From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: Re: KS and Immunosuppression
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6237
Organization: unspecified
Date: Mon, 28 Sep 92 08:52:30 PDT

Immunosuppressant drugs are extremely dangerous for HIV+ individuals. 
Infected cells, for the most part, can be activated without problems. 
You cannot treat AIDS by inactivating the T cell immune response. Both 
cyclosporine and FK506 (and probably the corticosteroids) act directly 
against T lymphocytes. If the cell mediated immune response is 
suppressed, there is little hope for survival.
***********************************************************************
Phillips A; Wainberg MA; Coates R; Klein M; Rachlis A; Read S; Shepherd 
F; Vellend H; Walmsley S; Halloran P.
                                     
Cyclosporine-induced deterioration in patients with AIDS.              
Canadian Medical Association Journal, 1989 Jun 15, 140(12):1456-60.
     
Abstract: 
Eight patients with AIDS (acquired immune deficiency syndrome) but free 
of life-threatening infection were treated with the immunosuppressive 
drug cyclosporine for a mean of 53.9 days. The serum cyclosporine levels 
were maintained in the desired therapeutic range. All eight patients 
experienced severe toxic symptoms, which necessitated discontinuation of 
cyclosporine therapy in six. The serum levels of creatinine, urea and 
potassium rose during treatment and fell after therapy was stopped. The 
total leukocyte count, hemoglobin level, platelet count, total T-cell 
count, and T4- and T8-cell counts all fell markedly during treatment. 
The total leukocyte count, platelet count, and T4- and T8-cell counts 
rose after therapy was stopped, but the hemoglobin level remained low. 
No patient experienced resolution of symptoms during therapy, and the 
condition of all patients improved after treatment was stopped. The 
results of this pilot study indicate that cyclosporine does not 
alleviate, and may worsen, the symptoms and laboratory findings in 
patients with AIDS.

************************************************************************
Langhoff E; McElrath J; Bos HJ; Pruett J; Granelli-Piperno A; Cohn ZA;
Steinman RM.

Most CD4+ T cells from human immunodeficiency virus-1 infected patients
can undergo prolonged clonal expansion.    

Journal of Clinical Investigation, 1989 Nov, 84(5):1637-43.

Abstract: 
We have addressed the capacity of HIV-1 infection to alter the growth
of primary CD4+ T cells, but at the clonal level. Single T cells were 
expanded in the presence of PHA, IL-2, and small numbers of accessory
dendritic cells. We report two new findings. First, T cells from
seropositive individuals, even those with AIDS and markedly reduced CD4+
counts, exhibit a normal cloning efficiency, and proliferative capacity.
This result is in contrast to two prior reports of a low cloning 
efficiency in CD4+ T cells from HIV-1-infected patients. Second, when we 
added high doses of exogenous HIV-1 to T cell clones from control 
subjects, we observed infection but not cytotoxicity or loss of CD4+ 
cells, following addition of virus stocks at days 0, 3, and/or 7 of 
clonal growth. The same HIV-1 isolates markedly reduced CD4+ T cells in 
bulk mononuclear cultures. When tested at day 11, HIV-1 mRNA was 
expressed in some cells of exogenously infected clones by in situ 
hybridization; when tested at day 18, several clones could transactivate 
a TAT-sensitive cell line. These findings suggest that the loss of CD4+ 
T cells in infected individuals is not the inevitable result of the 
activation of latent infection, or spread of a productive infection, 
during clonal growth.

Newsgroups: sci.med.aids