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Intraepithelial CD15 infiltration identifies high-grade anal dysplasia in people with HIV
Joaquín Burgos, Aleix Benítez-Martínez, Cristina Mancebo, Núria Massana, Antonio Astorga-Gamaza, Josep Castellvi, Stefania Landolfi, Adrià Curran, Jorge N. Garcia-Perez, Vicenç Falcó, María J. Buzón, Meritxell Genescà
Joaquín Burgos, Aleix Benítez-Martínez, Cristina Mancebo, Núria Massana, Antonio Astorga-Gamaza, Josep Castellvi, Stefania Landolfi, Adrià Curran, Jorge N. Garcia-Perez, Vicenç Falcó, María J. Buzón, Meritxell Genescà
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Research Article Immunology Infectious disease

Intraepithelial CD15 infiltration identifies high-grade anal dysplasia in people with HIV

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Abstract

Men who have sex with men (MSM) with HIV are at high risk for squamous intraepithelial lesion (SIL) and anal cancer. Identifying local immunological mechanisms involved in the development of anal dysplasia could aid treatment and diagnostics. Here, we studied 111 anal biopsies obtained from 101 MSM with HIV, who participated in an anal screening program. We first assessed multiple immune subsets by flow cytometry, in addition to histological examination, in a discovery cohort. Selected molecules were further evaluated by immunohistochemistry in a validation cohort. Pathological samples were characterized by the presence of resident memory T cells with low expression of CD103 and by changes in natural killer cell subsets, affecting residency and activation. Furthermore, potentially immunosuppressive subsets, including CD15+CD16+ mature neutrophils, gradually increased as the anal lesion progressed. Immunohistochemistry verified the association between the presence of CD15 in the epithelium and SIL diagnosis for the correlation with high-grade SIL. A complex immunological environment with imbalanced proportions of resident effectors and immune-suppressive subsets characterized pathological samples. Neutrophil infiltration, determined by CD15 staining, may represent a valuable pathological marker associated with the grade of dysplasia.

Authors

Joaquín Burgos, Aleix Benítez-Martínez, Cristina Mancebo, Núria Massana, Antonio Astorga-Gamaza, Josep Castellvi, Stefania Landolfi, Adrià Curran, Jorge N. Garcia-Perez, Vicenç Falcó, María J. Buzón, Meritxell Genescà

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Figure 6

Detection of CD4/CD103 and CD15/CD66b by IF.

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Detection of CD4/CD103 and CD15/CD66b by IF.
(A) Microphotograph showing...
(A) Microphotograph showing anti-CD4 (red) and anti-CD103 (green) in the epithelium and the underlying stroma, indicated by a white dashed line, of a high-grade squamous intraepithelial lesion (HSIL) sample. Right panels depict magnified views of samples captured in various channel acquisition colors using a ZEISS LSM 980 confocal microscope with ×40 oil immersion Plan-Apochromat objectives (NA 1.3): top row denotes single CD4+ cells, middle row single CD103+ cells, and bottom row double CD4+CD103+ cells (all indicated by arrows). (B) Microphotograph showing anti-CD15 (red) and anti-CD66b (green) in the epithelium and the underlying stroma, indicated by a white dashed line, of an HSIL sample. Right panels depict magnified views, obtained as in A, of single CD15+ cells in top row, single CD66b+ cells in middle row, and double CD15+CD66b+ cells in bottom row (all indicated by arrows). (C–G) Median number of double CD4/CD103-positive (C and D) and CD15/CD66b-positive (F and G) cells detected per a median of 6 fields (range 2 to 15) at ×25 original magnification in the (C and F) epithelium or the (D and G) stroma in normal (green) and pathological (H/L-SIL, in purple; HSIL are highlighted in brown) samples. (E and H) Percentage of double positive out of total CD4 (E) and CD15 (H). Data are represented as a violin plot; horizontal lines are median and interquartile range. Statistical comparisons using nonparametric Mann-Whitney U test for 2-group analyses are shown: *P < 0.05; **P < 0.01.

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