Patterns of basal cell keratin 14 expression in Bowen's disease: a possible marker for tumour progression

BACKGROUND

Bowen's disease is a well-established in situ malignancy of the epidermis. The keratin expression in Bowen's disease has been studied in many reports. However, the patterns of keratin (K) 14 expression in each case have not been closely examined.

OBJECTIVES

To investigate if the pattern of expression of K14 has a relationship with tumour progression, we analysed the expression patterns of K14 in relation to the nature of tumour cells, comparing tumour cells in direct contact with the dermis, tumour cells separated from the dermis, and tumour cells invading into the dermis.

METHODS

Twenty-seven tissue sections from 22 patients were stained with anti-K14 antibody, as well as with antilaminin and periodic acid-Schiff (PAS) staining to evaluate the conditions of the basement membrane. Staining patterns of K10 and integrin beta1, and their relationships with proliferating cell nuclear antigen (PCNA) and Ki-67 staining patterns, were also examined.

RESULTS

Tumour cells with no, or with obscured, basement membranes always showed positive staining for K14, while those with continuous (intact) basement membranes usually did not. Of 10 sections showing dermal involvement of Bowen's disease, five were K14 positive and five were K14 negative. All of these K14-positive sections with dermal involvement showed negative or obscured laminin and PAS staining. Most of the sections having K14-negative tumour cells with dermal involvement showed K14-positive lining cells with continuous staining with laminin and PAS-positive basement membranes. K10 was reciprocally expressed with K14 in most of the sections. Integrin beta1 was expressed in the basal layers of non-tumour epidermal cells, but not in tumour cells. Ki-67 and PCNA were expressed at high frequencies in tumour cells, clearly demarcating tumour cells from non-tumour cells.

CONCLUSIONS

Tumour cells separated from the dermis by lining cells were K14 negative with PAS- and laminin-positive basement membranes around them; tumour cells without lining cells were K14 positive with or without continuous basement membranes. K14 expression may be a marker of tumour progression in Bowen's disease.

Expression of tetraspans transmembrane family in the epithelium of the gastrointestinal tract

Tetraspans transmembrane family (TSTF) members, also known as tetraspanin superfamily, have various effects on cell proliferation, motility, and adhesion not only in hematopoietic cells, but also in other type of cells. However, little is known about their expression in the human gastrointestinal (GI) tract. The authors characterized immunohistologically the localization of six members of TSTF (CD9, CD37, CD53, CD63, CD81, and CD82) in the normal epithelium from esophagus to colon. CD9 and CD82 molecules were strongly expressed in all epithelial surface membranes, from esophagus to colon, and their staining pattern was quite similar. Expression of CD37 was not detectable throughout the GI tract. Expression of CD53 was barely detectable. Expression of CD63 was clearly detected distal to the stomach, including the duodenum, small intestine, and colon. On the contrary, expression of CD81 was detected only in the esophagus--confined to a few layers from the basal layer. From these data it seems likely that the expression of TSTF molecules might be regulated differentially depending on the site of the GI tract.

Expression of fibrogenic cytokines in desmoplastic malignant melanoma

Desmoplastic malignant melanoma (DMM) consists of amelanotic spindle-shaped melanoma cells and is accompanied by desmoplasia with fibrous stromata. It has a strong tendency for local infiltrative growth and recurrence and a propensity for neurotropism. It is not yet known which cytokine is responsible for the desmoplasia in DMM. In the present study, we investigated the roles of several fibrogenic cytokines and cytokine receptors in DMM: basic fibroblast growth factor (bFGF), connective tissue growth factor (CTGF), transforming growth factor-beta, platelet-derived growth factor (PDGF) and PDGF receptors. Immunostaining and in situ hybridization were conducted in four cases of DMM and four cases of amelanotic malignant melanoma (AMM) as negative controls for desmoplasia. PDGF-beta receptor, bFGF and CTGF were intensely expressed in the DMM specimens in comparison with the AMM specimens. The reaction of PDGF-B ligand and CTGF to PDGF-beta receptor, in addition to the expression of bFGF, may contribute to the desmoplasia in DMM.

