medigraphic.com
ISSN 0210-5187 (Digital)

2003, Número 3

<< Anterior Siguiente >>

Med Cutan Iber Lat Am 2003; 31 (3)


Expresión del antígeno linfocitario cutáneo en las placas alopécicas de pacientes con alopecia areata

Lacueva L, Hausmann G, Ferrando J

Idioma: Español
Referencias bibliográficas: 81
Paginas: 161-172
Archivo PDF: 562.39 Kb.


RESUMEN

El objetivo de este trabajo ha sido el análisis cualitativo y cuantitativo del infiltrado inflamatorio presente en las placas alopécicas de cuero cabelludo de pacientes con alopecia areata (AA), a nivel intraepidérmico, intrafolicular, perifolicular y perivascular, así como la expresión del antígeno linfocitario cutáneo “cutaneous lymphocyte antigen” (CLA) por las células de ese infiltrado, en esas mismas áreas.
Material y métodos: Para ello, hemos contado con 20 muestras de cuero cabelludo(cc): 12 obtenidas de la periferia de placas alopécicas de pacientes con diferentes formas clínicas de AA (en los casos de AA total y AA universal se tomaron de la región occipital) y 8 de individuos control aparentemente sanos.
Se realizó estudio inmunohistoquímico con los anticuerpos monoclonales[AcMo) anti-CD1a, anti-CD4, anti-CD8, anti-CD68 y HECA-452 (anti-CLA) según la técnica de la biotina-estreptoavidina-peroxidasa.
Resultados: Los resultados mostraron que la mayor celularidad correspondió a las placas de AA, a las áreas perifolicular y perivascular, donde observamos un 34% y 36% de las células del infiltrado respectivamente. El fenotipo predominante fue de linfocitos T cooperadores (CD4), que suponían el 41% del total de células. La relación linfocitos T CD4/CD8 fue 5,2. En cuanto a las secciones de cc sano, el predominio del infiltrado se observó a nivel intraepidérmico (51%). El 76% de ese infiltrado eran células de Langerhans y el cociente CD4/CD8 fue de 1,47.
Respecto a la expresión del CLA, el 29% de las células en las muestras de AA se tiñeron con HECA-452; es decir, fue casi seis veces superior a la expresión del CLA en las secciones de cc sano, en las que solo el 5% de las células fueron HECA-452 positivas.
Conclusión: Los datos obtenidos dan soporte a la hipótesis de que el CLA probablemente está implicado en la etiopatogenia de la AA, posiblemente favoreciendo los movimientos migratorios de las células inmunocompetentes de la piel, secundarios a la manifestación autoantígeno.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Muller SA, Winkelmann RK. Alopecia areata. Arch Dermatol 1963; 88: 290-297.

  2. Penders AJM. Alopecia areata and atopy. Dermatologica. 1978; 156: 306-308.

  3. Wang SJ, Shohat T, Vadheim C, Shellow W, Edwards J, Rotter JI: Increased risk for type 1 (insulin-dependent) diabetes in relatives of patients with alopecia areata Amer J Med Gen 1994; 51: 234-239.

  4. Ueki R, Imai R, Takamori K, Ishihara A, Ogawa H. Threee patients with concurrent alopecia areata, vitiligo and chronic thyroiditis. Eur J Dermatol 1993; 3: 454-456.

  5. Klein U, Weinheimer B, Zaun H. Simultaneous ocurrence of alopecia areata and immunothy-roiditis. Int J Dermatol 1974; 13: 116-118.

  6. Camacho F. Alopecia areata. Cuadros clínicos. Dermatopatología. En: Camacho F, Montagna W. Tricología. Aula Médica. Madrid 1996; 10: 421.

  7. Bystryn JC, Tamesis J. Immunologic aspects of Hair Loss. J Invest Dermatol 1991; 96(suppl): 88-89.

  8. Cunliffe WJ, Hall R, Stevenson CJ, Weightman D. Alopecia areata, thyroid disease and auto-immunity. Br J Dermatol 1969; 81: 877-881.

  9. Adams BB, Lucky AW. Colocalization of alopecia areata and vitiligo. Pediatr Dermatol 1999; 16: 364-366.

  10. Becker WG, Buckley RH. Alopecia areata, hypogammaglobulinaemia, concanavalin A (con-A), hyporesponsiveness and autoimmune hemolytic anemia. Clin Res. 1977; 25: 75.

