OBJECTIVETo assess the efficacy and safety of Zhongyan-4 (ZY-4, a Chinese herbal preparation worked out according to the therapeutic principle of supplementing qi, nourishing Yin, clearing heat and detoxication) in treating HIV/AIDS patients in the early or middle stage.

METHODSAdopted was randomized double-blinded and placebo-parallel-controlled method, with 72 HIV/AIDS patients randomly divided into the ZY-4 group (36 patients) treated with ZY-4 and the control group (36 patients) treated with placebo. The treatment course was six months. The index of CD(4)(+), CD(8)(+) counts, body weight, clinical symptom scoring were estimated at 4 time points (0, 1, 3 and 6 month in the course), and also the viral load before and after treatment. The whole course of observation was completed in 63 patients, 30 in the ZY-4 group and 33 in the control group.

RESULTSCD(4)(+) count in the ZY-4 group got elevated by 7.70 +/- 150.96/mm(3) on average, while that in the control group lowered by 27.33 +/- 85.28/mm(3). Fifteen out of the 30 patients in the ZY-4 group had their CD(4)(+) count increased, which was evidently much higher than that in the control group (8/33, P < 0.05), suggesting that the efficacy of ZY-4 is superior to that of placebo in elevating CD(4)(+) count. Moreover, ZY-4 showed actions in elevating CD(45)RA(+) and CD(8)(+) count, reducing HIV virus load, improving clinical symptom/sign and increasing body weight of patients. No obvious adverse reaction was found in the clinical trial.

CONCLUSIONZY-4 has an immunity-protective and/or rebuilding function in HIV/AIDS patients in the early and middle stage, and also shows effects in lowering viral load, increasing body weight and improving symptoms and signs to a certain degree.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; virology ; Adult ; Anti-HIV Agents ; adverse effects ; therapeutic use ; Body Weight ; CD4 Lymphocyte Count ; CD4-CD8 Ratio ; Double-Blind Method ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; immunology ; virology ; Humans ; Leukocyte Common Antigens ; analysis ; Male ; Middle Aged ; Phytotherapy ; Viral Load

BACKGROUND: Human immunodeficiency virus (HIV) infection results in a selective CD4+ T cell depletion and an impairment of T cell regulation. Despite the immune depletion, the progression of HIV infection is accompanied by the stimulation of antibody synthesis. Thus, the prevalence and amplitude of the increase of total serum IgE level and the relationship between the IgE levels and the degree of immunodeficiency were evaluated in patients with HIV infection. METHOD: Twenty-six Korean adults infected with HIV, in different stages, were evaluated for serum IgE level and CD4+ T cell count. Serum IgG, IgM and IgA levels were also determined. All subjects enrolled in this study denied an individual and familial history of atopic diseases. The possibility of parasitic infestation was also excluded by history and stool examination. RESULTS: The mean serum IgE level was 473.5 IU/L with a standard deviation of 671.4 IU/L (range: 15.9~2000 IU/L) and increased serum IgE levels ( > 200 IU/L) were found in 38.5% of the study population. The mean serum IgG, IgA and IgM levels were 1,939.5 +/- 588.6 mg/dL (normal: 751~1,560 mg/dL), 388.9 +/- 216.7 mg/dL (normal: 82~453 mg/dL) and 153.6 +/- 75.3 mg/dL (normal: 46~304 mg/dL), respectively. The CD4+ T cell count was inversely correlated to the serum IgE level (r=-0.429, p < 0.05), but not to the other isotypes of immunoglobulin. CONCLUSION: Serum IgE levels are increased in adults with HIV infection and could be useful as a marker of disease progression. Further study is needed to elucidate the causes and clinical significance of these findings.
Adult ; CD4 Lymphocyte Count ; Eosinophils ; Female ; HIV Infections/*immunology/virology ; Human ; Immunoglobulin A/blood ; Immunoglobulin E/*blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Korea ; Leukocyte Count ; Male ; Middle Age ; RNA, Viral/blood

