Tumor antigen presentation by dermal antigen-presenting cells.

Several phenotypes of antigen-presenting cells are present in the dermis, where they presumably function to present encountered antigens for immune responses. This study examined the ability of dermal antigen-presenting cells to present tumor-associated antigens for the induction of in vivo antitumor immunity. Total murine dermal cells were exposed either to medium alone or to medium containing tumor-associated antigens from S1509a tumor cells. Subsequently, dermal cells were injected subcutaneously at weekly intervals into naïve mice for a total of three immunizations. One week following the final immunization, mice were challenged with living tumor cells. In these experiments, dermal cells pulsed with tumor-associated antigens induced protective immunity to tumor growth. Dermal cells exposed to tumor-associated antigens were also able to elicit delayed-type hypersensitivity after footpad injection into mice previously immunized against S1509a tumor cells. The ability to present tumor-associated antigens for both induction of antitumor immunity and elicitation of delayed-type hypersensitivity was dependent on I-A+ cells and was genetically restricted. Finally, dermal cells tended towards eliciting a greater antitumor delayed-type hypersensitivity response than epidermal cells. These results show that the murine dermis contains antigen-presenting cells capable of processing S1509a tumor antigens for the generation of protective antitumor immunity in vivo.

Reduced production of both Th1 and Tc1 lymphocyte subsets in atopic dermatitis (AD).

An imbalance of interferon-gamma (IFN-gamma)-bearing CD4+ T (Th1) cells in the pathogenesis of AD is well recognized; however, a possible role in AD for CD8+ T cells secreting Th1-like cytokines (Tc1) has not been properly addressed. In this study, two- and three-colour FACS analysis allowed us to discriminate the Th1 from the Tc1 subset. AD patients had half the number of IFN-gamma-producing circulating T cells (P < 0.005; 13.6 +/- 1.9% (mean +/- s.d.)) compared with normal donors (25.0 +/- 2.4%). Specifically, both Th1 (4.8 +/- 0.7%) and Tc1 (8.1 +/- 1.1%) cells in AD were decreased compared with Th1 (8.8 +/- 0.8%) and Tc1 (15.0 +/- 1.5%) cells in controls. Moreover, at the mRNA level, the ratios of IFN-gamma/IL-4 and IFN-gamma/IL-10 were lower in cells from AD patients compared with controls. In conclusion, the decrease of IFN-gamma-producing T lymphocytes in AD is due to a reduction in both Th1 and Tc1 IFN-gamma-secreting cells; this may not only contribute to the over-production of IgE, but also explain the high incidence of cutaneous infections observed in AD patients.

Regulation of tumor antigen presentation by urocanic acid.

Urocanic acid (UCA) accumulates in the epidermis after deamination of histidine. UCA isomerizes from the trans to the cis form upon exposure to environmental UV radiation. Cis-UCA is immunosuppressive in several models. Topically applied cis-UCA was reported to enhance the cutaneous tumor yield in chronically UV-irradiated mice, suggesting involvement of cis-UCA in photocarcinogenesis. Since Langerhans cells (LC) are capable of presenting tumor-associated Ags (TAA) for primary and secondary tumor-immune responses, we examined the effects of trans- and cis-UCA on LC tumor Ag presentation in a model of immunity to the S1509a spindle cell tumor (H-2a). In this system, induction of immunity requires exposure of LC to granulocyte-macrophage CSF. Naive CAF1 (H-2(a/d)) mice were immunized against S1509a by injection with granulocyte-macrophage CSF-exposed and TAA-pulsed epidermal cells (EC), as assessed by growth inhibition of inoculated tumor cells. Incubation of EC in cis-, but not trans-UCA completely inhibited Ag presentation in this system. Neither histamine antagonists nor indomethacin reversed these effects of cis-UCA. The ability of trans- and cis-UCA to modulate EC presentation of TAA for secondary immune responses was also examined. EC were pulsed with TAA in vitro and then injected into hind footpads of tumor-immune mice. After 24 h, footpad swelling was assessed as a measure of delayed-type hypersensitivity. Incubation with cis-, but again not trans-UCA before TAA exposure significantly inhibited elicitation of delayed-type hypersensitivity. These data indicate that cis-UCA may be an important regulator of LC Ag-presenting function in tumor-immune responses, and thus may play a role in photocarcinogenesis.

