Reduced Langerhans’ Cell Ia Antigen and ATPase Activity in Patients with the Acquired Immunodeficiency Syndrome

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Abstract
We investigated the possible role of a defect in antigen-presenting cells in the acquired immunodeficiency syndrome (AIDS), by enumeration of Langerhans' cells, the epidermal antigen-presenting cells. These cells were stained for the characteristic markers, surface la antigen and surface ATPase activity. A significant reduction was observed in the number of stained cells per square millimeter of body-surface area in 24 patients with AIDS and either opportunistic infections (la, 258±34, and ATPase, 274±46) or Kaposi's sarcoma (la, 378±100, and ATPase, 530±26), as compared with 38 appropriate controls (la, 721±13, and ATPase, 693±12). Examination of six patients with an "AIDS-related complex" revealed significantly reduced numbers of Langerhans' cells per square millimeter; this reduction was more pronounced in staining for la antigen (306±69) than in staining for ATPase activity (517±101). Given the known role of la expression in antigen presentation, we suggest that functional alterations in Langerhans' cells, and perhaps also in antigen-presenting cells in tissues other than skin, may be involved in the pathogenesis of AIDS. (N Engl J Med 1984; 310:1279–82.)