Immunophenotype of lung granulomas in HIV and non-HIV associated tuberculosis

Abstract

OBJECTIVE:To describe the immunophenotype of pulmonary TB granulomas from autopsied patients with tuberculosis (TB group) and from HIV patients with tuberculosis (TB/HIV group), and to identify the Mycobacterium species using polymerase chain reaction (PCR) technique. METHODS: Lung samples of 15 TB group patients and 23 TB/HIV group patients were selected. Histopathologic analyses and immunohistochemistry tests were performed to describe the granulomas and to detect the infectious agent (anti-BCG). CD4, CD8, CD20 and CD68 were evaluated to characterize the immnophenotype of the granulomas. Polymerase Chain Reaction was performed to identify the mycobacterium species. RESULTS: CD4 þ T lymphocytes were the cells with highest density in the TB group, whereas CD68 cells exhibited the highest density in the TB/HIV group. Comparison between groups showed that the CD4 þ T density was significantly higher in the TB patients; whereas, CD68 density was significantly higher in the TB/HIV patients. M. tuberculosis was identified in 8 cases of each group; M. avium was only found in one case of the TB/HIV group. CONCLUSION: With the advent of AIDS, the immunological profile of TB has changed. This may be associated with the depletion of CD4 þ T lymphocytes in lung granulomas. M. tuberculosis was the major etiological agent of TB in both groups.

Adaptation of Mycobacterium tuberculosis to Impaired Host Immunity in HIV-Infected Patients

“…Among persons with HIV infection, granuloma formation is impaired. Unlike immunocompetent persons, in whom granulomas display a finely organized architecture with spatially modulated gradients of T-cell and macrophage phenotypes [10][11][12], patients with tuberculosis with advanced HIV infection develop disorganized granulomas that are poorly contained collections of polymorphonuclear cells and eosinophils with a paucity of mononuclear, epithelioid, or giant cells [13][14][15][16][17]. Poorly contained lesions in animal tissues are not hypoxic, and this may also be the case in HIV-infected patients with tuberculosis [8,9,18,19].…”

Humanized Mouse Model Mimicking Pathology of Human Tuberculosis for in vivo Evaluation of Drug Regimens

“…Granuloma heterogeneity has been observed in Mtb infected non-human primates (NHPs) (31), guinea pigs (32), rabbits (33), Nos2 −/− mice (24), and C3HeB/FeJ mice (34), however it is virtually missing in traditional inbred mouse strains. Additionally, several unique pathologic features of TB (35, 36) and HIV-TB comorbidity (37) in humans cannot be examined in these models. On the other hand, small rodents are of relatively low cost, immunologically well-characterized, and a remarkable analytical toolbox exists.…”

Hubungan Antara Gambaran Histopatologi Dengan Jumlah Leukosit Pada Penderita Limfadenitis Tuberkulosis Di Nusa Tenggara Barat Tahun 2019

“…Sitokin ini mempunyai fungsi untuk merekrut sel immune innate, seperti monosit dan granulosit dan menginduksi apoptosis. 19,28 CD8+ berfungsi untuk menyekresi molekul sitotoksik seperti perforin, granzymes, dan granulysin yang bisa menginduksi apoptosis pada makrofag dan sel-sel lain yang terinfeksi MTB dan berada di dalam granuloma, sehingga membentuk gambaran nekrosis kaseosa. Selain itu, molekul sitotoksik tersebut dapat juga membunuh MTB secara langsung.…”

“…Penyebab terjadinya hal tersebut adalah pada HIV produksi TNF-α berkurang sehingga menurunkan respon apoptosis pada makrofag yang terinfeksi MTB sehingga meningkatkan gambaran jumlah makrofag. 28 Penelitian lain pada LNTB yang disertai HIV/AIDS oleh Eliandy dan Lubis (2011) menyebutkan bahwa tidak ada hubungan yang bermakna antara munculnya bercak-bercak gelap (dark specks) pada latar belakang material nekrotik granular eosinofilik dan tampilan sitologi dengan kadar CD4 pada penderita limfadenitis tuberkulosis yang disertai HIV/AIDS (p=0,55). Hal ini mungkin dikarenakan faktor jumlah sampel yang sedikit pada penelitian ini.…”