title: Lung involvement in childhood measles: severe immune dysfunction revealed by quantitative immunohistochemistry.
abstract: Measles, accounting for nearly 1 million deaths each year, presents intense involvement of lymphoid organs and the lungs. The immune response in situ in the lungs was determined in blocks recovered from 42 necropsies of children who died from measles determined by immune cell phenotype (CD4, CD8, CD20, CD45RO, CD68, natural killer [NK], and antigen S-100 B [S100]) and cytokine production (interferon, tumor necrosis factor, interleukin [IL]-1, IL-2, IL-4, IL-10, and IL-12). Compared with the lungs of age-paired controls, patients with measles presented severe depletion of CD4+, CD20+, CD68+, NK+, and S100+ cells in alveolus- and bronchus-associated lymphoid tissue without depletion of CD8+ cells. Most of these features were similar in both forms of measles lung involvement, Hecht giant cell, or interstitial pneumonia, but S100+ cells were depleted in bronchus-associated lymphoid tissue from patients with Hecht pneumonia, which also occurs more frequently in malnourished children. IL-10- and IL-12-producing cells were depleted in patients with measles, whereas IL-1-, interferon-, and IL-4-producing cells were more frequently seen in the alveolus of patients with measles compared with controls. Quantitative in situ immune cell phenotype and function in the lung in measles demonstrated severe immune dysfunction, with loss of key cells, such as dendritic, CD4+, and NK+ cells, and deficient cytokine production, which allows for a better comprehension of local reactions in this process.
authors.affiliation: Laboratory of Pathology of Transmissible Diseases, Depto Pathology, Faculdade de Medicina da Universidade de São Paulo, CEP 01246-903 Brazil.
authors.forename: Tálib Moysés
authors.initials: TM
authors.lastname: Moussallem
authors.forename: Fernanda
authors.initials: F
authors.lastname: Guedes
authors.forename: Elaine Raniero
authors.initials: ER
authors.lastname: Fernandes
authors.forename: Carla
authors.initials: C
authors.lastname: Pagliari
authors.forename: Carmen Lucia Penteado
authors.initials: CL
authors.lastname: Lancellotti
authors.forename: Heitor Franco
authors.initials: HF
authors.lastname: de Andrade
authors.forename: Maria Irma Seixas
authors.initials: MI
authors.lastname: Duarte
mesh_terms: D000293:Adolescent; D000328:Adult; D000956:Antigens, Viral / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000378:metabolism; D003713:Dendritic Cells / Q000276:immunology / Q000473:pathology; D005260:Female; D015726:Giant Cells; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008168:Lung / Q000378:metabolism / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology; D008221:Lymphoid Tissue / Q000276:immunology / Q000473:pathology*; D008297:Male; D008457:Measles / Q000150:complications / Q000276:immunology / Q000473:pathology*; D018103:Morbillivirus / Q000276:immunology / Q000302:isolation & purification
chemical_list: D000956:Antigens, Viral; D016207:Cytokines