Immunohistological analysis of immune cells in blistering skin lesions

Background: Bullous skin lesions are characterised by the presence of intraepidermal or subepidermal bullae. Although inflammatory cell infiltrate is a constant feature in these lesions, their immunophenotypic characterisation is still incomplete. Aim: To determine whether the development of bullous...

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Bibliographic Details
Published in:	Journal of clinical pathology Vol. 60; no. 1; pp. 62 - 71
Main Authors:	Hussein, Mahmoud R, Ali, Fayed Mahammad Nagy, Omar, Abd-Elhady M M
Format:	Journal Article
Language:	English
Published:	London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01-01-2007 BMJ BMJ Publishing Group LTD BMJ Group
Subjects:	Adolescent Adult Aged Biological and medical sciences CD3 Complex - analysis Child Child, Preschool CTL cytotoxic T lymphocyte Epidermis - pathology Female granzyme B GRB Histiocytes - pathology Humans Immunity, Cellular Immunoenzyme Techniques - methods Immunophenotyping Investigative techniques, diagnostic techniques (general aspects) Lymphocyte Subsets - pathology Male Medical sciences Middle Aged Neutrophils - pathology Original Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Skin Diseases, Vesiculobullous - immunology Skin Diseases, Vesiculobullous - pathology T cell intracellular-associated antigen T-Lymphocytes, Cytotoxic - pathology TIA Cell Anatomic pathology Skin disease
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Summary:	Background: Bullous skin lesions are characterised by the presence of intraepidermal or subepidermal bullae. Although inflammatory cell infiltrate is a constant feature in these lesions, their immunophenotypic characterisation is still incomplete. Aim: To determine whether the development of bullous skin diseases is associated with changes in the inflammatory cell infiltrate. Materials and methods: 34 cases representing lesions with both intraepidermal and subepidermal bullae were examined using immunoperoxidase staining methods and antibodies targeting antigens for histiocytes (CD68), B cells (CD20+), T cells (CD3+), T cells with cytotoxic potential (T cell intracellular associated antigen, TIA1+) and activity (granzyme B, GRB+). The adjacent normal skin (lesions) and an additional five cases of normal skin were also examined (controls). Results: The transition from normal skin to lesional skin (lesions with intraepidermal and subepidermal bullae) was associated with a significant increase (p⩽0.05) in the density of total inflammatory cell infiltrate, CD68+ cells, CD3+ T lymphocytes, CD20+ B lymphocytes, TIA1+-resting cytotoxic T cells and GRB+ T cells with cytotoxic activity. Conclusions: The increase in inflammatory cell infiltrate during the transition from normal to lesional skin may reflect the presence of an increased antigenicity of the lesional cells or a response to some basement membrane components. CD68+ and CD3+ cells, especially the resting cytotoxic ones, achieved numerical dominance in these lesions. Cell-mediated immunity seems to have critical role in the development of these lesions.
Bibliography:	ark:/67375/NVC-LQP4C6LH-B href:jclinpath-60-62.pdf PMID:17213348 Correspondence to:  Dr M R Hussein  Department of Pathology, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt; mrh17@swissinfo.org istex:0F54619BCD2759595D53B86B1850B59BF95FEA58 local:0600062 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0021-9746 1472-4146
DOI:	10.1136/jcp.2006.037010