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P021 Cutaneous vasculitis and apoptosis
S158
Posters - Autoimmune diseases
We conclude that PGEl is able to reduce serum levels of inflammatory cytokine TNF-a and of some adhesion molecules involved in the leukocytes-endotbelium interactions (ELAM, sVCAM). In this light we suggest that these immunological parameters could be a useful tool in the evaluation of therapeutical efficacy.
Cutaneous vasculitis and apoptosis I PO21 S. Barduagni, M. Ruffeli, S. Cadoni, G. Ferranti, M.G. Sanjust, 0. De Pita. Istituto Dermopatico dell’lmmacolata, I.R.C.C.S., Rome, italy Apoptosis is a biochemically and morphologically distinctive form of programmed cell-death initiated by a variety of intracellular and intercellular signals; this intrmsic “cellular suicide” results in early DNA Fragmentation accompanied by nuclear and cytoplasmic condensation. Several authors have documented that apoptosis may occur in dermatological disorders, such as psoriasis, lichenoid reactions and cutaneous lymphoma. In this light, we performed a study in order to evaluate apoptotic phenomena in cutaneous vasculitis, characterized by inflammatory vessel damage probably due to the release of proteases and free radicals able to induce apoptosis. Lesional skin biopsies were obtained from patients with both leukocytoclastic and lymphocytic vasculitis and an imununotluorescence technique (TUNEL) was performed to detect DNA fragmentation as index of apoptosis. The results showed the presence of apoptotic bodies in both group of patients, with a different pattern of staining. In fact, in patients with leukocytoclastic vasculitis a widespread distribution of apoptotic bodies was observed, while in all cases of lymphocytic vasculitis DNA fragmentation was focally circumscribed at perivascular level. In our view, the application of this apoptotic bodies labeling method could be a useful tool to better identify, in addition to histopathological evaluation, different pictures of cutaneous vasculitis. ElPO22 Extracorporeal photochemotherapy
and
systemic sclerosis: Our preliminary experience
A. Carabelli ’ , G. Crovetti ’ , M. Guizzardi ’ , E. Bertani ’ , E. Berti*. ’ Photopheresis Department, S.A. Abate Hospital Gallarate, VA; *lst Department of Dermatology, University of Milan, Italy Extracorporeal photochemotherapy (ECP) is an immune-modulating apheretic therapy first introduced by Edelson for treatment of the leukemic phase of cutaneous T-cell lymphomas. Following laboratory investigations demonstrated ECP capacity to supprime pathogenetic T-cell clones, making it interesting for treatment of autoimmune diseases. In 1989 Rook utilized ECP for the treatment of patients with progressive sistemic sclerosis with encouraging results. Since June 1995, in our photopheresis department, five patients with progressive sistemic sclerosis (Ssc) and one with generalized morphoea (GM) have been treated with ECP and evaluated after 6 months of therapy. ECP was given as two consecutive daily treatments every 4 weeks, using Therakos Uvar II system with 8methoxipsoralen (&MOP) in its liquid formulation. ECP demonstrated to be well tolerated in all patients. In all Ssc patients we observed a
significant amelioration of the Raynaud phenomenon, a partial resolution of inflammatory manifestations of the extremities, a clear regression of diffuse musculoskeletal pain and a mild improvement of joints contractures leading to a significative amelioration of the quality of life. We demonstrated a reduction of gastrointestinal involvement with an endoscopic evidence of esophageal motility recover, while only one patient referred a subjective amelioration of sclerodactly. From the immunohaematological point of view we noticed that the beginning and the persistence of clinical improvement coincided with the expansion of the lymphocytic population CD3-C16+. This event could assume a prognostic value worthy of further investigations. I PO23 The immunopathological
examination of oesophagus as useful criterion of remission of pemphigus vulgaris
