lewis-x-antigen and Skin-Diseases

: Acquired expression of CD30 is frequently noted in histological transformation of mycosis fungoides (MF), but simultaneous gain of CD15 accompanied with loss of pan-T-cell antigens are extremely rare. We report an unusual case of transformed MF with such an immunophenotypic alteration resembling classical Hodgkin lymphoma. The patient was an 81-year-old male with MF, who was initially treated with topical steroids and phototherapy. Despite the initial response, the patient developed a tumor-like skin lesion that was confirmed to be CD30-positive large T-cell lymphoma and was subsequently found to have a regional lymph node involvement by pleomorphic large cell lymphoma. Besides CD30, pleomorphic large cells were positive for CD15 but negative for all B cell- and T cell-specific antigens. Epstein-Barr virus was negative. Polymerase chain reaction-based assays demonstrated a clonal rearrangement of T-cell receptor gamma gene but detected no B-cell clone. The mechanism and clinical significance of this phenotypic conversion remains to be elucidated.

Topics: Aged, 80 and over; Biomarkers, Tumor; Cell Transformation, Neoplastic; Fucosyltransferases; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Primary Cutaneous Anaplastic Large Cell; Male; Mycosis Fungoides; Skin Diseases

Selectins mediate the initial adhesion of leukocytes to endothelial cells in many contexts of inflammation-dependent leukocyte recruitment. The glycans that contribute to P- and E-selectin counterreceptor activity arise through glycosylation reactions in which the terminal steps are catalyzed by alpha(1,3) fucosyltransferases (FTs). We examined how selectin ligand activities are controlled in eosinophils by characterizing FT expression profiles and regulatory mechanisms in eosinophils isolated from human blood. We found that FT-IV and FT-VII mRNAs were up-regulated by transforming growth factor-beta1, but the FT-IV transcript consistently predominated in eosinophils. To further define the physiological role of FT-IV and FT-VII in expression of eosinophil selectin ligand, we characterized models of dermal eosinophilia in FT-IV- and/or FT-VII-deficient mice in vivo. FT-IV deficiency yielded a significant decrease in eosinophil recruitment to the skin. Likewise, deficiency of FT-VII also yielded a decrease in eosinophil recruitment. Eosinophil recruitment that remained in the absence of FT-VII was further inhibited by blocking P- or E-selectin and was essentially absent in mice deficient in both enzymes. These observations indicate that FT-IV and FT-VII are both important contributors to selectin-dependent eosinophil recruitment to the skin and may represent therapeutic targets for treating diseases in which eosinophil recruitment contributes to pathophysiology.

Topics: Animals; Blood Cells; Chemokine CCL11; Chemokines, CC; Dermatitis; E-Selectin; Eosinophilia; Eosinophils; Fucosyltransferases; Humans; Lewis X Antigen; Ligands; Mice; Mice, Knockout; N-Acetylglucosaminyltransferases; P-Selectin; RNA, Messenger; Selectins; Skin; Skin Diseases

The atypical cells of CD30(+) cutaneous lymphoproliferative disorders (CD30CLD) are commonly of T-cell origin and frequently have a similar morphology as Hodgkin or Reed-Sternberg cells of Hodgkin's lymphoma (HL). HL is one of the tumors associated with CD30CLD. Although most studies support a B-cell derivation of the tumor cells in HL, recently a few cases of classical HL with T-cell genotype have been reported. We report a patient who presented with CD30CLD whose lymph nodes showed classical HL of mixed cellularity subtype at presentation. By single-cell PCR, the same clonal gene rearrangements of the T cell receptor-beta gene locus could be assigned to the CD30(+) and CD15(+) cells of both skin and lymph node. In a lymph node biopsy specimen taken in relapse after several courses of chemotherapy, the CD30(+) tumor cells were abundant. The T cell-derived tumor cells displayed aberrant expression of the Pax-5 gene in all specimens. A common clonal origin of both CD30CLD and HL of the lymph node in the patient presented here suggests that HL with T-cell genotype exists in association with CD30CLD as well as in sporadic cases and may share clonal origin with the skin tumor.

Topics: DNA-Binding Proteins; Female; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Lewis X Antigen; Lymph Nodes; Lymphoma, T-Cell; Lymphoproliferative Disorders; Middle Aged; PAX5 Transcription Factor; Polymerase Chain Reaction; Skin Diseases; Transcription Factors

