RESUMO
In order to gain insights into the dynamics of mast cell subpopulations in normal and diseased skin, a novel enzyme-histochemical double and triple staining method was employed that allowed the detection of metachromasia (toluidine blue) and the mast cell proteases tryptase and chymase within the same cell. Cryostat sections were used of skin biopsies from the following specimens: normal skin (N = 4), psoriasis (N = 13), atopic eczema (N = 7), lichen planus (N = 6), interferon alpha 2a injection sites (N = 1) of a leukemic infiltrate and corresponding normal skin of the same patient before and after treatment. (i) Equal numbers of tryptase- and chymase-positive mast cells (MCTC) were obtained in all normal and diseased specimens in papillary and reticular dermis, with threefold increases around appendages. (ii) Tryptase-positive mast cells (MCT) were absent in normal skin, but were markedly increased in a disease-specific pattern within the papillary dermis, the inflammatory infiltrate and around appendages. (iii) Marked increases of MCT were also noted at interferon injection sites within the leukemic infiltrate, but not in the normal skin of the same patient. These data suggest that disease-dependent mast cell dynamics involve only MCT in cutaneous inflammation and that MCT numbers are controlled by distinct, disease-specific local tissue factors.
Assuntos
Dermatite Atópica/patologia , Compostos de Diazônio , Líquen Plano/patologia , Mastócitos/patologia , Psoríase/patologia , Serina Endopeptidases/análise , Coloração e Rotulagem/métodos , Cloreto de Tolônio , o-Aminoazotolueno , Sequência de Aminoácidos , Quimases , Dermatite Atópica/enzimologia , Inibidores Enzimáticos , Humanos , Fatores Imunológicos/uso terapêutico , Interferon alfa-2 , Interferon-alfa/farmacologia , Interferon-alfa/uso terapêutico , Leucemia Linfocítica Crônica de Células B/patologia , Leucemia Linfocítica Crônica de Células B/terapia , Infiltração Leucêmica , Líquen Plano/enzimologia , Mastócitos/química , Dados de Sequência Molecular , Psoríase/enzimologia , Proteínas Recombinantes , TriptasesRESUMO
In this pilot study 12 patients with moderate to severe atopic eczema were treated with 2 million IU interferon alpha 2a (Roferon A) three times weekly for 8 weeks and followed up for a further 10 weeks: 2 patients showed clear and 9 a slight to moderate reduction of their skin lesions; 1 patient got worse. Pruritus did not decrease and even increased in a few patients, and IgE levels showed no change during and after treatment. All patients noted mild, transient, flu-like symptoms. The efficacy of interferon alpha in the present therapeutic design for the treatment of atopic eczema must thus be classified as only moderate.
