Papilloma viruses, warts, carcinoma and Langerhans cells

In human papillomavirus (HPV) infections, Langerhans cells (LC) are essential in the control of viral infection. The evolution of HPV-derived lesions in the normal population and in graft patients is drastically different, since a high proportion of papillomas progress towards malignancy in transplant recipients. We analyzed the distribution of markers of LC and T lymphocytes, the level of keratinocyte activation and the prevalence of HPV in a series of epithelial lesions obtained from the normal population and from graft patients. The local immune response of warts, condyloma acuminata, Bowen, basal and squamous cell carcinomas (SCC) showed a moderate to intense inflammatory reaction of HLA-DR positive cells, the intensity of the immune reaction being correlated with the degree of malignancy. In the normal population, CD4-positive cells were mainly overexpressed in the dermal infiltrate of condyloma and malignant lesions, whereas in grafted patients such infiltrates were CD4- and CD8-positive without significant predominance of a single T cell subset. The epidermis of most lesions was characterized by a reduced number of CD1a-positive LC with an altered morphology. This was concomitant with the decrease or loss of beta 2-microglobulin by epithelial cells. HLA-DR antigen was sometimes expressed by keratinocytes in genital lesions and SCC from the normal population but has not been detected in immunosuppressed patients. Whereas in the normal population HPV infection was only detected in benign papillomas, both benign and oncogenic HPV DNA may be present in carcinomas from graft patients.(ABSTRACT TRUNCATED AT 250 WORDS)