Differential expression of connective tissue growth factor gene in cutaneous fibrohistiocytic and vascular tumors

Connective tissue growth factor (CTGF) is a member of a family of immediate early gene products that may play an important role during tissue regeneration, wound repair and skin fibrosis. In this study, CTGF gene expression in mesenchymal tumors was investigated by in situ hybridization and CD34 antigen expression was studied by means of immunohistochemical staining. CTGF mRNA was expressed in fibroblasts of all nine dermatofibromas examined, but five of seven dermatofibrosarcoma protuberans (DFSP) or two cases of malignant fibrous histiocytoma were negative for its expression. In contrast, CD34 antigen was expressed only in DFSP. In vascular tumors, CTGF mRNA was expressed in pyogenic granuloma but not in angiosarcoma. In addition, the endothelial cells in angiolipoma and angioleiomyoma, but not in venous lake, expressed CTGF mRNA. These vascular lesions were all positive for CD34 expression. Tumors of other origins were negative for CTGF mRNA. Our findings indicated that benign fibroblasts and/or vascular endothelial cells have the capability to express CTGF mRNA when activated, but these cells lose this ability when they achieve malignant potency. Thus, examination of CTGF gene expression may be useful for differentiating between benign and malignant mesenchymal tumors, or to determine the origin of the tumors in connective tissue.

Expression of tetra-spans transmembrane family (CD9, CD37, CD53, CD63, CD81 and CD82) in normal and neoplastic human keratinocytes: an association of CD9 with alpha 3 beta 1 integrin

Tetra-spans transmembrane family (TSTF) members (CD9, CD37, CD53, CD63, CD81 and CD82) have potent effects on cell growth, motility and adhesion in various cells. However, little is known about their expression in human skin. Using immunohistological techniques, we have studied the localization of all six members of TSTF in normal and carcinomatous human keratinocytes. CD9, CD81 and CD82 were expressed in the entire living layers of the epidermis. Their staining pattern was quite similar, and was mainly intercellular with occasional intracellular immunoreactivity. CD53 expression was confined to the intercellular spaces of the upper spinous or granular layer in the normal epidermis. No clear-cut expression of CD63 could be detected in the epidermis. CD37 was not detected at all. Cultured human keratinocytes also expressed CD9, CD81 and CD82 at the surface membrane of cell-cell boundaries. Expression of CD37 and CD53 was negative in cultured keratinocytes, while CD63 was clearly localized in the cytoplasmic lysosomes. An immunoprecipitation assay revealed that alpha 3 beta 1 integrin is molecularly associated with CD9. The expression of CD9, CD81 and CD82 was markedly down-regulated in basal cell carcinoma but not in Bowen's disease. The abundant and differential expression of TSTF molecules and the selective association of CD9 with alpha 3 beta 1 integrin suggest that the TSTF molecules may be involved in the regulation of epidermal differentiation and integrity in vivo.

Dysregulated expression of transforming growth factor beta and its type-I and type-II receptors in basal-cell carcinoma

In mammals, transforming growth factor-beta (TGF-beta) is found in 3 highly homologous isoforms that exert their effects via heteromeric complexes of type-I and type-II receptors (TbetaR-I and TbetaR-II). TGF-beta regulates the growth and metabolism of various cell types, including keratinocytes. We have investigated the immunohistological localization of TGF-beta1, TGF-beta2, TbetaR-I and TbetaR-II in normal human skin, basal-cell carcinoma (BCC), Bowen's disease, seborrheic keratosis, eccrine poroma and eccrine spiradenoma using frozen tissue specimens. In normal human skin, the immunoreactive TGF-beta2, but not TGF-beta1, was detected predominantly in the epidermis, follicles and sebaceous glands. The epidermal expression of TbetaR-I and TbetaR-II was very weak in the majority of normal skins. In BCC, TGF-beta2 expression was markedly reduced or completely negative. In addition, TbetaR-I- and TbetaR-II-positive stromal cells were accumulated in the fibrotic stroma in some BCCs. These stromal cells were partly but moderately positive for TGF-beta1. Decreased expression of TGF-beta2 was likely to be associated with the differentiation state of BCC cells, since TGF-beta2 expression was clearly observed in the squamoid foci of BCC. In addition, no expression of TGF-beta2 was detected in the eccrine secretory portion or in eccrine spiradenoma, but it was detected in the upper eccrine ducts and in eccrine poroma.