BACKGROUND AND OBJECTIVES: As human immunodeficiency virus (HIV) infection increases in prevalence and new medical therapies prolong the survival of HIV-infected patients, otolaryngologists will see a larger number of patients with head and neck manifestations of HIV infection. The aims of study were to evaluate the various otorhinolaryngologic diseases and to analyze the useful markers for predicting immune function in HIV-infected patients. SUBJECTS AND METHOD: Of 380 HIV-infected patients, 40 patients (10.5% ; 39 males and 1 female, age ranging from 23 to 55) were referred to otorhinolaryngologists. Spectrum of disease and correlation between various surrogate markers (HIV RNA, leukocyte count, neutrophil, lymphocyte, CD3, CD4, CD8 T cell percentage and count, CD4/CD8 ratio) and risk of infectious otorhinolaryngologic diseases were analyzed. RESULTS: Thirty-three patients (82.5%) were infectious, 6 patients (15.0%) had non-infectious diseases and 1 patient (2.5%) malignancy. In otologic diseases, acute otitis media and chronic otitis media were frequently found in the mentioned order. In rhinologic diseases, rhinosinusitis and vestibulitis were frequently found in the mentioned order, with one primary extra nodal non-Hodgkin's lymphoma. In laryngologic diseases, pharyngolaryngitis, oral candidiasis, stomatitis were frequently found. In the surrogate markers of immune function, CD4 percentage, CD4 count and CD4/CD8 ratio were found significantly lower in the infectious diseases than in the non-infectious disease. CONCLUSION: Of HIV-infected patients, 10.5% had seen an otolaryngologist, and the majority had infectious diseases. The risk of infectious diseases was strongly correlated with the CD4 percentage, count and CD4/CD8 ratio.
Biomarkers ; Candidiasis, Oral ; CD4 Lymphocyte Count ; Communicable Diseases ; Ear Diseases ; Female ; Head ; HIV ; HIV Infections ; Humans ; Leukocyte Count ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Male ; Neck ; Neutrophils ; Otitis Media ; Otolaryngology ; Otorhinolaryngologic Diseases ; Prevalence ; RNA ; Stomatitis

Introduction: White blood cell (WBC) count, from which neutrophil-to-lymphocyte count ratio (NLCR) can be derived, is commonly requested in the hospital setting among admitting patients with community acquired pneumonia (CAP). This study aims to establish the predictive value of WBC count and NLCR in classifying CAP which guides the clinicians in the choice of antibiotics and site-of-care. The researchers aim to evaluate the predictive value of WBC count and NLCR during consultation and admission in classifying patients with CAP based on the managementoriented risk stratification of the 2016 Philippine Clinical Practice Guidelines on CAP. Methods: This was a prospective cross-sectional study conducted in St. Luke’s Medical Center, Quezon City. Adult patients diagnosed with CAP were classified according to severity of infection based on the 2016 Philippine Clinical Practice Guidelines on CAP. WBC count of each patient was determined, and their corresponding NLCR was derived. The differences of WBC count and NLCR per risk were evaluated using chi-square and ANOVA test adjusted for the distribution of the outcome. Sensitivity and specificity of WBC and NLCR were determined for the following: (1) between CAP low risk (LR) versus CAP moderate risk (MR) and CAP high risk (HR) and (2) between CAP LR and CAP MR versus CAP HR. Receiver operating characteristic (ROC) curve was constructed to evaluate the sensitivity and specificity of WBC and NLCR in classifying. ROC curves displayed sensitivity versus 1-specificity such that area under the curve (AUC) ROC for WBC and NLCR. Results: Two hundred eighty (280) CAP patients from June 2016 until April 2017 were studied. Among the CAP patients, 69 (24.6%) were classified as LR, 172 (61.5%) were classified as MR, and 39 (13.9%) were classified as HR. The mean WBC count was 11,725.8 (±5,205.82)/ụl. The mean WBC per risk were as follows: 9,178/ụl for LR; 12,251/ụl for MR, and 13,916/ ụl for CAP HR. It showed that the higher the risk, the higher the mean of the WBC count (<0.00001). The mean NLCR was 8.9 (±8.4). The mean average of NLCR per risk were as follows: 5.4 for LR, 8.6 for MR, and 16.1 for HR. It showed that the higher the risk, the higher the NLCR (<0.00001). In predicting CAP patients with HR and MR from LR, the AUC of NLCR (0.700) was almost the same as that of the WBC count (0.698). In predicting CAP patients with HR from MR and LR, the AUC of NLCR (0.726) was higher than the WBC (0.621), indicating that NLCR is a fair predictive marker in distinguishing HR from MR and LR. Conclusion As the severity of CAP increases, the mean of the WBC count and NLCR increases. Between the two biomarkers, NLCR predicts CAP severity more than the WBC count. Furthermore, NLCR better predicts HR from MR and LR
Leukocyte Count

