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T-Cell Subsets in Cutaneous Sarcoidosis

T-Cell Subsets in Cutaneous Sarcoidosis Abstract • Skin lesions from four patients with systemic and cutaneous sarcoidosis were studied, by the use of monoclonal antibodies, for the presence of T cells and T-cell subsets. Large numbers of lymphoid cells reacting with anti-pan T-cell (LEU-1) and anti—helper and inducer subset (LEU-3) monoclonal antibodies were observed around and within the sarcoid granulomas in three of the four patients. Only rare LEU-2-reactive suppressor cells were observed in all four patients. Activated T lymphocytes with focal acid phosphatase activity, together with epithelioid cells and multinucleated giant cells with strong diffuse activity of acid phosphatase and nonspecific esterase, were identified within the granulomas. The two patients with active disease demonstrated substantially more T cells in the sarcoid granulomas than did the two patients with chronic disease. Our study results suggest the importance of helper T cells in the formation of the sarcoid granuloma by mononuclear phagocytes and imply that the activity and duration of disease may be related to the T-cell populations. (Arch Dermatol 1983;119:728-732) References 1. Braverman IM: Skin Signs of Systemic Disease , ed 2. Philadelphia, WB Saunders Co, 1981, pp 516-531. 2. Mitchell DN, Scadding JG, Heard BE, et al: Sarcoidosis: Histopathological definition and clinical diagnosis . J Clin Pathol 1977;30:395-408.Crossref 3. James DG, Neville E, Walker A: Immunology of sarcoidosis . Am J Med 1975;59:388-394.Crossref 4. Hirschhorn K, Schreibman RR, Bach FH, et al: In vitro studies of lymphocytes from patients with sarcoidosis and lymphoproliferative diseases . Lancet 1964;2:842-843.Crossref 5. James DG: Immunology of sarcoidosis . Lancet 1966;2:633-635.Crossref 6. Siltzbach LE, James DG, Neville E, et al: Course and prognosis of sarcoidosis around the world . Am J Med 1974;57:847-852.Crossref 7. Daniele RP, Dauber JH, Rossman MD: Immunologic abnormalities in sarcoidosis . Ann Intern Med 1980;92:406-416.Crossref 8. Hunninghake GW, Crystal RG: Pulmonary sarcoidosis: A disorder mediated by excess helper T-lymphocyte activity at sites of disease activity . N Engl J Med 1981;305:429-434.Crossref 9. Semenzato G, Pezzutto A, Chilosi M, et al: Redistribution of T lymphocytes in the lymph nodes of patients with sarcoidosis . N Engl J Med 1982;306:48-49.Crossref 10. Crystal RG, Roberts WC, Hunninghake GW, et al: Pulmonary sarcoidosis: A disease characterized and perpetuated by activated lung T lymphocytes . Ann Intern Med 1981;94:73-94.Crossref 11. Hunninghake GW, Crystal RG: Mechanisms of hypergammaglobulinemia in pulmonary sarcoidosis: Site of increased antibody production and role of T lymphocytes . J Clin Invest 1981;67:86-92.Crossref 12. Hunninghake GW, Gadek JE, Young RC Jr, et al: Maintenance of granuloma formation in pulmonary sarcoidosis by T lymphocytes within the lung . N Engl J Med 1980;302:594-598.Crossref 13. Kung PC, Goldstein G, Reinherz EL, et al: Monoclonal antibodies defining distinctive human T cell surface antigens . Science 1979;206:347-349.Crossref 14. Warnke R, Levy R: Detection of T and B cell antigens with hybridoma monoclonal antibodies: A biotin-avidin-horseradish peroxidase method . J Histochem Cytochem 1980;28:771-776.Crossref 15. Reinherz EL, Kung PC, Goldstein G, et al: Further characterization of the human inducer T cell subset defined by monoclonal antibody . J Immunol 1979;123:2894-2896. 