Distribution of glycoconjugates in human skin appendages

The purpose of this paper is to describe the occurrence and distribution of glycoconjugates in normal human epidermis and skin appendages (pilosebaceous unit, eccrine sweat gland) by means of FITC-labelled lectins (ConA, WGA, UEA I). Both the outer hair root and the follicular ostium-epithel disclosed a glycoconjugate expression with close homology to interfollicular epidermis. The acinar epithelium of sebaceous glands and the inner layers of hair follicles showed a more or less distinct staining pattern. Lectin binding of eccrine sweat glands revealed marked differences between ducts and secretory coils. The epithelial distribution of glycoconjugates indicates a relatively independent differentiation pathway of eccrine sweat glands compared with other specialized epithelia of the human skin.

FITC-insulin binding to normal and psoriatic epidermis

FITC-insulin was prepared and applied to frozen human skin sections. In normal and nonlesional psoriatic epidermis, the binding was cytoplasmic in suprabasal cells. In psoriatic lesions, fairly stained or even unstained cells were littered in suprabasal epidermis indicating the expansion of selected basal cell qualities into the stratum spinosum.

[Antipsoriatic effect of (tape) occlusion]

Occlusive dressing may lead to a significant reduction of the induration and desquamation of psoriatic lesions. Our lectin-histochemical findings suggest that this effect is unlikely to be caused by a normalization of abnormal keratinocyte differentiation. Since epidermal cells rich in calmodulin can immunohistologically be detected, we conclude that the egress from the stratum basale is at least partially inhibited.

Alterations of epidermal lectin binding sites in acute contact dermatitis

We investigated alterations of epidermal lectin binding sites, as well as of pemphigus and bullous pemphigoid antigens, in 28 human patch test reactions, both allergic (nickel, formaldehyde, N,N'-1,3-dimethylbutyl-N'-phenylenediamine) and irritant (sodium lauryl sulfate). The epidermal reactivity to a panel of lectins and human antisera to pemphigus vulgaris and bullous pemphigoid antigens was compared with samples obtained from normal skin and from skin under tape occlusion. We observed selective perturbations of lectin and antibody binding in acute contact dermatitis, whether allergic or irritant. The main findings were a loss of terminal sialic acids and longer bi- and triantennary mannosyl residues as well as a loss of pemphigus vulgaris antigen. The only difference between allergic and irritant patch test reactions was in topography of loss of WGA binding sites: in the former, it was most pronounced in the lower and middle epidermis, whereas in the latter it was seen in the uppermost subcorneal layers. Our findings support a common pathway of cell membrane alterations of keratinocytes in acute contact dermatitis.

[UV-A exposure of the human epidermis enhances the binding of antibodies to SSA/Ro in vitro]

Normal and psoriatic skin specimens (n = 15) were processed to give 4-micron-thick frozen sections and exposed to a single UV irradiation in vitro. We used monochromatic UV-B (313 nm) and UV-A (365 nm). The doses were as follows: 10(3)/10(4) J/m2 (UV-B) or 4.10(3)/8.10(4) J/m2 (UV-A). We investigated the effect on epidermal binding of antibodies to SSA/Ro using the indirect immunofluorescence technique. Untreated and UV-B-treated human skin failed to bind anti-SSA/Ro. UV-A exposure disclosed reticular or granular staining of epidermal nuclei and a perinuclear halo. The effect was nearly the same throughout the dosage range. The combination of UV-A and methoxsalen increased the intensity of staining. Normal and psoriatic skin behaved in the same way.

[PUVA irradiation decreases the binding of membrane and basement membrane markers to human epidermis in vitro]

PUVA effects on frozen sections of human epidermis were investigated (20 micrograms 8-methoxypsoralen/ml; UVA wavelength 365 +/- 5 nm; radiation dose between 2 X 10(2) and 2 X 10(2) J/m2). The quality of the glycocalyx was characterized by lectins labeled with FITC (HPA, PHA, LCA, PNA, SBA, RCA, GCA I, UEA I). Serum antibodies of bullous pemphigoid (BP) served as membrane markers for the basement membrane. Fixed BP antibodies were detected by FITC-antihuman IgG. The fluorescence intensity was markedly decreased at a dose of 2 X 10(5) J/m2; 2 X 10(4) J/m2 were less effective. At 2 X 10(3) J/m2, there was nearly no alteration of the fluorescence intensity observed. Changes were seen in the case of BP antibodies and lectins, except UEA I. The relatively high intensity (radiation dose) and the effects immediately observable suggest direct membrane alterations by PUVA in vitro.