OBJECTIVE: To investigate the characteristics of T lymphocytic subsets in chronic tonsillitis patients for evaluation of their clinical implication. METHOD: Fresh peripheral blood samples were obtained from 54 chronic tonsillitis patients and 52 healthy counterparts. CD4+ and CD8+ T lymphocyte subsets including the naive (CD45RA+), memory (CD45RO+), functional (CD28+), activated (HLA-DR+, CD25+) and apoptosis (CD95+) T lymphocytes, were analyzed by flow cytometry, respectively. The clinical data such as serum Cystatin C con centration, ASO and ESR were simultaneously recorded from each chronic tonsillitis patient. RESULT: The CD4+ T cells, the rate of CD4+/CD8+ and CD4+ CD45RA+ /CD4+ CD45RO+, the CD4+ CD45RA+ T cells and the CD4+ CD25+ T cells in chronic tonsillitis were significantly lower than those of the control group (P < 0.05) while an obviously increasing percentage of memory (CD45RO+) and apoptosis (CD95+) T lymphocytes in chronic tonsillitis patients, and there were significant differences between the patients with chronic tonsillitis and the healthy volunteers (P < 0.05). Furthermore, in the chronic tonsillitis patients, Serum Cystatin C level was negatively correlated with CD4+ CD45RA+ T(P < 0.05), and not significantly correlated with other T lymphocyte subtypes (P > 0.05). CONCLUSION Immune disorder is present in the peripheral blood of chronic tonsillitis patients. Our data may provide valuable information for evaluation of disease progression of chronic tonsillitis patients.
Adolescent ; Adult ; CD4-Positive T-Lymphocytes ; Case-Control Studies ; Chronic Disease ; Female ; Flow Cytometry ; Humans ; Leukocyte Common Antigens ; Lymphocyte Count ; Male ; Middle Aged ; T-Lymphocyte Subsets ; Tonsillitis ; blood ; physiopathology ; Young Adult

OBJECTIVETo observe the effection of immune reconstitution efficiency and the immune function on Immune 2 with HAART to HIV/AIDS patients which poor immune reconstitution after HAART.

METHODTwo hundred and sixty four patients failure to immune reconstitution after HAART were randomly divided into treatment group (131 cases) and control group (133 cases), respectively, using Immune 2 plus HAART and placebo combined with HAART for 6 months. the CD4, CD8, CD45RA, CD45RO, CD4CD28, CD8CD28, CD8CD38, HLA-DR and CD4CD25 were observed in order to evaluate the immune reconstitution efficiency.

RESULTAfter the intervention for 6 months, the effective rate of treatment group (34.48%) was significantly superior to the control group (21.37%) (P = 0.0217). Treated group could significantly increased the CD4, CD45RA, CD45RO cell counts compared with control group (P < 0.05); CD8, CD3, CD4CD28 absolute count comparison between the two groups had no significant difference; CD8CD28 relative counting the treatment group group significantly increased (P < 0.05) compared to the control; CD4CD28, CD8CD38, CD8DR, CD4CD25 relative counting groups showed no significant difference.

CONCLUSIONImmune 2 can effectively improve the immune reconstitution efficiency, CD4 counts, CD45RA counts and CD45RO counts of patients after HAART, therefore promoting immune reconstitution.

Acquired Immunodeficiency Syndrome ; blood ; drug therapy ; immunology ; Adolescent ; Adult ; Aged ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Leukocyte Common Antigens ; blood ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the Immune No. 2 (2) on the immune reconstitution in patients with human immunodeficiency virus or acquired immune deficiency syndrome (HIV/AIDS) after highly active antiretroviral therapy (HAART).

METHODSA randomized, double-blind, placebo-controlled clinical trial was designed. 233 patients failing immune reconstitution after HAART were randomly divided into treatment group (116 cases) and control group (117 cases), respectively using Immune No. 2 plus HAART and placebo combined with HAART for 6 months. CD4, CD45RA, CD45RO cell numbers, as well as the symptoms, signs and integral improvement rates were observed in order to evaluate the immune reconstitution efficiency.

RESULTSafter the intervention for 1 month, the effective rate of the treatment group (18.97%, 22/116) was significantly higher than that of the control group (9.40%, 11/117) (P=0.02); 3 months after treatment, the effective rate of the treatment group (27.59%, 32/116) was no difference from that of the control group (22.22%, 26/117) (P=0.31); 6 months after treatment, the effective rate of the treatment group (34.48%, 40/116) was significantly superior to the control group (21.37%, 25/117) (P=0.02). CD4, CD45RA, CD45RO count of the treatment group was significantly higher than that of the control group (P<0.05). The total score of symptoms and signs in the treatment group was significantly lowered compared with the control group (P=0.02), and the improvement of fatigue, muscle and joint pain, pruritus and shortness of breath in the treatment group was better than the control group (P<0.05).

CONCLUSIONImmune No. 2 can effectively improve the numbers of CD4 cells and its subgroups, as well as the main clinical symptoms and signs of patients after HAART, thereby promoting the immune reconstitution.

