02584nas a2200325 4500000000100000008004100001260001200042653001000054653001700064653001200081653002500093653002100118100001500139700001800154700001800172700001200190700001400202700001500216700001100231700001800242700001500260700001200275700001500287245006500302856008000367300000900447490000700456520178100463022001402244 2020 d c01/202010aHIV-110aco-infection10aleprosy10amacrophage phenotype10amonocyte subsets1 ada Silva T1 aBittencourt T1 ade Oliveira A1 aPrata R1 aMenezes V1 aFerreira H1 aNery J1 ade Oliveira E1 ada Silva G1 aSarno E1 aPinheiro R00aMacrophage Polarization in Leprosy-HIV Co-infected Patients. uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7403476/pdf/fimmu-11-01493.pdf a14930 v113 a

In HIV-infected individuals, a paradoxical clinical deterioration may occur in preexisting leprosy when highly active antiretroviral therapy (HAART)-associated reversal reaction (RR) develops. Leprosy-HIV co-infected patients during HAART may present a more severe form of the disease (RR/HIV), but the immune mechanisms related to the pathogenesis of leprosy-HIV co-infection remain unknown. Although the adaptive immune responses have been extensively studied in leprosy-HIV co-infected individuals, recent studies have described that innate immune cells may drive the overall immune responses to mycobacterial antigens. Monocytes are critical to the innate immune system and play an important role in several inflammatory conditions associated with chronic infections. In leprosy, different tissue macrophage phenotypes have been associated with the different clinical forms of the disease, but it is not clear how HIV infection modulates the phenotype of innate immune cells (monocytes or macrophages) during leprosy. In the present study, we investigated the phenotype of monocytes and macrophages in leprosy-HIV co-infected individuals, with or without RR. We did not observe differences between the monocyte profiles in the studied groups; however, analysis of gene expression within the skin lesion cells revealed that the RR/HIV group presents a higher expression of macrophage scavenger receptor 1 (MRS1), CD209 molecule (CD209), vascular endothelial growth factor (VEGF), arginase 2 (ARG2), and peroxisome proliferator-activated receptor gamma (PPARG) when compared with the RR group. Our data suggest that different phenotypes of tissue macrophages found in the skin from RR and RR/HIV patients could differentially contribute to the progression of leprosy.

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