Immunosuppression may be present within condyloma acuminata

Background: Condyloma acuminatum are common lesions caused by human papillomavirus (HPV) HPV is associated with many human cancers, :and a vaccine now prevents infection with high-risk HPV. However, eradication of established disease is difficult, indicating that these lesions are capable of local immunosuppression. Objective: This study examines the immunohistochemical staining characteristics of condyloma acuminatum lesions for markers of Cellular immunity, including T-lymphocyte subsets, dendritic cells, and infected keratinocytes and markers Of antigen presentation in condyloma tissue. Methods: Five snap-frozen, optimal cutting temperature-embedded condyloma lesions were immunostained for T-lymphocyte markers Fox P3, CD8, CD25 and molecules involved in antigen presentation. Results: Condylomas demonstrated hallmarks of immunosuppression, such :as increased cellular interleukin-10 production, decreased expression of transporter associated with antigen presentation, CD40. and carbonic anhydrase IX, decreased dendritic cell counts, and increased T-regulatory cell infiltration. Limitations: This study was performed with lesions from a single center, and control tissue from the same, patients was not available because of lack of patient consent. Conclusion: These results demonstrate that condylomas induce a local immunosuppressive environment, with deficits in antigen presentation and enhancement of immunosuppressive T-regulatory cell populations. Strategies to block this immunosuppression are required to elicit effective immune responses to HPV infection. (J Am Acad Dermatol 2008;59:967-74.)