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Reasons for the increase and decrease in T-helper lymphocytes (CD4)
Last reviewed: 19.10.2021
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Insufficient activity of T-suppressors leads to the predominance of the influence of T-helpers, which contributes to a stronger immune response (pronounced antibody production and / or prolonged 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 to the 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, and therefore the clinical picture of immunodeficiency is dominated by infections and predisposition to malignant growth. The CD4 / CD8 index value of 1.5-2.5 corresponds to the normal state; more than 2.5 - hyperactivity; less than 1 - immunodeficiency. In severe 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, as a result of which the CD4 / CD8 ratio decreases to values significantly less than 1.
An increase in the ratio of CD4 / CD8 (up to 3) is often noted in the acute phase of various inflammatory diseases, by increasing the number of T-helpers and reducing 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. When the inflammatory process subsides, these indicators and their ratios are normalized. An increase in the CD4 / CD8 ratio is characteristic of virtually all autoimmune diseases: hemolytic anemia, immune thrombocytopenia, Hashimoto thyroiditis, pernicious anemia, Goodpasture syndrome, systemic red wolf, rheumatoid arthritis. An increase in the ratio of CD4 / CD8 due to a decrease in the number of CD8-lymphocytes in these diseases is usually detected with 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 leading to changes in the amount of CD4 in the blood
Increase in the
- Autoimmune diseases
- Systemic lupus erythematosus
- Sjogren's syndrome, Felty
- Rheumatoid arthritis
- Systemic sclerosis, collagenoses
- Dermatomyositis, polymyositis
- Cirrhosis of the liver, hepatitis
- Thrombocytopenia, acquired hemolytic anemia
- Mixed connective tissue diseases
- Waldenström's disease
- Thyroiditis Hashimoto
- Activation of anti-transplantation immunity (a crisis of rejection of donor organs), an 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;
- reception of glucocorticosteroids;
- treatment with cytostatics and immunosuppressants.
- Ionizing radiation