Changes to alveolar macrophage phenotype in HIV infected individuals with normal CD4 counts and no respiratory disease.

BACKGROUND: It has previously been shown that HIV infected individuals with pneumonitis have identifiable abnormalities in alveolar macrophages obtained by bronchoalveolar lavage (BAL). In particular, alterations in the expression of alveolar macrophage surface antigens associated with macrophage function have been reported. To determine whether these changes reflect HIV infection or the respiratory episode itself, a population of HIV infected patients with no respiratory disease was studied. METHODS: Twenty two HIV antibody positive individuals with a peripheral blood CD4 count of > 400/microliters and 10 healthy volunteer controls underwent bronchoscopy and BAL. Cytospin preparations from the recovered cells were stained using immunoperoxidase and double immunofluorescence techniques with monoclonal antibodies RFD1, RFD7, EBM11/CD68 (mature macrophages), UCHM1/CD14 (monocyte marker), and HLA-DR (RFDR1). Differential cell counts were also performed. RESULTS: There was an increase in overall alveolar macrophage HLA-DR expression in the HIV population. This was not reflected in a change in the percentage of cells staining CD14 (monocytes) or CD68 (mature macrophages) positive. The relative proportions of cells staining RFD1 + RFD7- (inducer cells), RFD1 - RFD7+ (effector cells), and RFD1 + RFD7+ (suppressive cells) were unchanged between HIV and control groups. CONCLUSIONS: In a population of HIV infected individuals with normal CD4 counts and no respiratory disease there was an increase in overall alveolar macrophage HLA-DR expression which occurred independently of any alteration in the relative proportions of alveolar macrophage subpopulations.

Antiretroviral treatment reverses HIV-induced reduction in the expression of surface antigens on alveolar macrophages in AIDS patients.

MoAbs and immunoperoxidase methods were used to identify antigen-presenting and phagocytic cells and to assess expression of HLA-DR molecules on cells obtained by bronchoalveolar lavage (BAL) from 33 AIDS patients and nine normal volunteers. In 17 patients, not receiving antiretroviral therapy, the expression of HLA-DR molecules (MoAb RFDR1) as well as the percentages of cells expressing RFD1 marker for antigen-presenting cells and RFD7 marker for mature phagocytes were significantly reduced. However, in BAL obtained after commencing treatment with zidovudine (AZT) in 21 patients or with 2',3'-dideoxyinosine (DDI) in five patients, the expression of the markers studied was found to have returned to levels of expression seen in normal lavages. The changes observed were clearly associated with antiretroviral treatment and did not correlate with applications of other drugs, blood CD4 counts or presence of infectious organisms in BAL fluid. As the alterations in the expression of HLA-DR molecules and RFD1 marker on macrophages have been shown to be associated with functional capacities of these cells, the reversal of impaired expression of phenotypic markers on alveolar macrophages in AIDS patients by AZT and DDI signifies an important ability of these drugs to modify immune reactivity and emphasizes the need to monitor such functions in HIV disease.

Alveolar macrophage populations are distorted in immunocompromised patients with pneumonitis.

Alveolar macrophages (AM) were obtained by bronchoalveolar lavage (BAL) from patients presenting with pneumonitis: 30 human immunodeficiency virus (HIV)-infected individuals and 12 transplant recipients. Nine normal volunteers acted as controls. The cells were washed and cytospins prepared. Monoclonal antibodies (MoAbs) and immunoperoxidase methods were used to analyse the expression of HLA-DR molecules as well as phenotypic macrophage markers. P values apply to the differences between medians using the Mann-Whitney test. Median percentages of macrophages, lymphocytes and neutrophils were similar in all three groups. No differences were found in the median percentages of macrophages expressing the monocyte phenotype (MoAb UCHM1, CD14). However, in HIV-infected patients and transplant recipients a median of only 45% of macrophages expressed the pan-macrophage phenotype identified by MoAb EBM11 (CD68) in contrast with 98% in the normal volunteers. The AM population expressing the dendritic cell marker (MoAb RFD1) was also markedly reduced in both groups of immunocompromised patients (2 vs 28% in normal volunteers). Transplant recipients had significantly more phagocytic cells identified by MoAb RFD7 than the HIV-infected patients (25 vs 2%), but the numbers were still low when compared with the volunteers (48%). HLA-DR expression on BAL cells was reduced by 90% in both immunocompromised groups. For the transplant recipients, severity of pneumonitis was correlated with expression of dendritic cell marker RFD1, (Spearman's rank correlation r = 0.538, p less than 0.05) and pan-macrophage marker EBM11 (r = 0.581, p less than 0.05), while no such correlation was found in HIV-infected patients. These results suggest that a defective macrophage population is probably a serious factor contributing to immunosuppression.

Antiamoebic and antiplasmodial activities of alkaloids isolated from Strychnos usambarensis.