Connective tissue growth factor gene expression in tissue sections from localized scleroderma, keloid, and other fibrotic skin disorders

Connective tissue growth factor (CTGF) is a novel peptide that exhibits platelet-derived growth factor-like activities and is produced by skin fibroblasts after activation with transforming growth factor-beta. Coordinate expression of transforming growth factor-beta followed by CTGF during wound repair suggests a cascade process for control of tissue regeneration. We recently reported a significant correlation between CTGF mRNA expression and histologic sclerosis in systemic sclerosis. To confirm the relation between CTGF and skin fibrosis, we investigated CTGF gene expression in tissue expression in tissue sections from patients with localized scleroderma, keloid, other sclerotic skin disorders using nonradioactive in situ hybridization. In localized scleroderma, the fibroblasts with positive signals for CTGF mRNA were scattered throughout the sclerotic lesions with no preferential distribution around the inflammatory cells or perivascular regions, whereas the adjacent nonaffected dermis was negative for CTGF mRNA. In keloid tissue, the fibroblasts positive for CTGF mRNA were diffusely distributed, especially in the peripheral expanding lesions. In scar tissue, however, the fibroblasts in the fibrotic lesions showed partially positive signals for CTGF mRNA. In eosinophilic fasciitis, nodular fasciitis, and Dupuytren's contracture, CTGF mRNA was also expressed partially in the fibroblasts of the fibrotic lesions. Our findings reinforce a correlation between CTGF gene expression and skin sclerosis and support the hypothesis that transforming growth factor-beta plays an important role in the pathogenesis of fibrosis, as it is the only inducer for CTGF identified to date.

Significant correlation between connective tissue growth factor gene expression and skin sclerosis in tissue sections from patients with systemic sclerosis

The role of some growth factors and cytokines in the pathogenesis of systemic sclerosis (SSc) has been suggested. In particular, the contribution of transforming growth factor beta in the progression of skin sclerosis is suspected. Connective tissue growth factor (CTGF) was originally identified in human umbilical vein endothelial cells, and a recent study has revealed that human skin fibroblasts produce CTGF after stimulation with transforming growth factor beta. In the present study, the distribution of CTGF gene expression in tissue sections from patients with SSc was investigated by digoxigenin-labeled in situ hybridization. Strong CTGF mRNA signals were observed in the fibroblasts in sclerotic lesions, especially in the deep dermis, of the skin specimens from patients with SSc, whereas there was no expression in the skin from normal controls. The number of fibroblasts with positive hybridization signals was more abundant in the dermis from the sclerotic stage than in that from the inflammatory stage. Our findings indicate a correlation between CTGF gene expression and skin sclerosis and support the hypothesis that transforming growth factor-beta plays an important role in the pathogenesis of SSc, because transforming growth factor beta is the only inducer for CTGF identified to date.

Bilateral periorbital eccrine hidrocystoma

We saw four patients showing identical features as cystic lesions on the bilateral external canthi. Histological examination showed cystic cavities in the dermis. Histological and enzyme histochemical findings suggest that these cystic tumors are of eccrine origin. Thus we diagnosed these cystic tumors as eccrine hidrocystoma with characteristic clinical feature. The recognition of this feature would help to correctly diagnose these eccrine hidrocystoma.

