Kenji Asagoe

Heterogeneity of Dendritic Cells in Human Superficial Lymph Node: In Vitro Maturation of Immature Dendritic Cells into Mature or Activated Interdigitating Reticulum Cells

A two-color immunofluorescent analysis indicated that dendritic cells (DCs) in the human axillar lymph nodes (ie, lymph nodal DCs (LnDCs)) can be classified into three subsets. The first subset consists of CD1a+/CD86(- or dim)/CD83(- or dim) nondendriform DCs found mainly in lymph sinuses, the second is of CD1a-/CD86+/CD83+ dendriform DCs scattered in normal T zones, and the third is of large CD1a(bright)/CD86+/CD83+ dendriform DCs occasionally found in hyperplastic T zones. A three-color flow cytometric analysis, immunoperoxidase staining, and electron microscopic observation indicated that the majority of LnDCs corresponded to the first subset, which showed distinctive characteristics of DCs but did not fulfill the ultrastructural criteria for interdigitating reticulum cells (IDCs) and did not contain Birbeck granules. When LnDCs were cultured for 7 days, they became large CD1a(dim)/CD86+/CD83+ dendriform cells, which formed large complexes with many T cells and exhibited distinctive ultrastructural features of interdigitating reticulum cells. LnDCs cultured in the presence of granulocyte/macrophage colony-stimulating factor became markedly larger CD1a(bright)/CD86+/CD83+ dendriform cells forming large complexes with numerous T cells. These findings suggest that cells of the first subset represent immature LnDCs just migrating from epidermis, those of the second subset represent interdigitating reticulum cells, and those of the third subset represent interdigitating reticulum cells probably stimulated with certain immunostimulatory cytokines such as granulocyte/macrophage colony-stimulating factor. It is also suggested that either the second or the third subsets of LnDCs are derived from the first subset.

Antimicrobial susceptibility and molecular characteristics of 857 methicillin-resistant Staphylococcus aureus isolates from 16 medical centers in Japan (2008–2009): nationwide survey of community-acquired and nosocomial MRSA

This study is a nationwide survey of all clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates, including community-acquired MRSA (CA-MRSA), in Japan. A total of 857 MRSA clinical isolates were collected from the 16 institutions throughout Japan that participated in the survey (2008-2009). The drug susceptibility and staphylococcal cassette chromosome mec (SCCmec) typing and the presence of specific pathogenic genes were evaluated. The isolates comprised SCCmec type II (73.6%), type IV (20%), and type I (6%). The percentage of SCCmec type IV isolates was significantly higher in outpatients than in inpatients. Most of the isolated strains were sensitive to vancomycin (VCM, MIC ≤2 μg/mL), linezolid (MIC ≤4 μg/mL), and teicoplanin (MIC ≤8 μg/mL). Although most strains were sensitive to VCM, the MIC value of VCM for SCCmec type II strains was higher than that for SCCmec type IV strains. Only 4 (2.3%) of 171 SCCmec type IV strains were Panton-Valentine leukocidin (lukS/F-PV)-positive. Thus, this result indicates a unique feature of SCCmec type IV strains in Japan. The information in this study not only is important in terms of local public health but will also contribute to an understanding of epidemic clones of CA-MRSA.

Induction of immune response against NY-ESO-1 by CHP-NY-ESO-1 vaccination and immune regulation in a melanoma patient.

BackgroundNY-ESO-1 is a cancer/testis antigen highly immunogenic in cancer patients. Cholesterol-bearing hydrophobized pullulan (CHP) is a nanoparticle-forming antigen-delivery vehicle and CHP complexed with NY-ESO-1 protein (CHP-NY-ESO-1) efficiently activates CD4 and CD8 T cells in vitro.AimIn this study we report on a 50-year-old male melanoma patient with multiple skin and organ metastases (T4N3M1c) who was vaccinated with CHP-NY-ESO-1 at biweekly intervals and who had an unusual disease course. We characterized in this patient humoral and cellular immune responses, immune regulatory cells, and cytokine profiles in the peripheral blood and at local tumor sites.ResultsTen days after the second CHP-NY-ESO-1 vaccination (day 25), blisters appeared on the skin at the metastatic lesions associated with inflammatory changes. A skin biopsy showed the presence of many NY-ESO-1-expressing apoptotic melanoma cells as determined by a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) test. However, the tumors continued to grow, and the patient died of pulmonary failure due to multiple metastases on day 48. Serum antibody responses were detected after the second CHP-NY-ESO-1 vaccination and antibody titer increased with subsequent vaccinations. Th1 dependent IgG1 was the predominant immunoglobulin subtype. Both, NY-ESO-1-specific CD4 and CD8 T cell responses were detected in PBMC by IFN-γ secretion assays. After CHP-NY-ESO-1 vaccination a slight decrease in CD4+CD25+Foxp3+ Tregs was observed in PBMC but significantly increased numbers of CD4+CD25+Foxp3+ Tregs and CD68+ immunoregulatory macrophages were detected at the local tumor sites. CD4+CD25+Foxp3+ Tregs were also increased in the blister fluid. Cytokines in the serum suggested a polarization towards a Th1 pattern in the PBMC and those in the blister fluid suggested a Th2-type response at the tumor site.ConclusionsOur observations indicate induction of specific humoral and cellular immune responses against NY-ESO-1 after CHP-NY-ESO-1 vaccination in a melanoma patient. The concomitant appearance of regulatory T cells and of immune regulatory macrophages and cytokines at the local tumor sites in this patient may explain immune escape.

Reactive intravascular histiocytosis associated with tonsillitis.

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Over-Expression of the Testis-Specific Gene TSGA10 in Cancers and Its Immunogenicity

The TSGA10 gene was originally isolated in normal testis by differential mRNA display. TSGA10 is located on chromosome 2q11.2 and consists of 19 exons extending over 3 kb. TSGA10 mRNA expression was investigated in normal and malignant tissues using quantitative real‐time RT‐PCR. It was predominantly expressed in the testis in adult normal tissues. In malignant tissues, TSGA10 was over‐expressed in 4 of 20 hepatocellular carcinomas (HCC), 1 of 20 colon cancers, 7 of 20 ovarian cancers, 3 of 20 prostate cancers, 1 of 21 malignant melanomas, and 8 of 21 bladder cancers. Serological analysis revealed that 3 out of 346 patients with various types of cancer possessed antibody against recombinant TSGA10 protein. They included 2 patients with hepatocellular carcinoma and a patient with malignant melanoma.

Dendritic cell subsets and immunological milieu in inflammatory human papilloma virus-related skin lesions

BACKGROUND Human papilloma virus (HPV)-related warts persist, evading host immune surveillance, but sometimes disappear with inflammation. OBJECTIVES To elucidate the immune evasion mechanisms of HPV, we have examined the density, dynamics, and subsets of dendritic cell (DC) types in non-inflammatory or inflammatory HPV-related skin lesions such as warts and Bowens disease (HPV-Bowen), and compared the epidermal expression levels of macrophage inflammatory protein (MIP)-3α and E-cadherin. METHODS The expression of various DC markers, MIP-3α, and E-cadherin in the tissue samples obtained from patients with warts, HPV-Bowen and HPV-unrelated skin diseases was evaluated by immunohistochemistry. MIP-3α gene expression levels were examined in warts and HPV-Bowen by in situ hybridization (ISH) and real-time quantitative polymerase chain reaction (RT-qPCR). RESULTS The numbers of Langerhans cells (LCs) and the expression levels of MIP-3α and E-cadherin were decreased in non-inflammatory warts and HPV-Bowen, as compared with normal skin. