Nihon Hifuka Gakkai zasshi. The Japanese journal of dermatology最新文献

Recently it has been reported that cell-mediated immune (CMI) reaction is related to the blister formation as well as the reaction of autoantibody against the basement membrane zone (BMZ-Ab) in bullous pemphigoid (BP). Previously we reported that T-cells infiltrated were producing gamma-interferon (IFN-gamma) and that high levels of IFN-gamma were detected in the blister fluids of BP. In the present study, in order to find the effect of IFN-gamma on the skin, we have done the organ culture of normal skin explants with IFN-gamma. The dermal-epidermal separation (DES) was histologically observed in skin explants which were incubated with high level of IFN-gamma after 24 hours. The DES was found to be located between the basal layer and the site of laminin and type IV collagen. It is considered that IFN-gamma alters the antigenicity and mediates to release some other cytokines in CMI reaction. In addition to these, IFN-gamma seems to directly work on the DES in normal skin. Around the DES of the skin explants, plasminogen activator was accelerated immunohistologically. The results suggest that IFN-gamma mediated by CMI response also plays an important role as well as the autoantibody in the blister formation of BP.

This study investigated the cell kinetic effects of a single treatment with PUVA on guinea pig epidermis after tape stripping. Flow cytometry was used to determine the proportion of cells in S phase and G2 + M phase. Bromodeoxyuridine incorporation was used to determine the labeling index. Conventional histological techniques were used to observe the mitotic index. An initial decrease followed by a subsequent significant increase compared to the non-PUVA-treated controls was observed in all parameters studied except the mitotic index, which was below or around the control level until 168 hours after the treatment with PUVA. The results obtained in this study suggest that PUVA induces a partial blocking at G1-S boundary for short duration, and that when the partial G1 block is released, then the cells of stimulated epidermis enter DNA synthesis and pass through the S phase to the G2 phase in partial synchrony. It is also suggested that PUVA blocks the passage of cells from the G2 phase to mitosis, resulting in an long-lasting accumulation of cells in the G2 phase.

It is known that PG is often associated with AOS. However, there have been no reports on long term follow-up of PG associated with AOS. We experienced a case of a 16 year old female who suffered from PG and AOS. The onset of both diseases occurred at the same time. On admission, many pustules and ulcers were found on the extremities. There was no finding of vasculitis in histopathological examinations. Development of skin lesions of PG coincided with the progress of AOS. But, AOS was progressive even when the patient was free of skin eruptions. It was concluded that the activity of PG was not always parallel to that of AOS.

Total DNAs obtained from Japanese patients with molluscum contagiosum (MC) were analyzed by agarose gel electrophoresis after digestion with Bam HI, Hind III or Cla I restriction enzymes, which revealed the presence of four different cleavage patterns of MC virus (MCV) DNAs. The comparison with previously reported MCV types clarified that two of them were identical with MCV-1 and -2, respectively. The other two isolates were considered as yet unrecognized types and named MCV-3 and -4, respectively.

Sixteen cases of Basal Cell Carcinoma have been tested with monoclonal antibodies to HLA-class I, beta 2-microglobulin, HLA-DR, DP and DQ antigens immunohistochemically using frozen tissues. HLA-class I antigens were expressed weakly on BCC in thirteen and fifteen out of sixteen cases using two different monoclonal antibodies respectively. beta 2-microglobulin was expressed differently with the same intensity as normal epidermis in 6 cases, weaker than normal epidermis in 8 cases and absent in 2 cases. There is no correlation with the expression of HLA-class I between histological type and lymphocyte infiltration. On the other hand, HLA-DR, DP and DQ antigens were positive in 4, 3 and 3 cases respectively. But the percentage of positive cells for HLA-class II were only 1-2%. The expression of HLA-DR antigen was most strongest among HLA-class II antigens.

Twenty one patients with livedo racemosa (LRa) and periarteritis nodosa cutanea were screened for the presence of anti-cardiolipin antibody (aCL) by ELISA. 11 out of 21 revealed positive aCL whose clinical features could be divided into 3 groups: 4 patients with livedo with ulceration, 2 with pyoderma gangrenosum-like lesions, and 5 with extensive LRa. #1. The summer ulceration of leg of 4 patients were surrounded by several tiny petechiae where hyaline microthrombi of blood capillaries in the upper dermis were demonstrated. All had multiple cerebral microinfarctions on magnetic resonance imaging (MRI). #2. Pyoderma gangrenosum-like lesions of 2 patients consisted of painful punched-out ulcers on livedoid lesions where intravascular endothelial hyperplasia in a small artery was demonstrated. Both had multiple cerebral microinfarctions. #3. Another clinical manifestation of the patients with positive aCL was extensive form of LRa of 5 patients. All had positive ANA, however none of them exhibited cerebral microinfarctions on MRI. #4. The remaining 10 patients with negative aCL showed no relationship with such clinical and laboratory manifestations. These results indicate that there is a significant correlations between summer ulceration with petechiae, capillary microthrombi of the skin, positive aCL and cerebral microinfarctions on MRI.