Seven alkaloids isolated from Strychnos usambarensis have been assessed for in vitro activities against Entamoeba histolytica and Plasmodium falciparum and for in vivo activity against Plasmodium berghei in mice. Strychnopentamine and 3',4'-dihydrousambarensine were highly active against P. falciparum in vitro, but were inactive and non-toxic against P. berghei in vivo. Usambarensine, usambarine, and 18,19-dihydrousambarine were highly active against E. histolytica in vitro, but were less active against P. falciparum in vitro. Nb-Methylusambarensine was less active against both protozoa than was usambarensine, and akagerine possessed little antiprotozoal activity. Structure-activity relationships are discussed in the context of the reported cytotoxic and pharmacological properties of these alkaloids.

Antimalarial activity of Tanzanian plants and their active constituents: the genus Uvaria.

Petroleum ether, dichloromethane, and methanol extracts of leaves, stem, and root bark of nine Uvaria species: U. dependens, U. faulknerae, U. kirkii, U. leptocladon, U. lucida ssp. lucida, Uvaria sp. (Pande)k U scheffleri, and U. tanzaniae were tested for their in vitro activity against the multidrug resistant K1 strain of Plasmodium falciparum. The IC50 values of the extracts varied between 5 and 500 micrograms/ml. The most active extracts were obtained from the stem and root bark of U. lucida ssp. lucida and Uvaria sp. (Pande) and the root bark of U. scheffleri, all of which had IC50 values between 5 and 9 micrograms/ml. Among the compounds isolated, uvaretin, diuvaretin, and (8',9'-dihydroxy)-3-farnesylindole were the most active (IC50 = 3.49, 4.20, and 2.86 micrograms/ml, respectively).

Antimalarial activity of Tanzanian medicinal plants.

Tanzanian medicinal plants were extracted and tested for in vitro antimalarial activity, using the multidrug resistant K1 strain of Plasmodium falciparum. Of 49 plants investigated, extracts of three plants were found to have an IC50 between 5-10 micrograms/ml, extracts of 18 other plants showed an IC50 between 10 and 50 micrograms/ml, all others were less active. The three most active extracts were obtained from the tubers of Cyperus rotundus L. (Cyperaceae), the rootbark of Hoslundia opposita Vahl. (Labiatae), and the rootbark of Lantana camara L. (Verbenaceae).

Antimalarial compounds containing an alpha,beta-unsaturated carbonyl moiety from Tanzanian medicinal plants.

Pure compounds were isolated from plant extracts with antimalarial activity. The extracts were obtained from the tubers of Cyperus rotundus L. (Cyperaceae), the rootbark of Zanthoxylum gilletii (De Wild) Waterm. (Rutaceae), and the rootbark of Margaritaria discoidea (Baill.) Webster (Euphorbiaceae). The most active compounds included (IC50 within brackets): alpha-cyperone (1) (5.5 micrograms/ml), N-isobutyldeca-2,4-dienamide (2) (5.4 micrograms/ml), and securinine (3) (5.4 micrograms/ml). A mixture of autoxidation products of beta-selinene was found to be the most active antimalarial substances obtained from C. rotundus (5.6 micrograms/ml.

Antiplasmodial activity of Artemisia annua plant cell cultures.

Extracts of Artemisia annua cultures have been assessed for in vitro activity against the malarial parasite Plasmodium falciparum. Callus and suspension cells and medium were analysed and examined for their activity at different stages of growth and development. Time-course experiments were carried out to investigate the influence of various basal media, plant growth regulators and light on both growth and possible artemisinin production. Two active fractions were obtained but artemisinin was not detected.

Plants as sources of antimalarial drugs, Part 6: Activities of Simarouba amara fruits.

Extracts prepared from Simarouba amara fruits collected in Panama have been found to be active against Plasmodium falciparum in vitro and against Plasmodium berghei in mice. Four active quassinoids have been identified as ailanthinone, 2'-acetylglaucarubinone, glaucarubinone and holacanthone.

Plants as sources of antimalarial drugs, Part 4: Activity of Brucea javanica fruits against chloroquine-resistant Plasmodium falciparum in vitro and against Plasmodium berghei in vivo.

Extracts of Brucea javanica fruit have been prepared and monitored for their in vitro and in vivo antiplasmodial activities. The antimalarial activity of the fruit was found to be attributable to its quassinoid constituents. Nine of the quassinoids possessed in vitro IC50 values between 0.046-0.0008 microgram/ml against the chloroquine resistant Plasmodium falciparum strain (Kl) tested. The two quassinoid glycosides tested were considerably less active in vitro than the aglycones. Four quassinoids were found to possess activity in vivo against Plasmodium berghei infections in mice after oral dosing. All five quassinoids tested in vivo showed some toxicity.

Plants as sources of antimalarial drugs: in vitro antimalarial activities of some quassinoids.

Fourteen quassinoids, obtained from simaroubaceous plants, were tested for in vitro antimalarial activity. All of these inhibited the incorporation of [3H]hypoxanthine into Plasmodium falciparum in vitro at concentrations below 0.41 microgram ml-1. The two most potent quassinoids, bruceantin and simalikalactone D, showed 50% inhibitory concentration values of 0.0008 and 0.0009 microgram ml-1, respectively. The results are compared with the antiamoebic, antileukemic, and cytotoxic activities of these compounds reported in the literature.