Table 1.
Clinical characteristics of patients with HTLV-1/Strongyloides co-infection and chronic duodenitis controls.
Table 2.
Histopathological findings in duodenal biopsies from S. stercoralis co-infected patients and duodenitis controls.
Fig 1.
Number and localization of CD3+ T cells in intestinal biopsies from patients with HTLV-1 and Strongyloides co-infection (SS/HTLV-1) compared to controls.
Panel A. The number of CD3+ T cells was quantified using ImagePro Plus software demonstrating similar total numbers in SS/HTLV-1 and chronic duodenitis controls, but the numbers were increased compared to healthy controls (*p = 0.03, Mann-Whitney). Panel B. Immunohistochemistry staining for CD3 (positive cells identified by the brown color) showing expression localized to the villi in duodenitis controls and the crypts for SS/HTLV-1. Panel C. In SS/HTLV-1, the CD3+ cells were significantly increased in crypts compared to villi. Long horizontal lines are the medians, vertical line and short horizontal lines demonstrate the interquartile range. (* P<0.004, Mann-Whitney).
Fig 2.
Number and localization of CD8+ cells in intestinal biopsies from patients with HTLV-1 and Strongyloides (SS/HTLV-1) compared to controls.
Panel A. The number of CD8+ T cells was quantified using ImagePro Plus software demonstrating increased numbers in SS/HTLV-1 compared to chronic duodenitis controls (Mann-Whitney p = 0.04). Panel B. Immunohistochemistry staining for CD8 in biopsies from SS/HTLV-1 patients and chronic duodenitis controls (positive cells identified by the brown color). Distribution in the villi is illustrated on the top panels and between the crypts in the bottom panels. Panel C. Graph demonstrating differential localization of CD8+ cells for SS/HTLV-1 patients with significantly increased expression in the crypts compared to the villi (Mann-Whitney p<0.003). Long horizontal lines are the medians, vertical lines and short horizontal lines demonstrate the interquartile range. * marks statistically significant differences.
Fig 3.
The number of CD3+ T cells and CD8+ cells adjacent and not adjacent to parasites.
Panel A. Parasites were identified by microscopy (arrow). Areas within a 0.335 mm radius of the parasite material on the slides were classified as adjacent to the parasite, which was the largest area that allowed characterization of adjacent and non-adjacent cells. Cells in areas adjacent or non-adjacent areas were quantified using ImagePro plus software. Panel B. Slides were stained by immunohistochemistry for CD3+ or CD8+ cells and positive cells were quantified using ImagePro Plus software demonstrating decreased numbers of CD3+ and CD8+ cells in areas adjacent to parasites compared to non-adjacent areas. Long horizontal lines are the medians, vertical line and short horizontal lines demonstrate the interquartile range (*p = 0.03, Mann-Whitney).
Fig 4.
Increased numbers of cells positive for the regulatory T cell marker FoxP3 in HTLV-1 and Strongyloides co-infected (SS/HTLV-1) patients.
Panel A. Regulatory T cells were identified by immunohistochemistry staining for FoxP3, comparing SS/HTLV-1 patients and controls. Immunohistochemical stains for FoxP3 showing biopsies from an SS/HTLV-1 patient and a control patient (positive cells identified by the brown color). Panel B. FoxP3+ cells were quantitated using ImagePro Plus software. More of the lymphocytes were FoxP3+ in the SS/HTLV-1 patients compared with chronic duodenitis and healthy controls. Long horizontal lines are the medians, vertical line and short horizontal lines demonstrate the interquartile range (*p = 0.03, Mann-Whitney).
Fig 5.
Eosinophils and IgE+ cells in HTLV-1 and Strongyloides co-infected (SS/HTLV-1) patients.
Panel A. IgE+ cells were identified by immunohistochemistry staining and quantitated using ImagePro Plus software. More of the lymphocytes were IgE+ in the SS/HTLV-1 patients compared with chronic duodenitis and healthy controls (*p = 0.03, Mann-Whitney). Panel B. Three of the SS/HTLV-1 patients had marked infiltration of the duodenum with eosinophils, but there was sparing of sections with parasites. The panels show representative sections containing parasites, but few eosinophils (left, parasite form marked with the arrow) or no parasites and numerous eosinophils (right, some eosinophils marked with arrowheads). Panel C The number of eosinophils per 100x field were counted for fields with or without parasites visible. Eosinophilic infiltrate was less intense in fields with parasites but this was not statistically significant (p = 0.06, Mann-Whitney). Long horizontal lines are the medians, vertical line and short horizontal lines demonstrate the interquartile range.