16. Reinherz EL, Schlossman SF: Regulation of the immune response: Inducer and suppressor T-lymphocyte subsets in human beings . N Engl J Med 1980;303:370-373.Crossref 17. Reinherz EL, Kung PC, Goldstein G, et al: Separation of functional subsets of human T cells by a monoclonal antibody . Proc Natl Acad Sci USA 1979;76:4061-4065.Crossref 18. Ledbetter JA, Evans RL, Lipinski M, et al: Evolutionary conservation of surface molecules that distinguish T lymphocyte helper/inducer and cytotoxic/suppressor subpopulations in mouse and man . J Exp Med 1981;153:310-323.Crossref 19. Li CY, Yam LT, Lam KW: Acid phosphatase isoenzyme in human leukocytes in normal and pathologic conditions . J Histochem Cytochem 1970;18:473-481.Crossref 20. Burg G, Braun-Falco O: Fortschritte in der cytochemischen Differenzierung von Infiltratzellen in der Haut . Hautarzt 1974; 25:1-8. 21. Li CY, Lam KW, Yam LT: Esterases in human leukocytes . J Histochem Cytochem 1973;21:1-12.Crossref 22. Leder LD: The chloroacetate esterase reaction: A useful means of histological diagnosis of hematological disorders from paraffin sections of skin . Am J Dermatopathol 1979;1:39-42.Crossref 23. Davey FR, Dock NL, MacCallum J: Cytochemical reactions in resting and activated T lymphocytes . Am J Clin Pathol 1980; 74:174-179. 24. Alario A, Viac J, Thivolet J: Evidence for a T-cell reaction in the cutaneous sarcoid granuloma . Arch Dermatol Res 1977; 259:135-140.Crossref 25. Schmitt D, Alario A, Thivolet J: In situ characterization of tissue lymphoid cells of cutaneous infiltrates using specific membrane antigens . Clin Exp Dermatol 1979;4:161-173.Crossref 26. Bjerke JR, Krogh HK, Matre R: In situ identification of mononuclear cells in cutaneous infiltrates in discoid lupus erythematosus, sarcoidosis and secondary syphilis . Acta Derm Venereol 1981;61:371-380. 27. Umbert P, Belcher RW, Winkelmann RK: Lymphokines (MIF) in the serum of patients with sarcoidosis and cutaneous granuloma annulare . Br J Dermatol 1976;95:481-485.Crossref 28. Buechner SA, Winkelmann RK, Banks PM: Identification of T-cell subpopulations in granuloma annulare . Arch Dermatol 1983;119:125-128.Crossref 29. Winkelmann RK, Buechner SA, Powell FC, et al: The T-lymphocyte and cutaneous Churg-Strauss granuloma . Acta Derm Venereol , in press. 30. Umbert P, Winkelmann RK: Histologic, ultrastructural, and histochemical studies of granuloma annulare . Arch Dermatol 1977;113:1681-1686.Crossref 31. Umbert P, Winkelmann RK: Granuloma annulare and sarcoidosis . Br J Dermatol 1977;97:481-486.Crossref 32. Rohrbach MS, DeRemee RA: Pulmonary sarcoidosis and serum angiotensin-converting enzyme . Mayo Clin Proc 1982;57:64-66. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1983.01650330020007
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Abstract