Diurnal variation and increase of disaccharidase activity in diabetic rats

The small intestinal disaccharidase activity and its daily variation in the diabetic rat have not been well described. Therefore, the small intestinal disaccharidase (maltase, lactase and sucrase) activity and its daily profile were studied in streptozotocin-induced diabetic rats under physiological conditions. In diabetic rats, a similar pattern of diurnal variation of disaccharidase activity to control rats was observed, while the relationships between daily change of disaccharidase activity and that of food consumption suggested that there was a different mechanism of diurnal variation in diabetic rats. On the other hand, a significant increase of mean 24-h lactase and sucrase activities was noted in diabetic rats, while that of maltase was not significant. Using the in vitro incubation method, a significant correlation between glucose concentration and lactase or sucrase activity but not maltase activity was observed. However, insulin showed no effect on disaccharidase activity. Thus we clarified the presence of a diurnal variation of disaccharidase activity and an increase in its activity in diabetic rats. This change was suggested to be derived from high plasma glucose level.

Chromosome abnormalities of porokeratosis-cultured epidermal keratinocytes. Comparison with those of cultured dermal fibroblasts

Cultured epidermal keratinocytes and dermal fibroblasts derived from porokeratosis (PK) patients' skin lesions or normal-appearing skin had numerical and sometimes structural chromosomal abnormalities. Such abnormal cells were seen in 4.08% and 0.375% of all the studied epidermal keratinocytes derived from affected skin and normal-appearing skin, respectively. Similar abnormalities were present in 1.70% and 3.67% of the dermal fibroblasts from the patients' affected skin and normal-appearing skin, respectively. Chromosomal abnormalities were more frequent in keratinocytes and fibroblasts from the patients' skin than in keratinocytes (0.429%) or in fibroblasts (1.22%) derived from normal control donors. Clonal proliferation of such abnormal cells was frequently seen in keratinocytes from the patients' affected skin. The frequent appearance of chromosomal abnormalities and clonal proliferation in epidermal keratinocytes may explain skin lesion formation and skin cancer development in PK patients.

Cicatricial pemphigoid with linear IgA deposit

A Japanese woman with typical clinical and histological manifestations of cicatricial pemphigoid was presented. Direct immunofluorescent (IF) investigation of perilesional skin revealed in vivo deposits of IgA but not of IgG, IgM, or C3. Indirect IF study revealed that this patient had circulating antibody against epidermal basement membrane zone of the IgA class. We would like to classify this case as cicatricial pemphigoid with IgA deposits rather than as a cicatricial variant of linear IgA bullous dermatosis.

Lichen planus pemphigoides: case report and results of immunofluorescence and immunoelectron microscopic study

A Japanese woman with lichen planus pemphigoides is reported. Immunologic characteristics of lichen planus pemphigoides antigen in the patient were investigated by indirect immunofluorescence and compared with those of bullous pemphigoid antigen or epidermolysis bullosa acquisita antigen. Ultrastructural localization of lichen planus pemphigoides antigen was studied with the use of immunoelectron microscopic techniques. Lichen planus pemphigoides antigen showed localization similar to that of bullous pemphigoid antigen but different from that of epidermolysis bullosa acquisita antigen. The antigenic stability of lichen planus pemphigoides antigen was different from that of bullous pemphigoid antigen or epidermolysis bullosa acquisita antigen. Thus this study demonstrates that lichen planus pemphigoides antigen is different from bullous pemphigoid antigen.

Pemphigoid vegetans

A Japanese case of pemphigoid vegetans is described. The clinical, histopathological and immunological features were similar to the previously reported cases. The patient also developed vesicular lesions. Indirect immunoelectronmicroscopy revealed that the autoantibody in this patient's serum reacted with basal cell hemidesmosomes. This study provides further evidence that pemphigoid vegetans is a subtype of bullous pemphigoid.