  11. Lerchin E, Schwimmer B. Alopecia areata associated with discoid lupus erythe- matosus. Cutis 1975; 15: 87-88.

  12. Gupta A, Ellis C, Cooper K, Nickoloff BJ, Ho VC, Chan LS, et al. Oral ciclosporin for the treatment of alopecia areata. A clinical and immunohistochemical analysis. J Am Acad Dermatol 1990; 22: 242-250.

  13. Happle R. Topical Immunotherapy in Alopecia areata. J Invest Dermatol 1991; 96 (suppl.): 71-72.

  14. Seiter S, Ugurel S, Tilgen W, Reinnhold U. High-dose pulse corticosteroid therapy in the treatment of severe alopecia areata. Dermatology 2001; 202: 230-234.

  15. Bröcker EB, Echternach-Happle K, Hamm H: Abnormal expression of class I and class II major histocompatibility antigens in alopecia areata : modulations by topical immunotherapy. J Invest Dermatol 1987; 88: 564-568.

  16. Ferrando J, Grimalt R. Partial response of severe alopecia areata to cyclosporin A. Dermatology 1999; 199: 67-69.

  17. Kern F, Hoffman WH, Hanibrick GW, Blizzzard RM. Alopecia areata: Immunologic studies and treatment with prednisone. Archs Dermatol 1973; 107: 407.

  18. Jautova J, Jarkuskova D, Dubiska M, Ficova M. Immunoestimulation theraphy in patients with alopecia areata. Bratisl Lek Listy 1995; 96: 160-164.

  19. Scerri L, Pace JL: Identical twins with identical alopecia areata. J Am Acad Dermatol 1992; 27: 766-767.

  20. Weidmannn AI, Zion LS, Mamelok AE. Alopecia areata occurring simultaneously in identical twins. Arch Dermatol 1956; 74: 424-426.

  21. Chieregato C, Misciali C, Lorenzi S, Guerra L. Alopecia areata e síndrome di Down. G Ital Dermatol Veneorol 1994; 129: 275-278.

  22. Hordinsky MK, Hallgren H, Nelson D, Filipovich AH : Familial alopecia areata. Arch Dermatol 1984; 120: 464-468.

  23. Wolf D, Wolf R. Simultaneous alopecia areata in two siblings. J Am Acad Dermatol 1984; 11: 897-898.

  24. Duvic M, Hordinsky MK, Fiedler VC, O’Brien WR, Young R, Reveille JD: HLA-D locus associations in alopecia areata. DRw52a confer disease resistance. Arch Dermatol 1991; 127: 64-68.

  25. Welsh E, Clark HH, Epstein SZ, Reveille JD,Duvic M: Human Leukocyte Antigen-DQB1*03 alleles are associated with alopecia areata. J Invest Dermatol 1994; 103: 758-763.

  26. Colombe BW, Price VH, Khoury EL, Lou CD. HLA class II alleles in longstanding alopecia totalis/alopecia universalis and long-standing patchy alopecia areata. Differentiate these two clinical groups. J Invest Dermatol 1995; 104: 4s-5s.

  27. de Andrade M, Jackkow CM, Dahm N, Hordinsky M, Reveille JD, Duvic M. Alopecia areata in families: association with the HLA locus. J Invest Dermatol Symp Proc 1999; 4: 220-223.

  28. Duvic M, Welsh EA, Jackow C, Papadopoulos E, Reveille JD, Amos CH. Analysis of HLA-D locus alleles in alopecia areata patients and families. J Invest Dermatol 1995; 104: 5s-6s.

  29. Offidani AM, Simonetti O, Politi A, Salvi A, Gabrielli A, Bossi G. Antigeni HLA-DR e alopecia areata. G Ital Dermatol 1998; 123: 409-412.

  30. Tobin D, Hann SK, Song MS, Bystryn JC. Hair follicle structures targeted by antibodies in patients with alopecia Areata. Arch Dermatol 1997; 133: 57-61.

