Document Detail

Langerhans cells in benign, premalignant and malignant skin lesions of renal transplant recipients and the effect of retinoid therapy.
MedLine Citation:
PMID:  9553909     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND DESIGN: Langerhans cells (LC) are a unique population of antigen-presenting cells in the epidermis which may play a role in the defense mechanisms against skin tumors. Renal transplant recipients (RTRs) have a significantly increased incidence of premalignant and malignant skin lesions. Langerhans cells, which are important for local immune surveillance, may be depleted or downregulated in skin neoplasms of RTRs, facilitating their growth. We investigated the Langerhans cell densities in 29 squamous cell carcinomas (SCCs), five basal cell carcinomas (BCCs), four Bowen's disease, eight dysplastic lesions (actinic keratoses), and three viral warts from 15 RTRs and compared these to the Langerhans cell densities in normal control skin. Eleven RTRs were receiving low-dose etretinate as chemoprophylaxis for recurrent skin cancer and the effect of low-dose retinoid therapy on Langerhans cell densities in SCCs from these patients was also assessed. Langerhans cells in frozen tissue sections were stained with the anti-human Leu-6 monoclonal antibody. RESULTS: There was no significant difference in LC numbers between normal skin from RTRs and normal skin from non-immunosuppressed individuals. There was a statistically significant reduction in LC/mm2 and LC/1000 K (keratinocytes) for SCC, BCC, dysplastic lesions and viral warts compared with normal skin (P < 0.001, P < 0.01, P < 0.001, P < 0.05, respectively). There was a trend for an increase in Langerhans cell density in SCCs which developed during etretinate therapy compared with pre-etretinate but the difference was not statistically significant. CONCLUSIONS: In this study of RTRs, a significant reduction in Langerhans cell densities was observed in SCCs, BCCs and dysplastic lesions compared with normal skin. A reduction in Langerhans cell density in viral warts from RTRs was also observed. A working hypothesis may include a multifactorial etiology for this reduction in Langerhans cell densities. It is possible that human papilloma virus (HPV) infection, by reducing intraepidermal Langerhans cell density, may decrease local immune surveillance and facilitate the development of skin cancers. Ultraviolet radiation and immune suppression may also play a role. The marked depletion of Langerhans cells in skin cancers, precursor lesions and viral warts suggests a central role for Langerhans cells in skin cancer promotion in RTRs.
G E Gibson; A O'Grady; E W Kay; M Leader; G M Murphy
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the European Academy of Dermatology and Venereology : JEADV     Volume:  10     ISSN:  0926-9959     ISO Abbreviation:  J Eur Acad Dermatol Venereol     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-06-10     Completed Date:  1998-06-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9216037     Medline TA:  J Eur Acad Dermatol Venereol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  130-6     Citation Subset:  IM    
Department of Dermatology, Beaumont Hospital, Dublin, Ireland.
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MeSH Terms
Carcinoma, Basal Cell / drug therapy,  pathology
Carcinoma, Squamous Cell / drug therapy,  pathology
Cell Count / drug effects
Etretinate / administration & dosage*
Keratolytic Agents / administration & dosage*
Kidney Transplantation / pathology*
Langerhans Cells / drug effects*,  pathology*
Precancerous Conditions / drug therapy,  pathology
Sensitivity and Specificity
Skin Diseases / drug therapy*,  pathology*
Skin Neoplasms / drug therapy,  pathology
Statistics, Nonparametric
Reg. No./Substance:
0/Keratolytic Agents; 54350-48-0/Etretinate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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