ABSTRACT
BACKGROUND: The role of dendritic cells (DCs) in disease progression of primary cutaneous T-cell lymphoma (CTCL) is not well understood. With their unique ability to induce primary immune responses as well as immunotolerance, DCs play a critical role in mediation of anti-tumor immune responses. Tumor-infiltrating DCs have been determined to represent important prognostic factors in a variety of human tumors. OBJECTIVE: To date, only circulating DC populations have been investigated in CTCL. Therefore we analyzed the expression and tissue distribution of different DC subset markers in lesional and nonlesional skin of patients with CTCL. METHODS: Twelve patients with mycosis fungoides or Sézary syndrome were included in the study. Tissue samples were obtained from lesional and nonlesional skin as a control. Immunohistochemistry was performed with different DC subset and regulatory T-cell markers and assessed using a digital image analysis system. Tissue distribution of DCs in relation to the tumor was analyzed by double immunofluorescence. RESULTS: We found a significant infiltration of CTCL lesions by immature CD209/DC-SIGN+ DCs with close contact to tumor cells. Matured and activated DCs were only rarely detected in lesions of CTCL. LIMITATIONS: The sample size was small. CONCLUSIONS: The preponderance of immature CD209/DC-DIGN+ DCs in contact with regulatory T cells in lesions of CTCL points to an important role of this subset in the host's immune reaction to the malignant T cells. Since these immature DCs are known to induce immunotolerance, they might play a role in the mediation of immune escape of the proliferating clone.
Subject(s)
Cell Adhesion Molecules/metabolism , Dendritic Cells/immunology , Lectins, C-Type/metabolism , Lymphoma, T-Cell, Cutaneous/immunology , Receptors, Cell Surface/metabolism , Skin Neoplasms/immunology , Skin/immunology , Adult , Aged , Antigens, CD/analysis , Dendritic Cells/classification , Dendritic Cells/metabolism , Dendritic Cells/pathology , Female , Fluorescent Antibody Technique , Forkhead Transcription Factors/metabolism , Humans , Immunohistochemistry , Lymphoma, T-Cell, Cutaneous/pathology , Male , Middle Aged , Mycosis Fungoides/immunology , Mycosis Fungoides/pathology , Sezary Syndrome/immunology , Sezary Syndrome/pathology , Skin/pathology , Skin Neoplasms/pathology , T-Lymphocytes, Regulatory/immunologyABSTRACT
Treatment of widespread moderate to severe atopic eczema remains a challenge. The therapeutic efficacy and modifications of the immune response during treatment of atopic eczema with efalizumab are so far unknown. We hereby report the clinical findings and characterize the inflammatory infiltrate during treatment of severe recalcitrant atopic eczema with efalizumab.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal/therapeutic use , Dermatitis, Atopic/drug therapy , Adult , Antibodies, Monoclonal, Humanized , CD11 Antigens/immunology , Dermatitis, Atopic/immunology , Dermatitis, Atopic/metabolism , Dermatitis, Atopic/pathology , Humans , Immunohistochemistry , Macrophages/immunology , Male , Skin/immunology , Skin/pathologyABSTRACT
Alopecia areata (AA) is considered an autoimmune disease targeted at hair follicles with T-lymphocytes playing an important role in the pathogenesis. Treatment of AA, particularly the totalis and universalis subtypes, is often difficult and remains a therapeutic challenge. Novel biologic therapies that have been developed for the treatment of other immune-mediated inflammatory skin diseases may represent a new therapeutic modality for this disease. Efalizumab is a humanized monoclonal anti-CD11a antibody that inhibits T-cell activation and migration. We report a case of a 19-year-old man suffering from AA partim universalis, treated with efalizumab monotherapy. The treatment was well tolerated with no reported side effects. The striking improvement warrants further studies with this biologic therapy in AA.
