HLA-E molecules expression in placental tissue of HIV-1 infected and non-infected women

Author(s)

Juliana Martinez

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
• Defense date: 2013-11-28

Examining board members

Ana Paula Morais Fernandes; Eduardo Antonio Donadi; Silvana Maria Quintana

• Advisor: Ana Paula Morais Fernandes

Abstract

During pregnancy, the expression of HLA -E molecules occurs mainly in extravillous trophoblasts of the placenta and are associated with the inhibition of the immune system resulting in immune tolerance to the fetus. This inhibition of the immune response may be beneficial in physiological conditions such as pregnancy, but harmful in the presence of tumors and infections. In this condition, it has been reported that HIV infects trophoblast cells and uses the HLA -E as an escape mechanism, increasing its expression to inhibit the activity of cytotoxic cells. However, despite the continued viral exposure, the fact that most newborns are not vertically infected suggests the existence of naturally protective barriers that prevent mother to child transmission (MTCT) of HIV. Due to the lack of studies evaluating HLA-E in the maternal-fetal immunological interaction, specifically in HIV-1 infection, and the importance that this topic has towards the prevention of MTCT, this project aimed to evaluate the expression of HLA-E in placental tissues of infected women or not by HIV-1. It is a cross sectional study, which were submitted to immunohistochemical processing the paraffin- embedded placental tissue of 106 women infected with HIV-1 and 100 uninfected women. The expression of HLA-E was analyzed by a pathologist and classified qualitatively as mild, moderate or severe and quantitatively as negative (<5% markup), 1+ (6-25 %), 2+ (26-50%), 3+ (51-75%) and 4+ (>75%). The sociodemographic results indicate that pregnant women infected with HIV-1 were not women living in marital union (p<0,0001) and have lower education (p=0,0004). In immunohistochemical analysis, it became evident that the expression of HLA-E occurred mainly in the extravillous trophoblast and endothelial cells, but not in the villi of the placenta. The statistical tests used were chi-square and Fisher exact tests. The results showed that in women with the HIV-1 infection, the expression of HLA-E was significantly lower among those who had undetectable viral load (p=0,03), and there was no association between the expression of HLA- E with other conditions such as the presence or absence of HIV infection, miscarriage in previous pregnancies, number of CD4+ cells and antiretroviral therapy used. These results suggest that HIV-1 induces the expression of HLA-E placental cells, using it as a mechanism to escape the immune system. However other studies with genetic polymorphisms and microRNAs are needed to increase knowledge about the molecule, its role in HIV-1 infeccion and its role in MTCT (AU)

• FAPESP's process: 11/16885-6 - HLA-E molecules expression in placental tissue of HIV-1-infected and non-infected women
• Grantee: Juliana Martinez
• Support Opportunities: Scholarships in Brazil - Master