Causes of increased and decreased helper T-lymphocytes (CD4)

Insufficient activity of T-suppressors leads to the predominance of the influence of T-helpers, which contributes to a stronger immune response (expressed antibody production and/or long-term activation of T-effectors). Excessive activity of T-suppressors, on the contrary, leads to rapid suppression and abortive course of the immune response and even phenomena of immunological tolerance (the immunological response to the antigen does not develop). With a strong immune response, the development of autoimmune and allergic processes is possible. High functional activity of T-suppressors does not allow the development of an adequate immune response, due to which infections and a predisposition to malignant growth prevail in the clinical picture of immunodeficiencies. The CD4/CD8 index value of 1.5-2.5 corresponds to a normergic state; more than 2.5 - hyperactivity; less than 1 - immunodeficiency. In severe cases of inflammation, the CD4/CD8 ratio may be less than 1. This ratio is of fundamental importance in assessing the immune system in patients with HIV infection. HIV selectively affects and destroys CD4 lymphocytes, resulting in the CD4/CD8 ratio decreasing to values significantly less than 1.

An increase in the CD4/CD8 ratio (up to 3) is often noted in the acute phase of various inflammatory diseases, due to an increase in the number of T-helpers and a decrease in T-suppressors. In the middle of the inflammatory disease, a slow decrease in the content of T-helpers and an increase in T-suppressors are noted. As the inflammatory process subsides, these indicators and their ratios normalize. An increase in the CD4/CD8 ratio is characteristic of almost all autoimmune diseases: hemolytic anemia, immune thrombocytopenia, Hashimoto's thyroiditis, pernicious anemia, Goodpasture's syndrome, systemic lupus erythematosus, rheumatoid arthritis. An increase in the CD4/CD8 ratio due to a decrease in the number of CD8 lymphocytes in the listed diseases is usually detected during an exacerbation and high activity of the process. A decrease in the CD4/CD8 ratio due to an increase in the number of CD8 lymphocytes is characteristic of a number of tumors, in particular Kaposi's sarcoma.

Diseases and conditions that change the CD4 count in the blood

Increase in the indicator

• Autoimmune diseases
• Systemic lupus erythematosus
• Sjögren's syndrome, Felty
• Rheumatoid arthritis
• Systemic sclerosis, collagenoses
• Dermatomyositis, polymyositis
• Liver cirrhosis, hepatitis
• Thrombocytopenia, acquired hemolytic anemia
• Mixed connective tissue diseases
• Waldenstrom's disease
• Hashimoto's thyroiditis
• Activation of antitransplant immunity (crisis of rejection of donor organs), increase in antibody-dependent cytotoxicity

Decrease in the indicator

• Congenital defects of the immune system (primary immunodeficiency states)
• Acquired secondary immunodeficiency states:
  • bacterial, viral, protozoal infections with a protracted and chronic course; tuberculosis, leprosy, HIV infection;
  • malignant tumors;
  • severe burns, injuries, stress; aging, malnutrition;
  • taking glucocorticosteroids;
  • treatment with cytostatics and immunosuppressants.
• Ionizing radiation