[Paraneoplastic acrokeratosis (Bazex syndrome)]

Bazex acrokeratosis was found in a 79-year-old man with squamous cell carcinoma of the lung. The psoriasiform skin lesions preceded the tumor diagnosis by 8 months. The symptoms, the course of the disease, and histological findings are presented. Acrokeratosis paraneoplastica is a rare disease observed only in patients either with cancer of the upper aerodigestive tract or cervical lymph-node metastases.

[Effect of dithranol therapy on membrane, basement membrane and nuclear markers in psoriasis lesions]

We investigated the effects of anti-psoriatic therapy with dithranol (1/20-1%) in salicylic acid (0.5%) in white petrolatum on lesional skin. FITC-labeled lectins and pemphigus vulgaris antibodies (PV) served as analytical means to study the glycocalyx. Antibodies of bullous pemphigoid (BP) were used as basal membrane markers. Nuclear antigens were recorded according to the binding of speckled, anti-nuclear antibodies (ANA) as well as antibodies to dsDNA. With some lectins, dithranol therapy resulted in pronounced fluorescence of the lower parts of the basal cells. ConA was fixed by the basal cell layer. To a lesser degree, ANA were fixed by nuclei of keratinocytes. PV antibodies were not fixed at all.

[Characterization of lectin binding by psoriatic epidermis--dependence on pH]

The binding of five different lectins by normal as well as psoriatic lesional epidermis was investigated with regard to its dependence on the pH value. As we studied the reactions within the pH range of 3.0 to 9.66, we obtained the following results: lectin binding almost independent from pH (FITC-Con A, -PHA, HPA), fluorescence intensity dependent on pH (TRITC-Con A, FITC-LCA, -GCA), binding pattern dependent on pH (FITC-LCA, GCA). In contrast to normal epidermis, there was no pH dependence of the FITC-GCA binding pattern in psoriatic lesional epidermis.

[Effect of neutral solvents on lectin binding of healthy and psoriatic epidermis]

We studied the influence of neutral solvents on epidermal lectin binding in normal and lesional psoriatic skin. 1% solution of Tween 80 or Triton X-100 had no effect on the binding of the following lectins: PHA, ConA, and LCA. The HPA staining of the str. spinosum in normal skin, however, was completely removed by neutral solvents. In psoriatic skin, str. spinosum staining with HPA was resistant. Our results are discussed in the light of an altered keratinocyte maturation in psoriasis.

[Lectin binding of psoriatic skin]

The aim of our study was the characterization of epidermal lectin binding pattern in psoriatic vs. non-psoriatic skin in order to reveal possible alterations of the glycocalyx composition of psoriatic keratinocytes. We used fluoroisothiocyanate-labeled lectins of Canavalia ensiformis (ConA), Phaseolus vulgaris (PHA), Lens culinaris (LCA), and Helix pomatia (HPA). The binding pattern of psoriatic (involved and non-lesional) skin did not differ from the control samples in ConA, PHA, and LCA. In psoriasis, there was a prominent HPA binding to the dermo-epidermal junction and to a lesser degree, intercellular epidermal near the uppermost cell layers. In seborrheic keratosis, in contrast, there was no fluorescence of the dermo-epidermal junction or the first layers of the epidermis. The most pronounced binding was observed perinuclear in the upper epidermis. The results are discussed in the light of an altered keratinocyte maturation in psoriasis.

[Characterization of subepidermal immune deposits in clinically unchanged skin in patients with lupus erythematosus (SLE)]

Subepidermal immune deposits containing IgG and C3 by 9 patients suffering from SLE were exposed to extreme excess of antigens in order to solubilize tissue-bound immune complexes. Sections of 4 micron were incubated at room temperature either with calf thymus DNA (0.3-30 mg/ml) or with human gamma-globulin (HGG) (1.6-16 mg/ml). The sections thus pretreated were compared with "native" samples by means of direct immunofluorescence technique. Only HGG resulted in drastic removal of IgG deposits along the dermoepidermal junction. DNA proved to be ineffective; deposits of C3 remained uninfluenced. Our results are discussed in the light of the composition of the subepidermal immune complex in SLE.

