Laryngeal papillomas: local cellular immune response, keratinization and viral antigen.

Various parameters of the local cellular response have been studied in 16 laryngeal papillomas from ten patients with recurrent papillomas as well as normal control laryngeal and tracheal tissue by indirect immunofluorescence on frozen sections using monoclonal antibodies specific for T-cell subsets, Langerhans cells (LC) and HLA-DR antigens. Keratinization was investigated with a monoclonal antibody KL1 recognizing an acidic 56.5 Kd keratin, which is a marker of suprabasal cells in stratified squamous epithelium and is absent from the basal layer. The presence of viral antigen was detected with a rabbit antiserum raised against SDS-dissociated purified virus. A mild inflammatory response was observed in most biopsies. Cytotoxic/suppressor T-cells were the predominant cells found in the lesions. Compared with normal epithelium, the number of LC was dramatically reduced in the papillomatous epithelium. High densities of HLA-DR-positive cells were found mainly in the corium. The keratinization process was disturbed in most specimens in that both basal and suprabasal compartments reacted positively with the KL1 monoclonal antibody. Viral antigen was present in the nucleus of very occasional epithelial cells in some samples.