Avaliação da resposta tecidual "in situ" do fenótipo, da expressão de HHV-8/LANA e de citocinas em lesões cutâneas de sarcoma de Kaposi clássico e sarcoma de Kaposi associado à AIDS na era pré e pós-terapia anti-retroviral combinada / Evaluation of tissue response "in situ" of the phenotype, expression of HHV-8/LANA and cytokines in cutaneous lesions of classic Kaposi sarcoma and AIDS associated Kaposi sarcoma in the pre-and post- highly active antiretroviral therapy era

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Kaposis sarcoma (KS) is a vascular-originated tumor associated to human herpesvirus 8 (HHV-8). The incidence of AIDS-KS has decreased after the advent of highly active antiretroviral therapy (HAART), without studies regarding cutaneous inflammatory response and HHV-8 expression in pre- and post-HAART era. We used immunohistochemistry to characterize and to quantify in situ inflammatory cells, its cytokines pattern and the expression of HHV-8 in cutaneous lesions of classic Kaposis sarcoma (CKS), AIDS associated Kaposis sarcoma (with or without HAART). The decreased number of T CD4+ lymphocytes in lesions of AIDS-KS as compared with CKS, reflect the severe immunodeficiency caused by HIV. T CD8+ lymphocytes numbers were similar in three KS groups, which appeared unrelated to the clinical or epidemiological type of KS. S100+ cells and FXIIIa+ DD were increased in all KS lesions as compared with normal skin. We also found a peculiar dermal cellular population in KS lesions. CD68+ macrophages were higher in CKS lesions as compared with AIDS-KS lesions, but similar to those found in lesions of HAART/AIDS-KS. Similar data were found in epidermal Langerhans cells in these groups, suggesting a partial immune recovery by HAART. The high number of cells expressing IFN- in CKS lesions and HAART/AIDS-KS as compared with AIDS-KS suggests that this cytokine may be a marker of effective immune response. The increased expression of IL-1 in CKS lesions and HAART/AIDS-KS could be related with its anti-tumor effect. Expression of TNF-, IL-4 e IL-6 were similar between KS lesions. Demonstrated by double-immunostaining, nuclear identification of HHV-8 in FXIIIa+ DD suggests this cell type as target for HHV-8 infection. CKS lesions showed increased number of cells with HHV-8 expression as compared with another groups of AIDS-KS, independent of HAART. Our data shown that there was a partial recovery of local immune response in HAART/AIDS-KS lesions and that the KS clinical severity cannot be directly associated with the increased density of HHV-8 infected cells in tissue

ASSUNTO(S)

citocinas pele síndrome de imunodeficiência adquirida acquired immunodeficiency syndrome imunohistoquímica skin herpesvirus 8 human antiretroviral therapy highly active terapia anti-retroviral de alta atividade kaposi sarcoma células dendríticas sarcoma de kaposi dendritic cells herpesvirus humano 8 cytokines immunohistochemistry

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