Bullous pemphigoid of childhood: immunofluorescent investigation

A four‐month‐old Japanese girl with bullous pemphigoid of childhood (BPC) was reported. The characteristics of BPC antigen were studied by immunofluorescent technique using the serum of this patient with variously treated normal human skin as substrate. This study showed that her BPC antigen was quite similar to bullous pemphigoid antigen seen in adult patients and that this BPC antigen was differed from epidermolysis bullosa acquisita (EBA) antigen.

Demonstration of GM1-ganglioside in nervous system in generalized GM1-gangliosidosis using cholera toxin B subunit

By using cholera toxin B subunit and its antibody, the deposition of GM1-ganglioside in the cerebral cortex and peripheral nerves including Meissner and Auerbach's plexuses in the intestine and other visceral nerves of generalized GM1-gangliosidosis was demonstrated. The GM1-ganglioside was found in the swollen neurons of cerebral cortex and ganglion cells of the peripheral nerves. Electron microscopically, parts of membranous cytoplasmic bodies, and amorphous substances among them, revealed a positive reaction for the cholera toxin staining.

Subcellular distribution of acid alpha-glucosidase in fibroblasts and of antigenically cross-reactive material in Pompe's disease fibroblasts

From fibroblasts of two cases of Pompe's disease (acid alpha-glucosidase deficiency), one of the childhood type (RH-SF-1) and one of the adult type (RH-SF-2), and normal fibroblasts, antigenically cross-reactive material and acid alpha-glucosidase were immunoprecipitated and analysed by immunoelectrotransfer blotting. The acid alpha-glucosidase and antigenically cross-reactive material (which reacts with antibody raised against normal acid alpha-glucosidase) revealed a precursor form of molecular weight 97,000 and two major components of 79,000 and 76,000. When monensin was added to the fibroblast culture, the two major components of normal acid alpha-glucosidase were decreased, whereas the large molecular weight precursor was increased. On the other hand, the 97,000 molecular weight component of cross-reactive material in the Pompe's fibroblasts (RH-SF-1 and RH-SF-2) was only slightly increased on monensin treatment. The fibroblasts were pulse-chase labelled with [2-H3] mannose and 32Pi. The cross-reactive material and acid alpha-glucosidase were precipitated with anti acid alpha-glucosidase antibody, and after sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), fluorography was performed. The radiolabel of 3H in the cross-reactive material of RH-SF-1 and -2 was weak, and 32P in the cross-reactive material of both fibroblasts was very weak when compared with those of the acid alpha-glucosidase. The radiolabel of 32P in the cross-reactive material of RH-SF-1 was extremely weak. Immunofluorescence histochemistry revealed a granular localization of acid alpha-glucosidase in the normal fibroblast cytoplasm, and a diffuse distribution of cross-reactive material in the cytoplasm of RH-SF-1 and -2. Immuno-electron microscopic examinations showed a normal acid alpha-glucosidase localization on the inner side of the lysosomal membrane and also diffusely in the lysosome; when treated with monensin, it was present on the trans part of the Golgi apparatus. Antigenically cross-reactive material, however, was found in the cytoplasm and endoplasmic reticulum. Some lysosomal localization was observed sporadically. Even after monensin treatment, it was not demonstrated on the Golgi apparatus.

Inguinal sweat gland carcinoma with choriocarcinomatous differentiation

An inguinal sweat gland carcinoma is described including the unusual occurrence of alpha hCG. The alpha hCG was demonstrated in the tumor presenting choriocarcinomatous differentiation and undifferentiated polygonal cells in ordinary tumor nests. beta hCG and SP-1 were weakly and sporadically demonstrated in a small area of the tumor presenting choriocarcinomatous differentiation. On the other hand, hPL and histochemical reaction of placental type alkaline phosphatase were not observed in the choriocarcinomatous and undifferentiated tumor cells. CEA was observed in both ordinary sweat gland carcinoma nests and choriocarcinomatous differentiated regions. In the ordinary tumor nests, enzyme histochemical reactions of phosphorylase and SDH were positive. And S 100 protein was sporadically demonstrated. In spite of chemotherapy and radiotherapy, the patient died after a short duration of the disease.