ABSTRACT
HIV infections frequently affect the oral cavity, and local changes may be utilized as indicators of immunosuppression in HIV-positive patients. Morphometric and morphological features of the lining, masticatory, and specialized epithelium of the oral mucosa were studied in 12 HIV-positive and 12 HIV-negative patients autopsied from 2007 to 2010. Mucosal samples from the cheek, gingival, and tongue of 24 individuals were fixed in Carnoy solution and stained with hematoxylin-eosin. Various morphometric characteristics (epithelial thickness, number of cell layers, mean cell diameter) and morphological parameters (basal layer hyperplasia, exocytosis of inflammatory cells, glycogenic acanthosis, cell ballooning degeneration) were then measured. The HIV-positive group had a greater epithelial thickness (mean: 304.4µm) and a higher mean cell diameter (11.84µm), whereas the HIV-negative group had more epithelial layers (26.7). Basal layer hyperplasia did not differ significantly between the two groups, but exocytosis of inflammatory cells, glycogenic acanthosis, cell ballooning, and spongiosis were more prevalent in the HIV-positive group. Our findings demonstrate that HIV infection causes diverse epithelial changes in the oral cavity, including thickening, increased cell diameter, increased migration of inflammatory cells, and inter- and intra-cellular edema.
Subject(s)
Epithelial Cells/pathology , HIV Infections/pathology , Mouth Mucosa/pathology , Adult , Autopsy , Brazil , CD4-CD8 Ratio , Case-Control Studies , Epithelial Cells/immunology , Epithelial Cells/virology , Female , HIV Infections/immunology , HIV Infections/virology , Humans , Inflammation/immunology , Inflammation/pathology , Inflammation/virology , Male , Middle Aged , Mouth Mucosa/immunology , Mouth Mucosa/virology , Staining and Labeling , Viral LoadABSTRACT
OBJECTIVE: The objective of this study was to examine mononuclear cell subpopulations and evidence of cellular activation in unaffected jejunal mucosa in Crohn's disease. DESIGN: A cross-sectional study was performed in patients with Crohn's disease from the ambulatory unity of the University Hospital, UFRJ. METHODS: Mucosal samples from 20 patients with Crohn's colitis or ileitis were obtained by peroral jejunal biopsy. Patients with jejunal involvement or pregnant women were excluded from the study. Specimens were analysed histologically and by indirect immunoperoxidase method using anti-monoclonal antibodies to CD2, CD4, CD8, CD25, CD45RO, RFDR1, RFD1 and RFD7 by two 'blind' observers. Seven patients with non-inflammatory bowel disorders and two healthy volunteers were studied as controls. RESULTS: Lamina propria CD2-positive (CD2+) cells were reduced in Crohn's disease (P < 0.004) whether clinically active (P < 0.02) or clinically inactive (P < 0.008). CD4+ and CD8+ cells were also reduced in Crohn's disease (P < 0.003), whereas the CD4:CD8 ratio did not differ from that in controls. CD25+, CD45RO+ and HLA-DR+ cells were not significantly increased in patients with Crohn's disease. RFD7+ cells were decreased in Crohn's disease (P < 0.02), whereas RFD1+ cells were not significantly different from the control group. CONCLUSION: No evidence of cellular activation was found in the unaffected mucosa of Crohn's disease. The reduction in T-cell and macrophage-like cell numbers may result from cell migration to inflamed areas. It is also possible that this finding represents a primary defect which may have a role in the pathogenesis of Crohn's disease.