J.D. Torzecka, A. Sysa-Jedrzejowska, E. Waszczykowska, A. Wotniacka, B. Dziankowska-Bartkowiak. Department of Dermatology Medical University of tddf, Poland In patients with pemphigus vulgaris with no clinical manifestations histopathological and immunopathological examinations of the oesophagus were performed. In the group of 14 patients without semm pemphigus antibodies, 5 were treated with low doses of steroids and Cyclophosphamide (as supporting treatment), while 9 have already finished the treatment. In all five cases of the treated patients bound in vivo pemphigus antibodies were found. Acantholysis were present in two of them. In all nine untreated patients acantholysis and immunopathological findings were negative. Our studies reveal that negative results of the immunopathological oesophagus examination indicate definite remission of pemphigus vulgaris and can be an indication for finishing the pemphigus treatment. I PO24 High expression in viva of THP-like
cytokines in dermatitis herpetiformis
M. Caproni, E. Salvatore, P Fabbri. Department of Dermatology, University of Florence, Italy Dermatitis herpetiformis (DH) is a chronic subepidermal blistering disease, in which a perivascular cellular infiltrate, composed mainly of CD4+T lymphocytes together with a varying number of neutrophils and eosinophils, is presumed to be important in the pathogenesis of blister formation. The aim of this study was to investigate the potential role of cytokines such as IL4 and IL5 which are known to be powerful chemotactic agents for neutrophils and eosinophils, and to quantify the distribution of T cells in involved skin as well as their state of activation. An immunohistochemical study was performed with a large panel of mAb using APAAP procedure (anti-CD3, -CD4, -CD8, -CD25, -CD30, -CDla, HLA-DR. -EGl, -EG2, -tryptase, -MPO, -human- IL4, -human-IL5, -humanIL8, -GM-CSF, -IFN-y) in 2 males and 5 females (age range was 8-71 years) with typical clinical and histologic features of DH; as control three healthy skin samples with DH were also taken. A strong extra-cellular staining with anti-IL4 mAb was detected in the upper dermis with a prevalent perivascular pattern in perilesional areas, whereas in the dermal-epidermal separa-
Posters - Autoimmune diseases
We conclude that PGEl is able to reduce serum levels of inflammatory cytokine TNF-a and of some adhesion molecules involved in the leukocytes-endotbelium interactions (ELAM, sVCAM). In this light we suggest that these immunological parameters could be a useful tool in the evaluation of therapeutical efficacy.
Cutaneous vasculitis and apoptosis I PO21 S. Barduagni, M. Ruffeli, S. Cadoni, G. Ferranti, M.G. Sanjust, 0. De Pita. Istituto Dermopatico dell’lmmacolata, I.R.C.C.S., Rome, italy Apoptosis is a biochemically and morphologically distinctive form of programmed cell-death initiated by a variety of intracellular and intercellular signals; this intrmsic “cellular suicide” results in early DNA Fragmentation accompanied by nuclear and cytoplasmic condensation. Several authors have documented that apoptosis may occur in dermatological disorders, such as psoriasis, lichenoid reactions and cutaneous lymphoma. In this light, we performed a study in order to evaluate apoptotic phenomena in cutaneous vasculitis, characterized by inflammatory vessel damage probably due to the release of proteases and free radicals able to induce apoptosis. Lesional skin biopsies were obtained from patients with both leukocytoclastic and lymphocytic vasculitis and an imununotluorescence technique (TUNEL) was performed to detect DNA fragmentation as index of apoptosis. The results showed the presence of apoptotic bodies in both group of patients, with a different pattern of staining. In fact, in patients with leukocytoclastic vasculitis a widespread distribution of apoptotic bodies was observed, while in all cases of lymphocytic vasculitis DNA fragmentation was focally circumscribed at perivascular level. In our view, the application of this apoptotic bodies labeling method could be a useful tool to better identify, in addition to histopathological evaluation, different pictures of cutaneous vasculitis. ElPO22 Extracorporeal photochemotherapy
and
systemic sclerosis: Our preliminary experience
