ABSTRACT
OBJECTIVES: Infiltration of many IgG4-positive plasma cells (G4-Ps) is seen in IgG4-related diseases and in several "non-IgG4-related diseases," such as pilonidal sinus (PS) as well. The involvement of CD4+CD25+ regulatory T cells (CD4CD25 Tregs) in IgG4-related diseases has been reported. To see whether CD4+CD25+ Tregs are involved in autoimmune pancreatitis (AIP)/non-IgG4-related diseases with many G4-Ps, we investigated the amount of G4-Ps and CD4+CD25+ Tregs histologically in AIP/PS. METHODS: Four AIP and 10 PS were immunostained with IgG4/Foxp3, a specific marker for CD4+CD25+ Tregs. Double immunohistochemistry and dual fluorescent immunohistochemistry were conducted to see the amount of CD4+CD25+ Tregs. RESULTS: All AIP and 30% of PS showed abundant G4-Ps. G4-Ps infiltrated diffusely for all AIPs and in a patchy pattern for PS at the abscess/granulation foci. Foxp3 immunostaining/double immunohistochemistry showed moderate to abundant CD4+CD25+ Tregs in AIP and abscess of PS, but few to moderate in granulation of PS. Dual fluorescent immunohistochemistry also showed many CD4+CD25+ Tregs in AIP. CONCLUSIONS: Many CD4+CD25+ Tregs were seen in AIP lesions, abscess of PS, but not in granulation of PS, suggesting that the amount of CD4+CD25+ Tregs sometimes do not synchronize with that of G4-Ps and might relate to the inflammatory activity of both AIP and PS.
Subject(s)
Autoimmune Diseases/immunology , Interleukin-2 Receptor alpha Subunit/analysis , Pancreatitis/immunology , Pilonidal Sinus/immunology , T-Lymphocytes, Regulatory/immunology , Adult , Aged , Biomarkers/analysis , Female , Forkhead Transcription Factors/analysis , Humans , Immunoglobulin G/analysis , Immunohistochemistry , Japan , Male , Microscopy, Fluorescence , Middle Aged , Young AdultABSTRACT
BACKGROUND: The term 'pilonidal sinus' (PS) reflects an acute exacerbating, purulent, fistulating chronic inflammation located in the coccyx region. Systematic histological investigations are scarce, and the etiology has remained controversial. METHODS: Histological and immunohistochemical characterization of totally excised material of 27 patients (68 specimens) with PS (no antecedent and no current clinical signs of hidradenitis suppurativa, HS) and its correlation with data on HS which we published earlier. RESULTS: Follicular hyperplasia/hyperkeratosis and interfollicular epidermal hyperplasia are main features of PS. Early pathology seems to take place at terminal hair follicles, whereas sinus tract formations are a secondary event. Focused regions show an inflammatory mixed infiltrate consisting of CD3+, CD4+, CD8+, CD68+ and CD79+ cells. CONCLUSIONS: PS and HS have various common characteristics at the histological and immunohistochemical level. Considering PS as a unilocalized type of HS, risk factors known in the latter should henceforth be evaluated in PS as well.
Subject(s)
Hidradenitis Suppurativa/pathology , Pilonidal Sinus/pathology , Adolescent , Adult , Antigens, CD/immunology , Female , Hair Follicle/immunology , Hair Follicle/pathology , Hidradenitis Suppurativa/immunology , Humans , Immunohistochemistry , Inflammation/immunology , Inflammation/pathology , Male , Pilonidal Sinus/immunology , Young AdultSubject(s)
Humans , Male , Adolescent , Adult , Female , Middle Aged , Pilonidal Sinus/classification , Pilonidal Sinus/physiopathology , Pilonidal Sinus/surgery , Pilonidal Sinus/diagnosis , Pilonidal Sinus/epidemiology , Pilonidal Sinus/microbiology , Pilonidal Sinus/immunology , Pilonidal Sinus/drug therapy , Pilonidal Sinus/therapy , Colorectal Surgery/methods , Diagnosis, DifferentialABSTRACT
An express evaluation of the functional state of neutrophil granulocytes by the indications of the lysosomal-cationic test are thought to be a necessary addition to routine clinico-laboratory methods of assessment of the wound process in patient with the suppurating epithelial coccygeal canal and acute paraproctitis. Use of cytochemical indices allow the antibacterial therapy to be optimized in patients with suppurating epithelial coccygeal canal and thus substantially decrease the amount of complications in the postoperative period.