Keratinocytes resident in normal human skin constitutively express, at low levels, the intercellular adhesion molecule-1. An in situ immunoelectronmicroscopy study.

The expression of intercellular adhesion molecule-1 (ICAM-1) on keratinocytes (KC) was previously demonstrated in biopsies from various inflammatory skin lesions. KC were, however, found virtually ICAM-1 negative, in normal skin, when the same immunocytochemical techniques were employed. By contrast, epithelial cells resident in different organs constitutively express ICAM-1, albeit weakly. The aim of the present study was to use an immunostaining system more sensitive than the conventional immunocytochemistry, namely the in situ immunogold labelling of ultracryosections, to investigate the constitutive ICAM-1 expression by resting KC in normal skin, in vivo. The semiquantitative analysis performed on 500 resident KC, visualized within tissue ultracryosections of normal human skin, revealed that gold granules were present long the cell membrane in a small percentage (14.6%) of resident KC. The density of gold particles (10 nm sized) observed on the cell surface per KC section was as scarce as 13.72 +/- 4.6 (mean +/- standard deviation), although highly significant when compared with controls (P < 0.005). This indicates the presumably low expression of ICAM-1 moieties on the plasma membrane of this KC subset. This ICAM-1 expression could be important in modulating the trafficking to and from normal epidermis of migrating Langerhans cells and occasional leucocytes. The fact that the ICAM-1 expression on KC in normal skin is limited can be considered favourable, because it can account for the prevention of inappropriate KC/leucocyte interactions in the resting cutaneous environment.

Macrophages, but not Langerhans cell-like cells of dendritic lineage, express the CD36 molecule in normal human dermis: relevance to downregulatory cutaneous immune responses?

The CD36 molecule has been shown to be associated with subsets of peripheral blood monocyte/macrophages and, in cells isolated from either ultraviolet (UV)-irradiated or diseased skin, to induce downregulatory immune responses. Although macrophages are certainly present within normal human dermis, whether they normally express CD36 is still a matter of debate. In this study, we investigated dermal CD36-expressing macrophages in situ using the gold immunoelectron microscopic technique on tissue ultracryosections. This is a very sensitive and specific method, and its results clearly reflect the in vivo immunophenotypic constitutive situation. Macrophages in normal human dermis were variously shaped from round to dendritic and were localized either immediately beneath the epidermis, in perivascular areas, or in intervascular zones. Macrophages showed consistent gold-positive staining on their cell surface. In contrast, other dermal cells, including fibroblasts, lymphocytes, and mast cells, as well as dermal fibers, were not decorated with gold; dermal Langerhans cell-like dendritic cells (LC/DC), though they did show gold labeling in some intracytoplasmic organelles, did not show any gold particles along their plasma membranes. Therefore, although macrophages in normal human dermis exhibit variability with regard to their localization and shape, they regularly and constitutively expressed CD36. CD36 molecules may be considered a useful marker for macrophages in normal human dermis and may furthermore confer on macrophages, or a subpopulation thereof, intriguing functional properties (e.g., downregulatory capacity versus upregulatory capacity subserved by LC/DC) within the cutaneous immune system.

Generalized melanosis associated with malignant melanoma: unusual histologic appearance.

A case of generalized melanosis associated with malignant melanoma, characterized by up-to-date, previously undescribed histologic findings, is reported. Markedly dilated dermal lymphatics with features resembling secondary lymphangioma were found. We speculate that a further mechanism, as well as those previously reported in the literature, could be operative in the pathogenesis of this disorder of altered pigmentation.

Melanocytes freshly isolated from normal human skin express the cell membrane receptor for the adhesive glycoprotein thrombospondin.

