Abstract
Vestibular folds (VF) protect upper airways, but contain fewer immune cells in AIDS patients, which affects the structure of lymphoid follicles (LF). ObjectiveTo characterize fibrosis and immunoglobulin production in vestibular fold lymphoid tissues of AIDS patients with or with no infection and malnutrition. Materials and MethodsA retrospective study of 71 adult vestibular fold autopsy specimens. The morphological analysis was done using the picrosirius staining method. Immunohistochemical methods consisted of anti-IgA, anti IgG, and anti IgM antibodies. ResultsFibrosis was less intense in AIDS patients compared to subjects without AIDS; the same applied to patients with infection or malnutrition. IgA and IgG titers were higher in AIDS patients; IgM titers were higher in cases with infection. ConclusionThis study helps understand variations in lymphoid follicle components of AIDS patients; it also shows the influence of architectural changes and the effect of associated respiratory infection and malnutrition on lymphoid follicle function.
Highlights
AIDS, identified in 1981, arose as an epidemic caused by the human immunodeficiency virus,[1] which could result in decreased and dysfunctional CD4 T lymphocytes
Fibrosis was less intense in AIDS patients compared to subjects without AIDS; the same applied to patients with infection or malnutrition
The morphometric analysis of vestibular fold lymphoid follicles showed that fibrosis was less intense in AIDS patients compared to subjects without AIDS (p=0.002) (Figs. 1 and 2)
Summary
AIDS (the Acquired Immunodeficiency Syndrome), identified in 1981, arose as an epidemic caused by the human immunodeficiency virus,[1] which could result in decreased and dysfunctional CD4 T lymphocytes. Lymphoid follicles result from the union of different types of B and T lymphocytes; when close to mucosae, they produce substances that active the local immune response against infectious agents. Mucosa-associated lymphoid tissues prevent the penetration of many microorganisms into the body.[10,11,12] Cytokines produced in lymphoid follicles cause plasmacytic differentiation and antibody production (mostly IgA in the respiratory tract), a component of mucosal cell secretions, including that of the vestibular folds.[5,13] Cellmediated and humoral immunity are unable to control infection in HIV-positive subjects, resulting in loss of several lymphocyte functions and increased susceptibility to secondary and opportunistic infection. Changes in IgA secretion may be expected following HIV infection, little is known about the humoral responses in mucosae in the presence of immunodeficiency.[15]
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