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Possible involvement of CD14(+)  CD16(+) monocyte lineage cells in the epidermal damage of Stevens-Johnson syndrome and toxic epidermal necrolysis.
MedLine Citation:
PMID:  21936856     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are characterized by keratinocyte apoptosis and necrosis, resulting in epidermal detachment. Although monocytes abundantly infiltrate the epidermis in SJS/TEN skin lesions, the properties and functions of these cells have not been fully examined. Objectives:  To determine the properties of monocytes infiltrating into the epidermis in SJS/TEN. Methods:  Immunostaining of skin sections was performed to examine the membrane markers of monocytes infiltrating into skin lesions. Results:  Immunostaining of cryo-sections from 11 SJS/TEN skin lesions revealed numerous CD14(+) monocytes located along the dermo-epidermal junction and throughout the epidermis. The cells co-expressed CD16, CD11c, and HLA-DR. CD14(+) CD16(+) cells were identified in very early lesions without epidermal damage, suggesting that their infiltration is a cause, rather than a result, of epidermal damage. Moreover, these cells expressed CD80, CD86, and CD137L, indicative of their ability to facilitate the proliferation and cytotoxicity of CD8 T cells. CD16(+) cells infiltrating the epidermis and detected at the dermo-epidermal junction were immunostained and counted in paraffin-embedded skin sections obtained from 47 patients with drug rash manifested as TEN, SJS, maculopapular-type rash, or erythema multiform-type rash. The number of CD16(+) monocytes infiltrating the epidermis increased significantly, depending on the grade of epidermal damage. Conclusions:  These findings suggest that the appearance of CD14 (+) CD16 (+) cells of monocyte lineage play an important role in the epidermal damage associated with SJS/TEN, most likely by enhancing the cytotoxicity of CD8 T cells.
Authors:
M Tohyama; H Watanabe; S Murakami; Y Shirakata; K Sayama; M Iijima; K Hashimoto
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-21
Journal Detail:
Title:  The British journal of dermatology     Volume:  -     ISSN:  1365-2133     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 British Association of Dermatologists.
Affiliation:
Department of Dermatology, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan Department of Dermatology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
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