Demonstration of defective C3-receptor-mediated clearance by the reticuloendothelial system in patients with acquired immunodeficiency system

The function of macrophage C3 receptors was assessed in vivo by measuring the clearance of C3-sensitized autologous erythrocytes in seven acquired immunodeficiency syndrome (AIDS) patients, eight healthy homosexual men, eight healthy heterosexual men, and four infected controls. Healthy heterosexual men had an initial clearance of 50.1 ± 2.0% of the inocolum, with a release of a small portion of these cells (10.9 ± 1.3%) into the circulation. Healthy homosexual men had a greater initial clearance of 66.0 ± 4.2% (P < 0.01) followed by a similar release (14.0 ± 3.3%). AIDS patients had an initial clearance of 60.6 ± 7.5% but had a relatively large release of cells (25.6 ± 3.2%) (P < 0.005 vs. heterosexuals; P < 0.05 vs. homosexuals), suggesting a failure of macrophage phagocytosis. Infected controls had an initial clearance of 59.4 ± 4.9%, with a release of 19.6 ± 3.8% (P = NS vs. AIDS). These data, in addition to Fc-receptor dysfunction, demonstrate a global reticuloendothelial system dysfunction in AIDS patients. This may contribute to their frequent infections with opportunistic pathogens and inappropriate immune responses against these microorganisms.