Beatrice Bianchi

Monochromatic excimer light (308 nm): an immunohistochemical study of cutaneous T cells and apoptosis-related molecules in psoriasis

Background Various types of UVB radiation source (290–320 nm) are used in treating psoriasis and their therapeutic mechanism has been attributed to immunosuppressive properties. Recently, a new UVB source generated by a 308‐nm excimer laser has been introduced for the treatment of psoriasis.

In vivo relevance of CD30 in atopic dermatitis.

CD30 expression was evaluated by immunohistochemistry in lesional skin biopsies of eight patients with active atopic dermatitis (AD) and three patients with allergic contact (nickel‐induced) dermatitis (ACD). CD30 expression was also assessed in a large panel of CD4 + and CDS + T‐cell clones generated from the skin biopsies of four patients with AD. Finally, the levels of soluble CD30 (sCD30) were measured in the serum of 41 patients with AD, 19 patients with ACD, and 60 healthy controls. In all specimens of lesional AD skin, where the great majority of infiltrating cells were CD4+ T cells, remarkable numbers of cells were CD30+, whereas virtually no CD30 + cells were found in the skin of patients with ACD. In CD4+ T‐cell clones generated from the lesional AD skin, most of which produced both interleukin (IL)‐4 and interferon‐gamma (IFN‐γ) (Th0–like cells) or IL‐4 and 1L‐5, but not IFN‐γ (Th2–like cells), CD30 expression directly correlated with the ability to produce IL‐4 and IL‐5, but was inversely related to IFN‐γ production. High levels of sCD30 (correlated with disease activity: r= 0.618) were detected in the serum of most AD patients, whereas there was no increase of sCD30 levels in the serum of patients with ACD. These data support the view that Th0/Th2–type responses predominate in the skin of patients with AD and suggest that the presence of CD30 + T cells in tissues and/or increased levels of sCD30 in biologic fluids are indicative of Th2–dominated responses.

Neuropeptides and skin disorders. The new frontiers of neuro–endocrine–cutaneous immunology

In the past, much work has been devoted to psychosomatic dermatology (or psychodermatology) by well-known pioneers. In recent years, the molecular mechanism by which neuropeptides (NPs) link the neural–immune–endocrine axis has been receiving increasing attention. This bidirectional communication between the immune–endocrine system and the nervous system also involves soluble factors, such as neurotransmitters and cytokines, that are produced by each system. It is also well known that the skin contains numerous NPs released from the sensory nerves and produced by the resident cells of the immune system or by skin cells. Functional dysregulation of NPs has been associated with pathologic cutaneous conditions, such as psoriasis and atopic dermatitis, and the current understanding of the bidirectional loops between the immune–endocrine system and the central and autonomic nervous systems may clarify the pathophysiology of these diseases, thus providing potential targets for therapeutic interventions.

Immunological activity of photodynamic therapy for genital warts

Background  An increasing body of evidence supports the usefulness of photodynamic therapy (PDT) in the treatment of non‐neoplastic pathological conditions, including genital warts. In particular, PDT has demonstrated good clinical cure rates and low recurrence, and is now suggested as a safe alternative means of treating condylomata.

Immunopathogenesis of folliculitis decalvans: clues in early lesions.

Folliculitis decalvans (FD) is a rare variant of primary cicatricial alopecia, for which the etiopathogenesis remains unclear. Our purpose was to evaluate whether certain immunologic mechanisms might have a significant role in the pathogenesis of FD. Lesional scalp biopsy specimens from 7 patients with FD, 7 with lichen planopilaris, and 4 with alopecia areata were studied immunohistochemically by using monoclonal antibodies to CD1a, CD3, CD4, CD8, CD20, CD25, HLA-DR, interleukin (IL)-1beta, IL-4, IL-8, interferon gamma, tumor necrosis factor alpha, basic fibroblast growth factor (b-FGF), transforming growth factor (TGF)-beta, endothelial leukocyte adhesion molecule 1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule. We showed that early FD lesions are characterized by an infiltration of activated T-helper cells, featuring mixed TH1/TH2 polarization. IL-8 and ICAM-1 may contribute to the infiltration of neutrophils, whereas b-FGF and TGF-beta may represent important mediators of the fibrosis that characterizes late-phase FD.

Regulatory T cells in skin lesions and blood of patients with bullous pemphigoid

Although regulatory T cells (Tregs) are affected in several autoimmune skin diseases, only two studies have been performed in patients with bullous pemphigoid (BP) with contrasting results.

The role of T lymphocytes and cytokines in the pathogenesis of pemphigoid gestationis

Summary Background Pemphigoid gestationis (PG), also known as herpes gestationis, is a rare autoantibody‐mediated bullous disease, usually associated with pregnancy and the postpartum period. However, infiltrating cells have recently been suggested to also contribute to the pathogenesis of cutaneous lesions.

Evaluation of inflammatory infiltrate and fibrogenic cytokines in pseudopelade of Brocq suggests the involvement of T‐helper 2 and 3 cytokines

Background  Pseudopelade of Brocq (PB) is an acquired progressive cicatricial alopecia which is characterized by some distinctive clinical features. It may represent either a distinct entity, i.e. an idiopathic primary scarring alopecia, or the end stage of various forms of scarring alopecia such as discoid lupus erythematosus (DLE) or lichen planopilaris (LPP).

Can the brain inhibit inflammation generated in the skin? The lesson of α-melanocyte-stimulating hormone

The neuro‐immuno‐cutaneous‐endocrine network is not a simple construct featuring organ systems intimately involved in the bridge between body and mind. Mind‐body influences are bi‐directional and the skin should be considered an active neuroimmunoendocrine interface, where effector molecules of neuropeptides act as common words used in a dynamic dialogue between brain, immune system and skin. Alpha‐melanocyte stimulating hormone (α‐MSH), one of the principal neuroimmunomodulating peptides, seems to exercise some control on the cutaneous inflammatory process, through a central action mediated by descending anti‐ inflammatory neural pathways and via local direct influence on inflammatory cells infiltrating the dermis, such as monocytes, macrophages and neutrophils. α‐MSH down‐regulates the production of proinflammatory cytokines, while the production of the anti‐inflammatory cytokine IL‐10 is stimulated by α‐MSH. Finally, α‐MSH seems to regulate the expression of surface molecules in immunocompetent cells. Thus, further studies may lead to the use of α‐MSH as an important anti‐inflammatory agent in clinical dermatology.

Characterization of [3H]substance P binding sites in human skin.

Radioligand binding experiments were performed with crude homogenates from normal human skin in order to investigate substance P receptor density. Binding of [3H]substance P ([3H]SP) reached equilibrium after 20 min and was saturable; analysis of saturation curves gave a significantly better fit using two‐site binding compared to the single‐site model. Competition studies employing some selective agonists for NK1, NK2 and NK3 receptors have demonstrated that only the NK1 selective agonist, [Sar9, Met(O2)11]‐SP, was a competitor for [3H]SP binding. In addition, the non‐hydrolyzable guanosine 5′‐0‐(3‐thiotriphosphate) altered the dissociation of SP from NK1 receptors by increasing the number of low‐affinity sites. These data show that in the skin [3H]SP binds to a single population of substance P high‐affinity sites, which represent NK1‐type receptors.