  31. Tobin DJ, Sundberg JP, King LE, Boggess D, Bystryn JC. Autoantibodies to hair follicles in the C3H/HeJ mouse model of alopecia areata. J Invest Dermatol 1996; 106: 939.

  32. Mc Elwee KJ, Pickett P, Oliver RF, Hair follicle autoantibodies in DEBR rat sera. J Invest Dermatol 1995; 104: 34s-35s.

  33. Randall VA, Mc Donald SP, Nutbrown M, Calver NS, Parkin SM, Cunliffe WJ. Is the dermal papilla a primary target in alopecia areata?. J Invest Dermatol 1995;104: 7s.

  34. Friedmann PS: Alopecia areata and auto-immunity. Br J Dermatol 1981;105:153-157.

  35. Kumar B, Sharma VK, Sehgal S: Antismooth muscle and antiparietal cell antibo- dies in indians with alopècia areata. Int J Dermatol 1995; 34: 542-545.

  36. Main RA, Robbie RB, Gray ES, Donald D, Horne Ch H W: Smooth-muscle antibodies and alopecia areata. Br J Dermatol 1975; 92: 389-393.

  37. Gilhar A, Ullman Y, Berkutzi T, Assy B, Kalish RS. Autoimmune Hair Loss (Alopecia Areata) Transferred by T Linphocytes to Human Scalp Explants on SCID Mice. J Clin Invest 1998; 101: 62-67.

  38. Bystryn JC, Orentreich N, Stengel F. Direct Immunofluorescence studies in Alo- pecia Areata and male pattern alopecia. J Invest Dermatol 1979;73: 317-320. Bibliografía 171 Med Cutan Iber Lat Am 2003; 31(3): 161-172 32 Lacueva L, et al. Expresión del antígeno linfocitario cutáneo en las placas alopécicas de pacientes con alopecia areata

  39. Igarashi R, Takeuchi S, Sato Y. Immunofluor-escent studies of complement C3 in the hair follicles of normal scalp and of scalp affected by alopecia areata. Acta Dermatovener (Stockh) 1980; 60: 33-37.

  40. Igarashi R, Morohashi M, Takeuchi S, Sato Y. Immunofluorescence studies on complement components in the hair follicles of normal scalp and of scalp affected by alopecia areata. Acta Dermatovener (Stockh) 1981; 61: 131-135.

  41. Mc Donagh AJG, Snowden JA, Stierle C, Elliott, Messenger AG: HLA and ICAM-1 expresion in alopecia areata in vivo and in vitro: the role of cytokines. Br J Dermatol 1993; 129: 250-256.

  42. Nickoloff BJ, Griffiths CEM. Aberrant Intercellular Adhesion Molecula-1 (ICAM-1) Expression by Hair-Follicle Epithelial Cells and Endothelial Leukocyte Adhesion Molecule-1 (ELAM-1) by vascular Cell Are Important Adhesion-Molecule. Alteracions in Alopecia Areata. J Invest Dermatol 1991; 96: 91-92.

  43. Bos JD, de Boer OJ, Tibbosch E, Das PK, Pals ST. Skin-homing T lymphocytes: detection of cutaneous lymphocyte associated antigen (CLA) by HECA-452 in normal skin. Arch Dermatol Res 1993; 285: 179-183.

  44. Picker LJ, Mitchie SA, Rott LS, Butcher EC. A unique phenotype of skin-associated lymphocytes in humans. Preferential expression of the HECA-452 epitope by benigne and malignnant T cell at cutaneous sites. Am J Pathol 1990; 136: 1053-1068.

  45. Picker LJ, Martin RJ, Trumble A, Newman LS, Collins PA, Bergtresser PR, Leung DY.Differential expression of lymphocyte homing receptors by human memory/effector T cells in pulmonary versus cutaneous immune effector sites. Eur J Immunol 1994; 24:1269-1277.

  46. Picker LJ, Treer JR, Ferguson DB, Collins PA, Bergstresser PR, Terstappen LW. Control of lymphocyte recirculation in man. II. Differential regulation of the cutaneous lymphocyte-associated antigen, a tissue-selective homing receptor for skin-homing T cell. J Immunol 1993; 150: 1122-1136.