Thrombospondin (TSP) is an adhesive protein with multiple binding sites, which is able to mediate several cell-to-cell and cell-to-matrix interactions, particularly through its cell membrane receptor (TSP-R). Because human keratinocytes are able to synthesize and express TSP, and as TSP is also localized at the dermal-epidermal junction in normal human skin, we questioned whether epidermal cells are able to bind available TSP, that is, to express TSP-R. To investigate this, we employed gold immunoelectron microscopy on epidermal cells freshly isolated from normal human skin; the TSP-R was detected by OKM5 monoclonal antibody. Epidermal cells showing ultrastructural characteristics of melanocytes were gold-stained on their plasma membrane, whereas keratinocytes, Langerhans cells and lymphocytes were unstained. Although functional studies are clearly necessary to clarify the role(s) played by the TSP-R on the cell surface of melanocytes, it is tempting to speculate that the TSP-R may be important for melanocyte adhesion to the dermal-epidermal junction and to keratinocytes. Such adhesion may not only subserve the steric localization of melanocytes, but also have important implications for those functional activities of melanocytes which have been shown to require close contact between these cells and adjacent keratinocytes and/or basement membrane components.

Adhesion molecules on the plasma membrane of epidermal cells. IV. Immunolocalization of the intercellular adhesion molecule-1 (ICAM-1, CD54) on the cell surface of a small subpopulation of keratinocytes freshly isolated from normal human epidermis.

The intercellular adhesion molecule-1 (ICAM-1) is a cell membrane glycoprotein displaying a pivvtal role in cell-cell interactions in the immune system, and is a ligand for LFA-1, which is expressed on leukocytes. ICAM-1 is expressed in different cell types, including epithelial cells in a number of organs; the universal feature on all these cells is ICAM-1 induction from very low ICAM-1 constitutive levels on unstimulated resting cells to very high ICAM-1 levels triggered by mediators released at sites of inflammation. Therefore, since a strong expression of ICAM-1 on keratinocyte (KC) surface was recently demonstrated in various inflammatory skin lesions, in this investigation we asked whether very low ICAM-1 levels might be present on the plasma membrane of unstimulated KC in normal skin. Crude epidermal cell suspensions, freshly isolated from normal human skin, were immunolabeled by anti-ICAM-1 monoclonal antibody and stained by two highly sensitive ultrastructural detection systems, namely, the immunogold (5-nm-sized particles) method and the immunogold-silver-enhancement method. The quantitative analysis of 1000 KC scrutinized under the electron microscope revealed that 17.2% KC were ICAM-1-positive, although a density per KC section (midplane) of merely 18.92 +/- 13.02 5 nm-sized particles was scored (n = 100), indicating that the amounts of ICAM-1 moieties on this KC subset are presumably low. The ICAM-1 expression on a subset of KC in normal skin might account for the trafficking to and from normal epidermis of LFA-1-positive cells, including migrating Langerhans cells and occasional leukocytes.

[A comparison between amlodipine and nifedipine retard in patients with essential arterial hypertension]. / Confronto tra amlodipina e nifedipina ritardo in pazienti con ipertensione arteriosa essenziale.

Amlodipine, a novel dihydropyridine calcium-antagonist, was compared to slow-release nifedipine in a short-term study on 40 patients with mild to moderate essential hypertension, in order to assess the efficacy and tolerability of two different dihydropyridine calcium-antagonists with short and long half-life. After a two-week single-blind placebo period, patients were given, in a randomized sequence, amlodipine (5 or 10 mg/day od, 20 patients) or nifedipine s.r. (20 or 40 mg BID, 20 patients). At the end of treatment (12 weeks) a significant lowering of arterial pressure was obtained after 24h from the administration of amlodipin (-34/-17 mmHg) and after 12h from the administration of nifedipine s.r. (-33/-16 mmHg). Furthermore, with both drugs, no significant changes in heart rate and ECG have been reported. Amlodipine was better tolerated than nifedipine, as shown by the lower incidence of side effects. Therefore amlodipine proved to be an effective and well tolerated drug in the therapy of mild to moderate hypertension.