Ultrastructure of the polymorphonuclear leucocytes in human immunodeficiency virus infection

[What is new in 2010 for electron microscopy in surgical pathology?]

Différentes méthodes complémentaires permettant d’optimiser le diagnostic et le pronostic des lésions observées dans un laboratoire d’anatomopathologie ont permis, ces dernières années, d’améliorer considérablement l’offre de soins aux patients. Ces méthodes correspondent essentiellement aux techniques d’immuno-histochimie et de biologie moléculaire. La place d’une autre technique autrefois largement utilisée en anatomopathologie, la microscopie électronique (ME), est à l’inverse de plus en plus restreinte. La ME est une méthode longue, difficile, onéreuse, nécessitant un personnel hautement qualifié. Elle est de moins en moins implantée dans un laboratoire de pathologie et devient surtout réservée à des centres universitaires et de recherche. Toutefois, la ME reste un outil indispensable pour le pathologiste. En effet, elle permet parfois de confirmer, et plus exceptionnellement de poser, le diagnostic de certaines lésions tissulaires et cellulaires observées en pathologie humaine. La ME est aussi d’un apport très important pour la compréhension de la physiopathologie de certaines maladies humaines émergentes, notamment d’origine infectieuse. Nous abordons dans cette revue les principales indications actuelles de la ME, en insistant sur certains domaines de la pathologie humaine, comme les maladies infectieuses et certaines tumeurs.

HIV and other lentiviral infections cause defects in neutrophil chemotaxis, recruitment, and cell structure: immunorestorative effects of granulocyte-macrophage colony-stimulating factor

Patients with HIV infection exhibit deficits in bacterial and fungal clearance, and possibly depressed innate immunity. In this study, we observed that neutrophils from HIV-infected patients have a profound defect in chemotaxis in response to endogenous (IL-8) and bacterial (fMLP) chemoattractants, which was directly correlated with peripheral CD4(+) lymphocyte levels but not plasma viral load. A similar chemotactic defect was observed in the feline immunodeficiency virus (FIV) model of HIV infection. Intravital microscopy of FIV-infected animals revealed marked impairment in the in vivo recruitment of leukocytes; specifically integrin-dependent neutrophil adhesion and emigration induced by bacterial products. Treatment of FIV-infected animals with GM-CSF re-established both neutrophil recruitment (rolling, adhesion, and emigration) and in vitro chemotaxis to the levels seen in uninfected animals. This restoration of neutrophil responses was not due to GM-CSF-mediated priming. Rather, HIV and FIV infections resulted in defective neutrophil development, with an ensuing reduction in neutrophil granularity and chemotactic receptor expression. GM-CSF therapy restored neutrophil granularity, implying restoration of normal neutrophil development. Together, our findings underscore the fundamental defects in innate immunity caused by lentivirus infections, while also indicating that GM-CSF may be a potential immunorestorative therapy for HIV-infected patients.

Tubuloreticular structures in rectal biopsies of SIV-infected rhesus monkeys (Macaca mulatta)

Tubuloreticular structures (TRS) are considered to be a specific ultrastructural marker for AIDS in various organs. Experimental SIV infection in rhesus macaques is the most appropriate animal model of HIV infection. In 8 rhesus monkeys, experimentally infected with SIVmac251/MPBC, rectum biopsies were taken prior to and post infection (day 3; 1, 2, 4, 12 weeks p.i.) and were investigated by transmissionelectron microscopy to determine incidence and extent of tubuloreticular structures as well as affected cells. From the first week p.i. on TRS were found in all experimental animals as tubuli with a diameter of 20-30 nm. The tubuli were arranged in regular paracristalline formations and formed intracytoplasmatic heterogenous, polymorph accumulations, which were localized close to the endoplasmatic reticulum. In the rectal lamina propria macrophages, endothelial cells, plasma cells, lymphocytes, fibroblasts, and neutrophilic granulocytes were the affected cell types. In 5 control biopsies TRS were detected, too, but, in contrast to SIV-infected animals, they appeared only singular and very small. The results indicate that TRS are a characteristic morphologic criteria of intestinal SIV infection. They appear in very early stages of the infection. In the rectum, they can be detected as bigger, conspicuous, and abundant formations in several cells and have a restricted diagnostic and prognostic validity.