A. Carabelli ’ , G. Crovetti ’ , M. Guizzardi ’ , E. Bertani ’ , E. Berti*. ’ Photopheresis Department, S.A. Abate Hospital Gallarate, VA; *lst Department of Dermatology, University of Milan, Italy Extracorporeal photochemotherapy (ECP) is an immune-modulating apheretic therapy first introduced by Edelson for treatment of the leukemic phase of cutaneous T-cell lymphomas. Following laboratory investigations demonstrated ECP capacity to supprime pathogenetic T-cell clones, making it interesting for treatment of autoimmune diseases. In 1989 Rook utilized ECP for the treatment of patients with progressive sistemic sclerosis with encouraging results. Since June 1995, in our photopheresis department, five patients with progressive sistemic sclerosis (Ssc) and one with generalized morphoea (GM) have been treated with ECP and evaluated after 6 months of therapy. ECP was given as two consecutive daily treatments every 4 weeks, using Therakos Uvar II system with 8methoxipsoralen (&MOP) in its liquid formulation. ECP demonstrated to be well tolerated in all patients. In all Ssc patients we observed a
significant amelioration of the Raynaud phenomenon, a partial resolution of inflammatory manifestations of the extremities, a clear regression of diffuse musculoskeletal pain and a mild improvement of joints contractures leading to a significative amelioration of the quality of life. We demonstrated a reduction of gastrointestinal involvement with an endoscopic evidence of esophageal motility recover, while only one patient referred a subjective amelioration of sclerodactly. From the immunohaematological point of view we noticed that the beginning and the persistence of clinical improvement coincided with the expansion of the lymphocytic population CD3-C16+. This event could assume a prognostic value worthy of further investigations. I PO23 The immunopathological
examination of oesophagus as useful criterion of remission of pemphigus vulgaris
J.D. Torzecka, A. Sysa-Jedrzejowska, E. Waszczykowska, A. Wotniacka, B. Dziankowska-Bartkowiak. Department of Dermatology Medical University of tddf, Poland In patients with pemphigus vulgaris with no clinical manifestations histopathological and immunopathological examinations of the oesophagus were performed. In the group of 14 patients without semm pemphigus antibodies, 5 were treated with low doses of steroids and Cyclophosphamide (as supporting treatment), while 9 have already finished the treatment. In all five cases of the treated patients bound in vivo pemphigus antibodies were found. Acantholysis were present in two of them. In all nine untreated patients acantholysis and immunopathological findings were negative. Our studies reveal that negative results of the immunopathological oesophagus examination indicate definite remission of pemphigus vulgaris and can be an indication for finishing the pemphigus treatment. I PO24 High expression in viva of THP-like
cytokines in dermatitis herpetiformis
M. Caproni, E. Salvatore, P Fabbri. Department of Dermatology, University of Florence, Italy Dermatitis herpetiformis (DH) is a chronic subepidermal blistering disease, in which a perivascular cellular infiltrate, composed mainly of CD4+T lymphocytes together with a varying number of neutrophils and eosinophils, is presumed to be important in the pathogenesis of blister formation. The aim of this study was to investigate the potential role of cytokines such as IL4 and IL5 which are known to be powerful chemotactic agents for neutrophils and eosinophils, and to quantify the distribution of T cells in involved skin as well as their state of activation. An immunohistochemical study was performed with a large panel of mAb using APAAP procedure (anti-CD3, -CD4, -CD8, -CD25, -CD30, -CDla, HLA-DR. -EGl, -EG2, -tryptase, -MPO, -human- IL4, -human-IL5, -humanIL8, -GM-CSF, -IFN-y) in 2 males and 5 females (age range was 8-71 years) with typical clinical and histologic features of DH; as control three healthy skin samples with DH were also taken. A strong extra-cellular staining with anti-IL4 mAb was detected in the upper dermis with a prevalent perivascular pattern in perilesional areas, whereas in the dermal-epidermal separa-