Recurrent respiratory papillomatosis: altered CD8(+) T-cell subsets and T(H)1/T(H)2 cytokine imbalance.
Human papillomaviruses (HPVs) cause benign papillomas and squamous cell carcinomas in the genital and respiratory tracts. Recurrent respiratory papillomas (RRP) generate a high level of morbidity and significant mortality because of their location, resistance to treatment, and relentless recurrence that can vary in frequency in a given patient and between patients. We have found that T-cells from these patients, when exposed to or isolated from autologous papilloma tissue, have an elevated percentage of CD8(+), CD28(-) T-cells, and that T-cells from many of these patients express an increase in T(H)2-like cytokine mRNA in response to autologous papilloma tissue. Furthermore, both of these immunologic findings correlate with disease severity. These observations suggest that patients with RRP, and possibly others with refractory HPV-induced lesions, are unable to manage their disease with an appropriate and effective HPV-specific, T-cell response. This immune imbalance may be responsible for the development and severity of HPV-induced respiratory papillomatosis.
Bonagura
V R
VR
Department of Pediatrics, Schneider Children's Hospital, Long Island Jewish Medical Center, 269-01 76th Avenue, New Hyde Park, New York 11040, USA. bonagura@lij.edu
Hatam
L
L
DeVoti
J
J
Zeng
F
F
Steinberg
B M
BM
D000293:Adolescent; D000328:Adult; D018106:CD28 Antigens / Q000096:biosynthesis / Q000235:genetics; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007822:Laryngeal Neoplasms / Q000276:immunology / Q000473:pathology / Q000601:surgery; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000473:pathology / Q000601:surgery; D010212:Papilloma / Q000276:immunology / Q000473:pathology / Q000601:surgery; D012333:RNA, Messenger / Q000378:metabolism; D012142:Respiratory Tract Neoplasms / Q000276:immunology / Q000473:pathology / Q000601:surgery; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets / Q000276:immunology; D018417:Th1 Cells / Q000737:chemistry; D018418:Th2 Cells / Q000737:chemistry
D018106:CD28 Antigens; D016207:Cytokines; D012333:RNA, Messenger