Cytofluorographic analysis of lymph nodes from patients with the persistent generalized lymphadenopathy (PGL) syndrome.

Significant progress has been made in defining the clinical features, immunologic defects, and etiologic agent(s) of the acquired immune deficiency syndrome (AIDS) and its related disorders, but much remains to be learned about the natural history and pathogenesis of these diseases. Most immunologic studies to date have used peripheral blood lymphocytes or sections of lymph nodes for analysis. In this study lymph node cell suspensions from 37 patients with the persistent generalized lymphadenopathy syndrome (PGL) were phenotyped with monoclonal antibodies and flow cytometry and the results were compared with nodal suspensions from 49 patients with other types of reactive hyperplasia. Several significant differences were noted in the PGL nodes, including a decreased but not reversed T4/T8 ratio (1.44 vs 3.0, P less than 0.0001), a decreased percentage of T4+ lymphocytes, an elevation of T8+ lymphocytes, and increased numbers of activated lymphocytes. The shift in the T4/T8 ratio in PGL nodal suspensions was due primarily to a decrease in T4+ lymphocytes rather than in increase in T8+ cells. The possible specificity of these findings for infection by the AIDS agent and their potential prognostic utility are discussed.