Acquired Immunodeficiency Syndrome ; drug therapy ; immunology ; Adult ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Double-Blind Method ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Leukocyte Common Antigens ; metabolism ; Male ; Placebos ; Viral Load

The effect of prophylactic postoperative radiotherapy on peripheral lymphocyte count was determined for 20 cases of urogenital malignant tumors (bladder cancer-13 cases, prostatic cancer-4 cases, renal cancer-3 cases). The results were obtained as follows, l) Radiotherapy decreased the white blood cell count by a mean percentage of 16.7% (14.0% for bladder cancer, 16.4% for prostatic cancer. 36.8% for renal cancer, respectively) during the period of first month, but did not alter the granulocyte count. 2) Radiotherapy brought about high degree of decrease of peripheral lymphocyte count by a mean percentage of 47.9% (47. 3% for bladder cancer. 50.0% for prostatic cancer. 32.3% for renal cancer, respectively). 3) The recovery of the radiation-induced lymphocyte deficiency to pre-irradiation level was observed in 1-2 years after completion of radiation therapy (2 years for bladder cancer. 1 1/2 years for prostatic cancer. 1 year for renal cancer. respectively).
Granulocytes ; Kidney Neoplasms ; Leukocyte Count ; Lymphocyte Count* ; Lymphocytes* ; Prostatic Neoplasms ; Radiotherapy ; Urinary Bladder Neoplasms

OBJECTIVE: TNF-alpha related apoptosis inducing ligand (TRAIL) is a member of TNF superfamily that promotes apoptosis by binding to the transmembrane receptors. The effects of TRAIL in patients with rhematoid arthritis (RA) are still debatable. This study was performed to evaluate the effects of TRAIL on RA by measuring serum concentration of TRAIL in patients with RA and assessing relationships between the TRAIL concentration and various clinical parameters of RA. METHODS: A total of 105 patients with RA, 34 patients with osteoarthritis (OA), and 35 age- and gender-matched healthy controls were enrolled in this study. Data from the RA patients included subject's age, duration of disease, daily steroid doses, ESR, CRP, rheumatoid factor, leukocyte count, lymphocyte count, tender joint count, swollen joint count, and serum TRAIL concentration. Serum TRAIL concentration was measured by enzyme immunoassay (EIA) method. The serum concentration of TRAIL in RA patients was compared to those of OA patients and healthy controls. Relationships of TRAIL concentration with various clinical parameters were evaluated. RESULTS: Serum concentration of TRAIL in patients with RA was significantly decreased compared to that in healthy controls (RA: 42.60+/-26.39 pg/mL, control: 57.21+/-19.49 pg/mL, p=0.029). Serum concentration of TRAIL in patients with OA (50.79+/-15.92 pg/mL) was not different from that in normal controls (p=0.115). There were no significant differences in serum TRAIL concentration between patients with RA and those with OA (p=0.360). In patients with RA, serum TRAIL concentration showed no difference between high- and normal ESR subgroups, as well as high- and normal CRP subgroups. Serum TRAIL concentration correlated significantly with ESR (r=0.406, p<0.001). However, other clinical parameters, such as subject's age, duration of disease, daily steroid doses, CRP, leukocyte count, lymphocyte count, tender joint count, swollen joint count revealed no significant correlation with serum TRAIL concentration. CONCLUSION: Serum concentrations of TRAIL in RA patients were significantly lower than those in healthy controls, suggesting that apoptotic ability is decreased in the patients with RA. Serum TRAIL concentration does not seem to reflect disease activity of RA.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Humans ; Immunoenzyme Techniques ; Joints ; Leukocyte Count ; Lymphocyte Count ; Osteoarthritis ; Rheumatoid Factor ; Tumor Necrosis Factor-alpha

BACKGROUND: We evaluated residual leukocytes characteristics of white cell(WBC) reduction filter in platelet concentrates. Differential count and lymphocyte subset changes were measured before and after leukocyte filtration in platelet concentrates. MATERIAL AND METHODS: Ten units of platelet concentrates were prepared and were filtered with WBC-reduction filter(Sepacell PLS 5A, Japan). After filtration of blood products, WBC and differential leukocyte count and lymphocyte subsets were counted by microscopic examination of Wright-Giemsa stained smear and Facscan(Becton-Dickinson, USA). Monoclonal antibodies used for lymphocyte subset test were CD3(FITC), CD4(FITC), CD8(PE), CDl4(PE), CDl6(PE), CDl9(PE), CD33(PE), CD56(PE), IgGl(FITC), IgG2(PE). RESULTS: The main population of residual leukocytes after filtration was mainly lymphocytes(96.7%), and CD3 positive T lymphocytes showed 23.8% positivity of residual leukocyctes and the next were NK cell(8.7%). B lymphocytes were rarely found(<0.01%) and CD4/ CD8 ratio was within normal limits. CONCLUSION: The leukocyte reduction filters(Sepacell PLS-5A) would be effective for prevention of platelet alloimmunization but not sure about the effect for prevention of TA GVHD.
Antibodies, Monoclonal ; B-Lymphocytes ; Blood Platelets* ; Filtration ; Leukocyte Count ; Leukocytes* ; Lymphocyte Subsets ; T-Lymphocytes