  47. Rossiter H, van Reijsen F, Mudde GC, Kalthoff F, Bruijnzeel KC, Picker LJ, Kupper TS. Skin disease-related T cells bind to endothelial selectins: expression of cutaneous lymphocyte antigen (CLA) predicts E-selectin but not P-selectin binding. Eur J Immunol 1994; 24: 205-210.

  48. Robert C, Kupper TS. Inflammmatory skin diseases, T cells and immmune surveillance. N Engl J Med 1999; 341: 1817-1828.

  49. Berg EL, Yoshino T, Rott LS, Robinson MK, Warnoock RA, Kishimoto TK et al. The cutaneous lymphocyte antigen is a skin lymphocyte homing receptor for the vascular lectin endothelial cell-leukocyte adhesion molecule 1. J Exp Med 1991; 174: 1461-1466.

  50. Berg EL, Robinson MK, Mansson O, Butcher EC, Magnani JL. A carbohydrate domain common to both sialyl Le-a and sialyl Le-x is recognized by the endothelial cell leukocyte adhesion molecule, ELAM-1. J Biol Chem 1991; 266: 14869.

  51. Fuhlbrigge RC, Kieffer JD, Armerding D, Kupper TS. Cutaneous lymphocyte antigen is a specialized form of PSGL-1 expressed on skin-homing T cells. Nature 1997; 389: 978-981.

  52. Tu L, Delahunty MD, Ding H, Luscinskas FW, Tedder TF. The cutaneous lymphocyte antigen is an essential component of the L-selectin ligand induced on human vascular endothelial cells. J Exp Med 1999; 189: 241-252.

  53. Tu L, Murphy PG, Li X, Tedder TF. L-selectin ligands expressed by human leukocytes are HECA-452 antibody-defined carbohidrate epitopes preferentially displayed by P-selectin glucoprotein ligand-1. J Immunol 1999; 163: 5070-5078.

  54. Wagers AJ, Stoolman LM, Craig R, Knibbs RN, Kansas GS. An sLex-deficient variant of HL60 cells exhibitss high levels of adhesion to vascular selectins: further evidencee that HECA-452 and CSLEX-1 monoclonal antibody epitopes are not essential for high avidity binding to vascular selectins. J Immunol 1998; 160: 5122-5129.

  55. Koszik F, Strunk D, Simonitsch I, Picker LJ, Stingl G, and Payer E. Expression of monoclonal antibody HECA-452- defined E-selectinn ligands on Langerhans cells in normal and disease skin. J Invest Dermatol 1994; 102: 773-780.

  56. Unger RE, Yawalkar N, Braathen LR y Brand CU. The HECA-452 epitope is highly expressed on lymph cells derived from human skin. Br J Dermatol 1999; 141: 565-569.

  57. Nakamura K, Yasaka N, Asahina A, Kato M, Miyazono K, Furne M, Tamaki K. Increased numbers of CD68 antigen positive dendritic epidermal cells and upregulation of CLA expression on these cells in various skin diseases. J Dermatol Sci 1998; 18: 170-180.

  58. Kieffer JD, Fuhlbrigge RC, Armerding D, Robert C, Ferenczi K, Camphausen RT, Kupper TS. Neutrophils, monocytes and dendritic cells express the same specialized form of PSGL-1 as do skin-homing memory T cells: CLA. Biochem Biophys Res Common 2001; 285: 577-587.

  59. Yoshino T, Okano M, Chen HL, Tsuchiyama J, Kondo E, Nishiuchi R, Teramoto N, Nishizaki K, Akagi T. Cutaneous lymphocyte antigen is expressed on memory/effector B cells in the peripheral blood and monocytoid B cells in the limphoid tissues. Cell Immunol 1999; 197: 39-45.

  60. Jones SM, Dixey J, Hall ND, McHugh NJ. Expression of the CLA and its counter-receptor E-selectin in the skin and joints of patients with psoriatic arthritis. Br J Rheumatol 1997; 36: 748-757.

  61. Pitzalis C, Cauli A, Pipitone N, Smith C, Barker J, Marchesoni A, et al. Cutaneous lymphocyte antigen-positive T lymphocytes preferentially migrate to the but not to the joint in psoriatic arthritis. Arthritis Rheum 1996; 39: 137-145.