The pathogenic role of proteinases and Ca++ in the action of staphylococcal epidermolytic toxin A (ETA) was investigated using recombinant ETA (rETA). rETA was released from the periplasmic space of E. coli transformed with the plasmid carrying ETA gene and purified by high performance liquid chromatography. The epidermolytic activity of the purified rETA was 5,000 epidermolytic unit per mg of protein. Pieces of newborn mouse skin were cultured in minimum essential medium containing rETA. Various concentrations of alpha 2-macroglobulin, N-ethylmaleimide, leupeptin, L-transepoxysuccynyl-leucylamide (4-guanidino) butane, phenylmethylsulfonyl fluroide, pepstatin A, ethylenediaminetetraacetic acid (EDTA), ethyleneglycol-bis (2-aminoethylether) tetraacetic acid (EGTA) and 8-(N,N-diethylamino) octyl 3,4,5-trimethoxybenzoate (TMB-8) were added to the medium. Splitting in the upper epidermis occurred after 4 hr of incubation in the presence of 10 micrograms/ml rETA and was not inhibited by the proteinase inhibitors except EDTA and EGTA. EDTA, EGTA and TMB-8 inhibited the splitting completely at concentrations of 0.1-1 mM. The inhibitions caused by these agents were restored by the addition of Ca++ to the medium. These results strongly suggest that the action of ETA is mediated by the increase in cytoplasmic Ca++ concentration resulting from Ca++ influx and/or intracellular Ca++ mobilization.

We measured immunoreactive endothelin-1 in plasma of a patient with malignant hemangioendothelioma. A 74-year-old female first visited our clinic in July, 1989. Physical examination revealed reddish nodule measured 4 x 5 x 1 cm and erythematous plaque with erosion on her scalp. A biopsy specimen showed extensive proliferation of atypical tumor cells intermingled with a large number of capillary vessels in dermis. Some of tumor cells were positively stained for factor VIII related antigen by PAP method. From these findings we diagnosed malignant hemangioendothelioma and resected the tumor on August 3. The measurement of immunoreactive endothelin-1 in plasma was performed by radio-immunoassay on August 2 (before operation), October 20 and December 27 (after operation). The results were 16.2, 4.3 and 5.6 pg/ml, respectively (normal range: 0.5 +/- 0.2 pg/ml). Plasma endothelin-1 level may be run parallel to quantity of tumor cells in malignant hemangioendothelioma.

The expressions of several cytokeratins (CKs) in the outer root sheath (ORS) of the human anagen hair follicles were immunohistochemically studied using 11 antikeratin monoclonal antibodies (MoAbs) and 10 specimens from scalp. CKs 1, 10, 11, which are markers for differentiating keratinocytes, were exclusively found in the intermediate cells and the granular cells at the infundibulum. In cytokeratin expression, a distinct linear demarcation between the infundibulum and the isthmus was observed. Trichilemmal keratinization appeared to go in an inner-upward direction toward the hair canal. CK 19, a marker of undifferentiated stem cells, was found in outermost cells of the ORS at the isthmus and in some cells of the lower ORS. CK 16, a marker of hyperproliferative keratin, was detected in the outermost cells of the infundibulum and all the cells of the ORS below the isthmus. Therefore, the keratinocytes at the infundibulum may show a differentiation similar to that of the interfollicular epidermal keratinocytes. The ORS cells below the isthmus seem to move up to inner-upward direction along the hair axis with differentiation.

Response of murine lymphnode cells (LNC) sensitized with sulfhydryl drugs to recombinant interleukin 2 (rIL-2) was studied in antigen-specific lymphocyte proliferation test (LPT). Mice were primed with tiopronin (TP) and gold sodium thiomalate (GTM) and the secondary response to LNC was measured in a proliferative assay in vitro. Rapid fluorochromasia assay with propidium iodide (RFP) was used for the quantitative measurement of LPT instead of 3H-thymidine uptake. There was no difference in proliferative response to specific antigen between TP or GTM-primed LNC and control ones. In contrast, a significant proliferation was observed when LNC from sensitized mice were cultured with sensitizing antigen and rIL-2. The strength of response was dependent on the concentration of rIL-2. It was considered that adding rIL-2 to LPT of TP or GTM-sensitized mice enhanced antigen-specific lymphocyte proliferative response and the measurement of IL-2 responsiveness using RFP method might be useful to detect sulfhydryl drug allergy in man.