[Characterization of lymphocytic infiltrate cells in bullous pemphigoid and pemphigus vulgaris].

Abstract

By means of monoclonal antibodies (mab) and alkaline phosphatase anti-alkaline-phosphatase (APAAP) technique, the distribution and characteristics of lymphocytic infiltrates were studied in biopsies from 15 patients with bullous pemphigoid (b.P.) and 5 patients with pemphigus vulgaris (P.v.). The biopsies were obtained from freshly developed blisters along with perilesional tissue. The lymphocytic infiltrates in b.P. as well as in P.v. were located in the area of the fresh lesions and consisted almost exclusively of T cells (CD3 positive lymphocytes). In b.P., the discrepancy between a decreased number of CD2 positive lymphocytes (10-20%) and markedly higher number of CD3 staining cells (50-60% of all infiltrate cells) was striking. The characterization of the T cell subpopulations in both dermatoses showed mainly T helper cell infiltrates (CD4), while only up to 10% of T suppressor cells (CD8) were detected. CD45R positive (CD4+/CD45R+: suppression inducing) as well as CD29-positive (CD4+CD29+: cells which provide help for antibody production) T-cell subpopulations were detected in both dermatoses particularly adjacent to blister in up to 10% of the cell infiltrates. Epidermal staining with CD29 mab in b.P. up to the stratum spinosum and in P.v. within intraepidermal blisters was detected. By means of CD19 and CD21 mab B lymphocytes were minimal. Perivascular individual cell staining occurred with CD7 CD16, CD56 and CD57 mab (K/NK cells) in b.P. as well as in P.v. patients. The predominance in T cell infiltrates, particularly T helper cells, suggests the role of cellular immune mechanism in the pathogenesis of these diseases, in b.P. the CD2 antigen (SE receptor) appears to be of particular importance.