  62. Santamaría Babi LF, Pérez Soler MT, Hauser C, Blaser K. Skin-homing T cells in human cutaneous allergic inflamation. Immunol Res 1995; 14: 317-324.

  63. Santamaria Babi LF, Picker LJ, Perez Soler MT, Drzimalla K, Flohr P, Blaser K, Hauser C. Circulating allergen-reactive T cells from patients with atopic dermatitis and allergic contact dermatitis express the skin-selective homing receptor, the cutaneous lymphocyte-associated antigen. J Exp Med 1995; 181: 1935-1940.

  64. Akdis M, Akdis CA, Weigl L, Disch R, Blaser K. Skin-homing, CLA+ memory T cells are activated in atopic dermatitis and regulate IgE by an IL-13-dominated cytokine pattern: IgG4 counter-regulation by CLA- memory T cells. J immunol 1997; 159: 4611-4619.

  65. Campbell DE, Kemp AS. Cutaneous lymphocyte-associated antigen expression in children with atopic dermatitis and non-atopic healthy children. Pediatr Allergy Immunol 1999; 10: 253.

  66. Teraki Y, Hotta T, Shiohara T. Increased circulating skin-homing cutaneous lymphocyte-associated antigen (CLA)+ type 2 cytockine-producing cells, and decreased CLA+ type 1 cytokine-producing cells in atopic dermatitis. Br J Dermatol 2000; 143: 373-378.

  67. Davis RE, Smoller BR. T lymphocytes expressing HECA-452 epitope are present in cutaneous acute graft-versus-host disease and erythema multiforme, but not in acute graft-versus-host disease in gut organs. Am J Pathol 1992; 141: 691-698.

  68. Al Badri AMT, Todd PM, Garioch JJ, Gudeon JE, Stewart DG, Goudie RB. An immunohistological study of cutaneous lymphocytes in vitiligo. J Pathol 1993; 170: 249-255.

  69. Walton LJ, Thornhill MH, Macey MG, FarthingPM. CLA and alpha e beta 7 integrins expressed by mononuclear cells in skin and oral lichen planus. J Oral Pathol Med 1997; 26: 402-407.

  70. Baadsgaard O. Alopecia Areata: An Immunologic Disease? J Invest Dermatol 1991; 96 (suppl): 89-90.

  71. Gianetti A, Di Silverio A, Castellazzi AM and Maccario R. Evidence for defective T cell function in patients with alopecia areata. Br J Dermatol 1978; 98: 361.

  72. Kupper TS. Immune and Inflammatory Processes in Cutaneous Tissues. J Clin Invest 1990; 86: 1783-1789.

  73. Ghersetich I, Campanile G, Lotti T. Alopecia areata: Immunohistochemistry and ultraestructure of infiltrate and identification of adhesion molecula receptors. Int J Dermatol 1996; 35:28-33.

  74. Todes-Taylor N, Turner R, Wood GS, Stratte PT, Morhenn VB. T cell subpoputations in alopecia areata. J Am Acad Dermatol 1984; 11: 216-223.

  75. D’Ovidio R, Vena GA, Angelini G. Cell-mediated immunity in alopecia areata. Arch Dermatol Res 1981; 271: 265-273

  76. Reinherz EL, Parkman R, Rappaport J, Rosen F, Schlossman SR. Aberrations of supressor T cells in human graft versus host disease. N Engl J Med 1979; 300: 1061-1068.

  77. Morimoto C, Abe T, Homma M. Altered function of suppressor T lymphocytes in patients with active systemic lupus erythematosus: In vitro immune response to autoantigens. Clin Immunol Immunopathol 1979; 13: 161-170.

  78. Leung DY, Rhodes AR, Geha RS. Enumeration of T cell subsets in atopic dermatitis using monoclonal antibodies. J Allergy Clin Immunol 1981; 67: 450-455.

  79. Leung DY. The immunologic basis of atopic dermatitis. Clin Rev Allergy 1993; 11: 447-469.

  80. Perret CM, Steijlen PM, Happle R. Alopecia areata. Pathogenesis and topical immunotherapy. Int J Dermatol 1990; 29: 83-88.

  81. Happle R. Antigenic competition as a therapeutic concept for alopecia areata. Arch Dermatol Res 1980; 267: 109-114.




2020     |     www.medigraphic.com