Lymph node hemophagocytosis in rickettsial diseases: A pathogenetic role for CD8 T lymphocytes in human monocytic ehrlichiosis (HME)?

Kerry L. Dierberg, J. Stephen Dumler

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Human monocytic ehrlichiosis (HME) and Rocky Mountain spotted fever (RMSF) are caused by Ehrlichia chaffeensis and Rickettsia rickettsii, respectively. The pathogenesis of RMSF relates to rickettsia-mediated vascular injury, but it is unclear in HME. Methods: To study histopathologic responses in the lymphatic system for correlates of immune injury, lymph nodes from patients with HME (n = 6) and RMSF (n = 5) were examined. H&E-stained lymph node tissues were examined for five histopathologic features, including hemophagocytosis, cellularity, necrosis, and vascular congestion and edema. The relative proportions of CD68 macrophages, CD8 and CD4 T lymphocytes, and CD20 B lymphocytes were evaluated by immunohistochemical staining. Results: Hemophagocytosis was similar in HME and RMSF, and was greater than in control cases (p = .015). Cellularity in HME was not different from controls, whereas RMSF lymph nodes were markedly less cellular (p < 0.002). E chaffeensis-infected mononuclear phagocytes were infrequent compared to R. rickettsii-infected endothelial cells. More CD8 cells in lymph nodes were observed with HME (p < .001), but no quantitative differences in CD4 lymphocytes, macrophages, or B lymphocytes were identified. Conclusion: Hemophagocytosis, CD8 T cell expansion, and the paucity of infected cells in HME, suggest that E chaffeensis infection leads to macrophage activation and immune-mediated injury.

Original languageEnglish (US)
Article number121
JournalBMC infectious diseases
Volume6
DOIs
StatePublished - Jul 21 2006

ASJC Scopus subject areas

  • Infectious Diseases

Fingerprint Dive into the research topics of 'Lymph node hemophagocytosis in rickettsial diseases: A pathogenetic role for CD8 T lymphocytes in human monocytic ehrlichiosis (HME)?'. Together they form a unique fingerprint.

Cite this