The cutaneous lymphocyte-associated antigen recognized by the monoclonal antibody HECA-452 has been thought to play a major role in the homing of memory T-cell subsets to the skin by virtue of its ability to bind to E-selectin of dermal microvascular endothelial cells. Considering that the homing of different leukocyte populations to the skin may involve similar mechanisms, we studied the expression of HECA-452-reactive molecules on CD1a+ epidermal Langerhans cells. Immunofluorescence double-labeling of cryostat sections and epidermal sheets of normal skin revealed HECA-452 immunoreactivity on a subpopulation of dermal and epidermal CD1a+ cells, whereas upon flow-cytometric analysis of epidermal single cell suspensions virtually all CD1a+ cells bound HECA-452 antibodies. We observed a marked upregulation of HECA-452-antigen expression on CD1a+ epidermal cells and a pronounced increase in the number of HECA-452+/CD1a+ dermal cells in lesional skin from inflammatory and neoplastic lymphocytic skin diseases, compared to normal skin. The molecule detected by the HECA-452 antibody on Langerhans cells is neuraminidase sensitive and contains a CD15 (LewisX) carbohydrate backbone. Because Langerhans cells react with the sialyl-LewisX-specific antibody CSLEX1, it is very likely that the HECA-452-reactive structure is or contains sialyl-LewisX. Our data are compatible with the view that i) resident epidermal Langerhans cells upregulate HECA-452-antigen expression due to the cytokine profile generated in the disease process or ii) that Langerhans cell precursors express HECA-452-antigens and show an enhanced immigration into lesional skin. The characterization of HECA-452+ cells in peripheral blood may not only clarify this issue but may also help to identify the still elusive Langerhans cell-precursor.

Topics: Antibodies, Monoclonal; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Cell Adhesion Molecules; Cross Reactions; E-Selectin; Epitopes; Humans; Langerhans Cells; Lewis X Antigen; Ligands; Membrane Glycoproteins; Receptors, Lymphocyte Homing; Skin; Skin Diseases

The results of several investigations proved that, in special circumstances, human keratinocytes (HKs) synthesize and express cell surface moieties characteristic of effector and/or accessory cells of the immune system, such as CD16, CD36, HLA-DR, and intercellular adhesion molecule-1 (CD54), which are all detectable on the surfaces of macrophages. In the present study, skin biopsies from healthy volunteers, from positive tuberculin skin tests, and from patients with acute urticaria (AU), lichen planus (LP), psoriasis vulgaris (PV), mycosis fungoides (MF), and purpura pigmentosa chronica (PPC) were investigated by means of a multistep immunoperoxidase method to examine the reactivity of the HKs with a panel of monoclonal antibodies (MABs) characteristic of monocyte/macrophage cell lines. In biopsies obtained from positive tuberculin tests and from clinically involved skin of patients with LP, PV, MF, or PPC, a multifocal, positive peroxidase reaction was observed on the membranes of HKs of the basal and suprabasal cell layers when the MABs OKM13 (CD13), OKM14 (CD14), and Dako-Macrophage (CD68) were used. In contrast, specific staining of the HKs was not observed with the same antibodies in the biopsies of healthy volunteers or of patients with AU or in the uninvolved skin specimens obtained from the other patients. The HKs of PV, LP, MF, PPC, and AU patients and those of the healthy subjects all failed to give positive reactions when MABs against CD11b, CD15, or CD33 were used. The published data supplement the known surface characteristics of HKs, reflecting their stage of activation and differentiation.

Topics: Antigens, CD; Antigens, Differentiation, Myelomonocytic; Antigens, Surface; Biomarkers, Tumor; CD13 Antigens; Humans; Immunohistochemistry; Keratinocytes; Lewis X Antigen; Lichen Planus; Lipopolysaccharide Receptors; Macrophage-1 Antigen; Membrane Glycoproteins; Monocytes; Mycosis Fungoides; Psoriasis; Purpura; Sialic Acid Binding Ig-like Lectin 3; Skin; Skin Diseases; Skin Neoplasms; Tuberculosis, Cutaneous; Urticaria

Occurrence of monocytoid B-lymphocytes (MBL) in extranodal organs in various inflammatory diseases was examined. MBL were present in 5 (11.4%) of 44 patients with Graves' disease, 11 (36.7%) of 30 with Hashimoto's thyroiditis, 1 (8.3%) of 12 with lymphoid follicular hyperplasia (LFH) of stomach, 1 (10%) of 10 with cutaneous LFH, and 0 of 5 with LFH of lung. The MBL presented as irregularly shaped nodular collections of cells, directly surrounding secondary follicles. Immunohistochemistry revealed a B-cell nature of these cells which expressed the following antigens; CD3-, CD 15-, CD45RA+, CD45Ro-, CDw 75+, CD74+, Mx-PanB+, MB-1+, EMA-. There were no immunoglobulin light chain restriction among infiltrating lymphoid cells. MBL in 2 of 18 cases showed positive reaction for CD43. The patients with MBL were older than those without MBL in each organ site, though the difference was not statistically significant. These findings showed that the MBL could appear in nonlymphoid organs affected by long-standing inflammation. High frequency of the appearance of the MBL in Hashimoto's thyroiditis suggest that MBL proliferation correlates with an impaired immune status.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, B-Lymphocyte; Antigens, Differentiation, Myelomonocytic; Autoimmune Diseases; B-Lymphocytes; CD3 Complex; Cell Movement; Female; Graves Disease; Histocompatibility Antigens Class II; Humans; Hyperplasia; Immunohistochemistry; Incidence; Leukocyte Common Antigens; Leukosialin; Lewis X Antigen; Lung Diseases; Male; Middle Aged; Sialoglycoproteins; Skin Diseases; Stomach Diseases; Thyroiditis, Autoimmune