Lack of evidence for local immune activity in oral hairy leukoplakia and oral wart lesions

• Published in: Oral microbiology and immunology Vol. 20; no. 3; pp. 154 - 162
• Main Authors: Lilly, E. A., Cameron, J. E., Shetty, K. V., Leigh, J. E., Hager, S., McNulty, K. M., Cheeks, C., Hagensee, M. E., Fidel Jr, P. L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01-06-2005; Blackwell
• Subjects: AIDS-Related Opportunistic Infections - immunology; AIDS-Related Opportunistic Infections - virology; Biological and medical sciences; CD3 Complex - analysis; CD4 Antigens - analysis; CD8 Antigens - analysis; Chemokines - analysis; cytokines; Cytokines - analysis; Dentistry; Epstein-Barr virus; Fundamental and applied biological sciences. Psychology; Herpesvirus 4, Human - genetics; HIV; Human immunodeficiency virus; Human papillomavirus; Human viral diseases; Humans; Immunohistochemistry; Infectious diseases; Leukoplakia, Hairy - immunology; Leukoplakia, Hairy - virology; Medical sciences; Microbiology; Miscellaneous; oral hairy leukoplakia; oral warts; Papillomaviridae - genetics; Polymerase Chain Reaction; RNA, Messenger - isolation & purification; Statistics, Nonparametric; T cells; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Virology; Warts - immunology; Warts - virology; Skin disease; Premalignant lesion; oral hairy leukoplakia; Microbiology; Stomatology; Wart; Cytokine; Retroviridae; T cells; Lentivirus; oral warts; Infection; Virus; Immunology; HIV; Viral disease; T-Lymphocyte; Oral hairy Leukoplasia; Oral cavity disease; cytokines; Human immunodeficiency virus
• ISSN: 0902-0055; 1399-302X
• DOI: 10.1111/j.1399-302X.2005.00198.x

Background:  Oral warts, caused by human papillomavirus (HPV), and oral hairy leukoplakia (OHL) caused by Epstein‐Barr virus (EBV), are common oral manifestations in HIV‐infected persons. Although both conditions occur most often with reduced blood CD4+ T‐cell numbers, oral warts and OHL rarely occur simultaneously, suggesting that dysfunctions in other secondary local immune parameters are also involved. The present study evaluated tissue‐associated proinflammatory and T‐helper cytokine and chemokine mRNA expression and the presence of T cells in each lesion.
Methods:  Biopsies were taken from lesion‐positive and adjacent lesion‐negative sites of HIV+ persons with oral warts or OHL and lesion‐negative sites from HIV+ persons who were oral HPV or EBV DNA‐positive (matched controls). Cytokine/chemokine mRNA expression was quantified by real‐time polymerase chain reaction. CD3, CD4, and CD8 cells were identified by immunohistochemistry.
Results:  No differences were detected in tissue‐associated cytokine/chemokine mRNA expression in warts or OHL when compared to lesion‐negative sites. Immunohistochemical analysis of T cells showed CD8+ cells exclusively, but few cells were present in either lesion. No differences were detected between lesion‐positive and ‐negative control sites of each pathologic condition.
Conclusion:  Little evidence was found for local immune reactivity to either oral warts and OHL, suggesting that CD4+ T cells are a primary host defense against both oral warts and OHL, but with nonimmune factors potentially responsible for the divergent prevalence of each.