Immunocytochemical identification of T-cells in HIV-1 encephalitis: implications for pathogenesis of CNS disease.

T-lymphocytes enter the brain in viral encephalitides. The monoclonal antibodies UCHL1 and Leu22 are widely used to identify these cells; however, both antibodies cross-react with peripheral blood monocytes, cells ontologically related to brain macrophages and microglia. This study examines the nature of UCHL1- and Leu22-positive cells in HIV-1 encephalitis, and investigates whether they carry the gp41 epitope of HIV-1. Formalin-fixed sections of brain from eight AIDS patients were double-stained using combinations of UCHL1 and Leu22 antibodies with the lectin Ricinus communis agglutinin (RCA), a lectin that binds to microglia, macrophages, and multinucleated giant cells (MNGC), or antibody to the gp41 transmembrane protein of HIV-1 and UCHL1. Some sections were also stained with the OPD4 antibody to helper/inducer T-cells. Small round cells were single-stained for UCHL1 and Leu22 in all cases. A few cells having morphologic characteristics of microglia, macrophages, and MNGC were observed using double stains employing UCHL1 or Leu22 and RCA, or UCHL1 or Leu22 and anti-gp41. Small round cells positive for both UCHL1 or Leu22 and gp41 could represent either macrophages or lymphocytes. The presence of small round cells positive only for UCHL1 or Leu22 in double-stained sections strongly suggests that T-cells are present in the brain in HIV encephalitis. Only a few of these cells were positive with OPD4 antibody for T-helper cells. Inability to demonstrate unequivocally HIV-1-infected T-cells suggests that microglia and macrophages, not T-cells, are the more important reservoirs of retrovirus in the brain.(ABSTRACT TRUNCATED AT 250 WORDS)