[Z-DNA and autoimmune derangement]

The Z conformation of DNA seems closely related to postulated pathogenetic mechanisms of autoimmune complaints like systemic lupus erythematosus (SLE). The following findings are of importance: 1. Z DNA occurs under physiological conditions. 2. Z DNA is likely to be a target of polymerases. 3. Z DNA is immunogen. 4. Antibodies to Z DNA have been detected in both, murine and human SLE.

[Reactivation of the alpha 1-fetoprotein synthesis in systemic lupus erythematosus]

Serum concentrations of AFP have been determined in patients suffering from systemic lupus erythematosus (SLE) or other "collagenoses" using fluorescence ELISA adapted to the chamber analytical technique. 20% of the SLE patients showed elevated AFP levels (range 30-233 ng/ml), some of them repeatedly. Only 2 of the 14 patients without SLE had AFP levels above 30 ng/ml (37 resp. 40 ng/ml). In SLE sera there was a significant correlation of raised AFP to higher anti-dsDNA antibody concentrations (Mann-Whitney U-test: p = 0.042). The mean dosage of azathioprin and prednisone in patients with SLE did not significantly differ from the non-SLE group. We discuss the possible reactivation of AFP synthesis on account of SLE itself.

[Alpha 1-fetoprotein--a marker of potential PUVA side-effects in psoriasis?]

Serum concentrations of alpha 1-fetoprotein (AFP) during PUVA treatment have been analyzed in 12 patients suffering from severe psoriasis or psoriatic arthritis. The results have been compared with AFP levels in psoriatics without PUVA treatment (group II), patients with psoriatic arthritis treated with methotrexate (group III), as well as dermatological patients without psoriasis (group IV). All groups revealed AFP levels below 25 ng/ml. Although a slight raise of AFP could be observed during PUVA therapy (p less than 0.005), we assume that AFP detection cannot be regarded as a marker of potential PUVA side-effects in psoriasis.

Prednisolone pulse therapy for childhood systemic lupus erythematosus with prominent dermatomyositis. A case report

A 10-year-old boy with systemic lupus erythematosus exhibiting prominent features of dermatomyositis has been treated with 600 mg prednisolone intravenously per day on 3 consecutive days. Clinical and serologic improvement started after the first course of pulse therapy, and was remarkable during a second course. Basic treatment using oral prednisolone is recommended.

[Central nervous system manifestations in patients with systemic lupus erythematosus. Review of pathogenetic aspects]

CNS manifestation is considered as a diagnostic as well as prognostic important variation of SLE course. Disturbances of blood flow and immunopathologic process participate in its induction. Antineuronal antibodies and circulating immune complexes in liquor show tight relations to CNS involvement.

Antibodies to dsDNA in connective tissue diseases measured by ultramicro enzyme-linked immunosorbent assay (ELISA) adapted to the chamber analytical technique (CAT)

Human sera (171 samples of patients with connective tissue diseases (CTD) were screened for anti-dsDNA antibodies by ultramicro ELISA adapted to the chamber analytical technique (CAT). The assay offers sensitivity superior to the Crithidia luciliae immunofluorescence technique (CLIFT). Positive results are not restricted to systemic lupus erythematosus (SLE). Nine sera of other CTD patients exhibited antibodies to dsDNA as well. This might be a symptom of a relatively slight immunodisturbance with presence of low-avidity antibodies.

[Drug-induced lupus erythematosus syndrome. Pathogenesis and relation to systemic lupus erythematosus]

The drug-induced lupus erythematodes syndrome is a heterogeneous group of exogenically caused transitory autoimmunopathies . Essential knowledge has been got concerning the pathomechanism of the syndromes evoked by hydralazine, procainamide, diphenylhydantoin and Venopyronum . Though there are analogies to the systemic lupus erythematosus, we must take into consideration a diversity of diseases. Antibodies against histone have a certain diagnostic as well as pathogenetic relevance.

[Recent aspects of selected autoantibodies in patients with systemic lupus erythematosus and their clinical relevance. II. Antibodies against histone, Sm, Ro and La]

Antigen-antibody systems (antigens: histone, Sm, Ro, La) are described. Aspects of diagnosis, differential diagnosis, and monitoring in SLE are especially considered. Their relevance in view of SLE-subclassification is discussed. Antibodies directed against histone and Sm, and--with some restriction--against Ro/La also are valuable tools in immunological characterization of SLE. Antibodies against La have only in association with anti-Ro-antibodies prognostic importance.