title: Morphometric analysis of dendritic cells from anal mucosa of HIV-positive patients and the relation to intraepithelial lesions and cancer seen at a tertiary health institution in Brazil.
abstract: OBJECTIVE
  To morphometrically quantify CD1a+ dentritic cells and DC-SIGN+ dendritic cells in HIV-positive patients with anal squamous intraepithelial neoplasia and to evaluate the effects of HIV infection, antiretroviral therapy and HPV infection on epithelial and subepithelial dendritic cells.
  
  
  METHODS
  A prospective study was performed to morphometrically analyze the relative volume of the dendritic cells and the relationship between anal intraepithelial neoplasia and cancer in HIV-positive patients from the Tropical Medicine Foundation of Amazonas, Brazil. All patients were submitted to biopsies of anorectal mucosa to perform a classic histopathological and immunohistochemical analysis, employing antibodies against CD1a and DC-SIGN for the morphometric quantification of dendritic cells.
  
  
  RESULTS
  HIV-negative patients displayed a CD1a DC density significantly higher than that of HIV-positives patients (3.75 versus 2.54) (p=0.018), and in patients with severe anal intraepithelial neoplasia had correlated between DC CD1a density with levels of CD4 + cells (p: 0.04) as well as the viral load of HIV-1 (p: 0.035). A not significant rise in the median density of CD1a+ DC was observed in the HIV positive/ HAART positive subgroup compared to the HIV positive/ HAART negative subgroup. The CD1a+ DC were also significantly increased in HIV-negative patients with anorectal condyloma (2.33 to 3.53; p=0.05), with an opposite effect in HIV-positive patients.
  
  
  CONCLUSIONS
  Our data support an enhancement of the synergistic action caused by HIV-HPV co-infection on the anal epithelium, weakening the DC for its major role in immune surveillance. Notoriously in patients with severe anal intraepithelial neoplasia, the density of CD1a+ epithelial dendritic cells was influenced by the viral load of HIV-1. Our study describes for the first time the density of subepithelial DC-SIGN+ dendritic cells in patients with anal severe anal intraepithelial neoplasia and points to the possibility that a specific therapy for HIV induces the recovery of the density of epithelial DC.
authors: UFAM, Manaus, AM, Brazil. adriana.daumas@gmail.com
authors: Adriana Gonçalves Daumas Pinheiro
authors: AG
authors: Guimarães
authors: Roberto Moreira da
authors: RM
authors: Silva Junior
authors: Oscar Tadeu Ferreira da
authors: OT
authors: Costa
authors: Ivan Tramujas da Costa e
authors: IT
authors: Silva
authors: Felicidad Santos
authors: FS
authors: Gimenez
authors: José Ribamar de
authors: JR
authors: Araujo
authors: Rosilene Viana de
authors: RV
authors: Andrade
authors: Erico Jander da Silva
authors: EJ
authors: Lopes
authors: Jacqueline Pereira
authors: JP
authors: Pinheiro
authors: Junia Raquel D
authors: JR
authors: Ferreira
authors: Adriana
authors: A
authors: Malheiro
authors: Luiz Carlos de Lima
authors: LC
authors: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000276:immunology / Q000473:pathology* / Q000821:virology; D002278:Carcinoma in Situ / Q000276:immunology / Q000473:pathology* / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000473:pathology* / Q000821:virology; D016022:Case-Control Studies; D003218:Condylomata Acuminata / Q000276:immunology / Q000473:pathology* / Q000821:virology; D003713:Dendritic Cells / Q000276:immunology / Q000473:pathology* / Q000821:virology; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000276:immunology; D030361:Papillomavirus Infections / Q000276:immunology / Q000473:pathology; D011446:Prospective Studies; D055815:Young Adult