Library

Notes: Background. Kaposi's varicelliform eruption (KVE) is characterized by disseminated cutaneous eruptions usually caused by infection with herpes simplex virus (HSV). Kaposi's varicelliform eruption is commonly observed among patients with atopic dermatitis (AD). Why AD patients are prone to HSV infections is still an enigma. Recent findings suggest that an increased number of IL-4-secreting cells can be cloned from lesions of AD. Because IL-4 is a known Th1 cell inhibitor, theoretically, by inhibiting the Th1 cells, it could downregulate the immune response against HSV. In this study, we have evaluated the role of IL-4 on HSV replication. Methods. Peripheral blood mononuclear cells (PBMC) from 10 HSV seronegative and five seropositive healthy individuals were stimulated with PHA, recall antigen (tetanus toxoid), and HSV antigen in combination with IL-4 and anti-IL-4. Supernatants were assessed for interferon (IFN) gamma, IL-4 by enzyme-linked immunosorbent assay (ELISA), and for anti-HSV effect. Anti-HSV effect was assessed by measuring inhibition of the cytopathic effect (CPE) of HSV on a Vero cell line. Results. Both seropositive and seronegative groups showed significant inhibition of IFN-gamma secretion with addition of IL-4 (P 〈 .001, Wilcoxon rank sum test) and this effect could be neutralized by anti-IL-4. There was a direct relationship between the IFN-gamma concentration and the HSV cytopathic effect and an inverse relationship between IL-4 concentration and HSV CPE. Conclusions. This study provides evidence that IL-4 can enhance HSV infection. Therefore, it is conceivable that patients with conditions of increased activity of IL-4, as in ad, would be prone to extensive forms of HSV infection.

Notes: Porokeratosis is an uncommon, inherited, autosomally dominant disorder. In the last decade association of porokeratosis and immunosuppression has been observed. In this study we carried out a comparative study between immunosup-pressed and nonimmunosuppressed porokeratosis cases. We found that 9 out of 20 cases of porokeratosis were associated with organ transplantation/immunosuppression. Clinicopathologic study revealed that the pattern of disease is alike both in immunosuppressed and nonimmunosuppress-ed patients. Our observations indicate that immune modulation could be a factor in the genesis of porokeratosis.

Notes: Background and objective In recent years, many reports have suggested an active role of neuropeptides in the pathogenesis of psoriasis. Increased numbers of neuropeptide-containing nerves positive for substance P (SP), vasoactive intestinal polypeptide (VIP), and calcium gene-related peptide (CGRP) have been reported in psoriatic tissue. As psoriatic epidermis has a larger mass/volume, however, it is expected to have more nerves and a higher number of neuropeptergic fibers. Therefore, instead of demonstrating a larger number of neuropeptergic fibers, a more significant study is to investigate whether the neuropeptergic fibers are denser in psoriatic tissue. In this study, we applied a double labeled immunofluorescence technique. This method allows the identification of the total number of nerve fibers and the number of nerves positive for specific neuropeptides. Materials and methods We obtained biopsies from nine lesional and seven non-lesional psoriatic skins and six normal controls. Biopsies were snap frozen and then cut into 14 μm cryosections. The tissues were first treated with anti-microtubule associated protein (MAP)2 antibody to stain the nerves. This was followed by a second set of stainings for SP, VIP, and CGRP. Primary antibodies were used in dilutions of 1 : 200 for anti-MAP2, 1 : 200 for anti-SP, 1 : 800 for anti-VIP, and 1 : 400 for anti-CGRP. Results We found that the percentage of SP-positive fibers was twofold greater and the percentage of CGRP-positive fibers was 2.5 times greater in the psoriatic epidermis than in the epidermis of normal skin. Psoriatic epidermis had 30.1 ± 3.9% SP-positive nerve fibers compared with 15.7 ± 3.7% in the normal control. The corresponding values for CGRP-positive nerve fibers were 30.1 ± 3.9% and 12.0 ± 4.2%. Conclusions The results of our study suggest that SP- and CGRP-containing neuropeptide nerve fibers are more dense in the psoriatic epidermis. Both SP and CGRP are chemotactic to neutrophils and mitogenic to keratinocytes and endothelial cells. In addition, SP activates T lymphocytes and induces adhesion molecules on the endothelial cells. Our observations suggest that neuropeptides may play a significant role in the inflammatory and proliferative process of psoriasis.

Notes: Background Since the landmark study on rheumatoid arthritis, many reports have suggested that physiological changes during pregnancy often induce remission of systemic and cutaneous inflammatory diseases. In this study we investigated the clinical course of psoriasis during pregnancy.Objective In this retrospective study information was collected from Psoriasis Life History Questionnaires. The data obtained from 736 questionnaires were entered into a computerized database. Information relevant to the clinical course of psoriasis during pregnancy was evaluated in respect to improvement/worsening, number of pregnancies, severity of the disease, and certain other clinical parameters.Results In a majority of the patients psoriasis improved during pregnancy. Data available from 91 pregnancies revealed: psoriasis improved in 51 (56%), worsened in 24 (26.4%), and remained unchanged in 16 (17.6%). Also, appearance of psoriasis new lesions was found to be frequent during the early postpartum period. Patients who improved in the first pregnancy were found to have a similar response in the following pregnancies.Conclusion Research on immuno-endocrine interactions during pregnancy is a relatively new field. Proinflammatory Th-1 cytokines are up-regulated in psoriasis and play a key role in the inflammatory cascades of psoriasis. It is likely that during pregnancy the Th-2 cytokine-mediated down-regulation of the immune response by virtue of its anti-inflammatory and antagonizing effects on the Th-1 cytokines improves psoriasis.

Notes: AbstractBackground  An important cellular aberration at sites of psoriatic inflammation is an increase in the number of dermal mast cells. Being multifactorial immune effector cells, it is believed that mast cells play an essential role in perpetuating the inflammatory process of psoriasis. However, factors responsible for the infiltration and accumulation of mast cells in psoriatic lesions are largely unknown. Recent studies have demonstrated that Interleukin-8 (IL-8) exerts strong chemotactic effects on mast cells in vitro. Overexpression of IL-8 has also been reported in psoriatic lesions. In this study, we have found a correlation between the expression of IL-8 and dermal mast cell density in lesional psoriatic skin as compared to nonlesional psoriatic skin.Methods  Four-mm punch biopsies were taken from 14 psoriatic patients and eight healthy volunteers. Using immunohistochemical techniques, 8 μm sections of lesional psoriatic, nonlesional psoriatic, and normal control samples were evaluated for dermal mast cell density and the density of IL-8 expressing keratinocytes.Results  It was found that dermal mast cell density in lesional psoriatic, nonlesional psoriatic, and normal skin was 105.4 ± 71.2, 42.3 ± 30.1, and 47.5 ± 32.5 mast cells/mm2, respectively. IL-8+ keratinocyte density in lesional psoriatic, non lesional psoriatic, and normal skin was 171.5 ± 67.1, 25.4 ± 14.9 and 20.6 ± 8.7 IL-8+ Keratinocytes/mm2, respectively.Conclusions  The results of this study suggest that increased levels of IL-8 in the keratinocytes of psoriatic plaques play a contributing role in the migration of mast cells to lesion sites.