001.

"For several years, HIV-specific CD4+ memory/effector T cells (CD4+ T cells) have been at the heart of a debate surrounding the progression of AIDS. ...if the cell count were low or nonexistent, clinical AIDS was probably just around the corner."

"That argument did not sit well with Louis J. Picker, associate director of the Vaccine and Gene Therapy Institute at Oregon Health Sciences University in Portland. "The proliferation studies [used to measure the presence of CD4+ T cells] have a six-day readout time," he says. "It's been shown that you're measuring the overall ability of T cells to proliferate under those conditions." In other words, cells that don't thrive in vitro might die in culture. At the experiment's end, those cells would be under-represented, leading researchers to conclude mistakenly that little or no CD4+ T cells were present in the sample.(2)"

""The absence of these cells was being touted as the 'missing link.' That is, the defect responsible for why the immune system doesn't control HIV infection. Our data suggests it is more complicated than that.""

"Picker has made a career of developing flow cytometry methods, and he applied his work, already completed on other viral systems, to HIV. He and his colleagues spent five years perfecting the conditions that would provide consistent T cell activation... This way, the cells would not go through any replication cycles and the results would not be skewed."

"As indicated in this Hot Paper, Picker and colleagues found that these patients had surviving CD4+ T cell populations, albeit at low levels. Previous observations had indicated otherwise."

""There was no clear-cut association between viral load and the [numbers] of these cells," says Picker, suggesting that HIV-specific CD4+ T cell levels are not an accurate marker of disease progression."

Read the whole article from The Scientists.

References:

(1) C.J. Pitcher, C. Quittner, D.M. Peterson, M. Connors, R.A. Koup, V.C. Maino, L.J. Picker, "HIV-1-specific CD4(+) T cells are detectable in most individuals with active HIV-1 infection, but decline with prolonged viral suppression," Nature Medicine, 5:518-525, May 1999.

(2) L.J. Picker and V.C. Maino, "The CD4+ T cell response to HIV-1," Current Opinion in Immunology, 12:381-6, 2000.


VIRUSMYTH HOMEPAGE