Infection with the human papilloma virus (HPV) is quite common in humans; however, a respiratory infection with this virus (HPV 6 and 11) is the cause of a rare, chronic respiratory disease, recurrent respiratory papillomatosis (RRP). It is characterized by the presence of wart-like lesions in the airway that affect respiratory function and voice quality. The condition is thought to result from a dysfunction of the immune response to HPV such that the virus is not cleared from the body.
A recent study was conducted to characterize the phenotype of the peripheral blood mononuclear cells of patients with RRP compared to healthy controls. Peripheral blood mononuclear cells were isolated from the blood of RRP patients and controls. Subpopulations of CD14+ cells (monocytes), CD4+ (T helper) cells, CD8+ (cytotoxic T) cells, and CD56+ (natural killer) cells were purified using immunomagnetic beads. Characterization of peripheral blood mononuclear cell phenotypes were achieved using immunoflow cytometric analysis (bead-based immunoassay for measuring cytokines in biological fluids).
There was upregulation of the percentage of cytotoxic T cells in comparison to T helper cells in the peripheral blood of patients compared to controls. This resulted in an inverted CD4+/CD8+ ratio (<1) in most patients with RRP patients. The CD4+/CD8+ ratio corresponds to the proportion between T helper and cytotoxic T cells in peripheral blood. Individuals with healthy immune systems have a ratio above 1, while a ratio of less than 1 (inverted CD4+/CD8+ ratio) indicates a compromised immune system.
The NK-cells in patients with RRP had higher expression of NK-cell receptors (NKG2D and CD161) compared to healthy controls. Using real-time quantitative RT-PCR, the cytokine mRNA profile was assessed, and it was found that patients with RRP with the lowest inverted CD4+/CD8+ ratio had downregulation of cytokine mRNA expression compared to those with normal CD4+/CD8+ ratio. Patients with RRP with the lowest CD4+/CD8+ ratio had lower levels of monocytes, T helper cells, cytotoxic T cells, and NK cells compared to patients with normal CD4+/CD8+ ratios >1. Overall, the study results suggest that patients with RRP have immune dysregulation with inverted CD4+/CD8+ ratio, downregulated T helper cell response, and altered cytokine mRNA production.
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Holm A, e. (2017). Lymphocyte profile and cytokine mRNA expression in peripheral blood mononuclear cells of patients with recurrent respiratory papillomatosis suggest... - PubMed - NCBI . Ncbi.nlm.nih.gov. Retrieved 22 September 2017, from https://www.ncbi.nlm.nih.gov/pubmed/28805308