Abstract • Skin lesions from four patients with systemic and cutaneous sarcoidosis were studied, by the use of monoclonal antibodies, for the presence of T cells and T-cell subsets. Large numbers of lymphoid cells reacting with anti-pan T-cell (LEU-1) and anti—helper and inducer subset (LEU-3) monoclonal antibodies were observed around and within the sarcoid granulomas in three of the four patients. Only rare LEU-2-reactive suppressor cells were observed in all four patients. Activated T lymphocytes with focal acid phosphatase activity, together with epithelioid cells and multinucleated giant cells with strong diffuse activity of acid phosphatase and nonspecific esterase, were identified within the granulomas. The two patients with active disease demonstrated substantially more T cells in the sarcoid granulomas than did the two patients with chronic disease. Our study results suggest the importance of helper T cells in the formation of the sarcoid granuloma by mononuclear phagocytes and imply that the activity and duration of disease may be related to the T-cell populations. (Arch Dermatol 1983;119:728-732) References 1. Braverman IM: Skin Signs of Systemic Disease , ed 2. Philadelphia, WB Saunders Co, 1981, pp 516-531. 2. Mitchell DN, Scadding JG, Heard BE, et al: Sarcoidosis: Histopathological definition and clinical diagnosis . J Clin Pathol 1977;30:395-408.Crossref 3. James DG, Neville E, Walker A: Immunology of sarcoidosis . Am J Med 1975;59:388-394.Crossref 4. Hirschhorn K, Schreibman RR, Bach FH, et al: In vitro studies of lymphocytes from patients with sarcoidosis and lymphoproliferative diseases . Lancet 1964;2:842-843.Crossref 5. James DG: Immunology of sarcoidosis . Lancet 1966;2:633-635.Crossref 6. Siltzbach LE, James DG, Neville E, et al: Course and prognosis of sarcoidosis around the world . Am J Med 1974;57:847-852.Crossref 7. Daniele RP, Dauber JH, Rossman MD: Immunologic abnormalities in sarcoidosis . Ann Intern Med 1980;92:406-416.Crossref 8. Hunninghake GW, Crystal RG: Pulmonary sarcoidosis: A disorder mediated by excess helper T-lymphocyte activity at sites of disease activity . N Engl J Med 1981;305:429-434.Crossref 9. Semenzato G, Pezzutto A, Chilosi M, et al: Redistribution of T lymphocytes in the lymph nodes of patients with sarcoidosis . N Engl J Med 1982;306:48-49.Crossref 10. Crystal RG, Roberts WC, Hunninghake GW, et al: Pulmonary sarcoidosis: A disease characterized and perpetuated by activated lung T lymphocytes . Ann Intern Med 1981;94:73-94.Crossref 11. Hunninghake GW, Crystal RG: Mechanisms of hypergammaglobulinemia in pulmonary sarcoidosis: Site of increased antibody production and role of T lymphocytes . J Clin Invest 1981;67:86-92.Crossref 12. Hunninghake GW, Gadek JE, Young RC Jr, et al: Maintenance of granuloma formation in pulmonary sarcoidosis by T lymphocytes within the lung . N Engl J Med 1980;302:594-598.Crossref 13. Kung PC, Goldstein G, Reinherz EL, et al: Monoclonal antibodies defining distinctive human T cell surface antigens . Science 1979;206:347-349.Crossref 14. Warnke R, Levy R: Detection of T and B cell antigens with hybridoma monoclonal antibodies: A biotin-avidin-horseradish peroxidase method . J Histochem Cytochem 1980;28:771-776.Crossref 15. Reinherz EL, Kung PC, Goldstein G, et al: Further characterization of the human inducer T cell subset defined by monoclonal antibody . J Immunol 1979;123:2894-2896. 16. Reinherz EL, Schlossman SF: Regulation of the immune response: Inducer and suppressor T-lymphocyte subsets in human beings . N Engl J Med 1980;303:370-373.Crossref 17. Reinherz EL, Kung PC, Goldstein G, et al: Separation of functional subsets of human T cells by a monoclonal antibody . Proc Natl Acad Sci USA 1979;76:4061-4065.Crossref 18. Ledbetter JA, Evans RL, Lipinski M, et al: Evolutionary conservation of surface molecules that distinguish T lymphocyte helper/inducer and cytotoxic/suppressor subpopulations in mouse and man . J Exp Med 1981;153:310-323.Crossref 19. Li CY, Yam LT, Lam KW: Acid phosphatase isoenzyme in human leukocytes in normal and pathologic conditions . J Histochem Cytochem 1970;18:473-481.Crossref 20. Burg G, Braun-Falco O: Fortschritte in der cytochemischen Differenzierung von Infiltratzellen in der Haut . Hautarzt 1974; 25:1-8. 21. Li CY, Lam KW, Yam LT: Esterases in human leukocytes . J Histochem Cytochem 1973;21:1-12.Crossref 22. Leder LD: The chloroacetate esterase reaction: A useful means of histological diagnosis of hematological disorders from paraffin sections of skin . Am J Dermatopathol 1979;1:39-42.Crossref 23. Davey FR, Dock NL, MacCallum J: Cytochemical reactions in resting and activated T lymphocytes . Am J Clin Pathol 1980; 74:174-179. 24. Alario A, Viac J, Thivolet J: Evidence for a T-cell reaction in the cutaneous sarcoid granuloma . Arch Dermatol Res 1977; 259:135-140.Crossref 25. Schmitt D, Alario A, Thivolet J: In situ characterization of tissue lymphoid cells of cutaneous infiltrates using specific membrane antigens . Clin Exp Dermatol 1979;4:161-173.Crossref 26. Bjerke JR, Krogh HK, Matre R: In situ identification of mononuclear cells in cutaneous infiltrates in discoid lupus erythematosus, sarcoidosis and secondary syphilis . Acta Derm Venereol 1981;61:371-380. 27. Umbert P, Belcher RW, Winkelmann RK: Lymphokines (MIF) in the serum of patients with sarcoidosis and cutaneous granuloma annulare . Br J Dermatol 1976;95:481-485.Crossref 28. Buechner SA, Winkelmann RK, Banks PM: Identification of T-cell subpopulations in granuloma annulare . Arch Dermatol 1983;119:125-128.Crossref 29. Winkelmann RK, Buechner SA, Powell FC, et al: The T-lymphocyte and cutaneous Churg-Strauss granuloma . Acta Derm Venereol , in press. 30. Umbert P, Winkelmann RK: Histologic, ultrastructural, and histochemical studies of granuloma annulare . Arch Dermatol 1977;113:1681-1686.Crossref 31. Umbert P, Winkelmann RK: Granuloma annulare and sarcoidosis . Br J Dermatol 1977;97:481-486.Crossref 32. Rohrbach MS, DeRemee RA: Pulmonary sarcoidosis and serum angiotensin-converting enzyme . Mayo Clin Proc 1982;57:64-66.

Journal

Archives of DermatologyAmerican Medical Association

Published: Sep 1, 1983

References