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Blood, Vol. 92 No. 6 (September 15), 1998:
pp. 2084-2092
Elevated Levels of Serum-Soluble CD14 in Human Immunodeficiency Virus
Type 1 (HIV-1) Infection: Correlation to Disease Progression and
Clinical Events
Egil Lien,
Pål Aukrust,
Anders Sundan,
Fredrik Müller,
Stig
S. Frøland, and
Terje Espevik
From The Institute of Cancer Research and Molecular Biology,
Norwegian University of Science and Technology, University Medical
Center, Trondheim, Norway; and the Section of Clinical Immunology and
Infectious Diseases, Medical Department A and Research Institute for
Internal Medicine, University of Oslo, The National Hospital, Oslo,
Norway.
Soluble (s) CD14, a marker for monocyte/macrophage activation and a
mediator of bacterial lipopolysaccharide (LPS) action, was elevated in
serum from human immunodeficiency virus type 1 (HIV- 1)-infected
individuals (n = 92) compared with seronegative controls. The highest
levels were found in patients with advanced clinical and immunological
disease. Patients with ongoing clinical events had significantly higher
sCD14 levels than symptomatic HIV-1-infected individuals without
clinical events, with especially elevated levels in patients infected
with Mycobacterium avium complex (MAC). On longitudinal testing
of patients (n = 26) with less than 100 × 106
CD4 lymphocytes/L at baseline, we found that increasing sCD14 serum
concentrations per time unit were associated with death, whereas no
differences in CD4 cell number decrease were found between survivors
and nonsurvivors. In vitro studies showed that HIV-1 glycoprotein 120 and purified protein derivative (PPD) from M avium (MAC-PPD)
stimulated normal monocytes to release sCD14. Furthermore, MAC-PPD
induced tumor necrosis factor (TNF) release from monocytes
through interactions with CD14 and, importantly, the addition of sCD14
enhanced this MAC-PPD stimulatory effect. Our findings suggest that the
CD14 molecule may be involved in the immunopathogenesis of HIV-1
infection, and it is conceivable that serial determination of sCD14 may
give useful predictive information concerning disease progression and
survival in HIV-1-infected patients.
© 1998 by The American Society of Hematology.
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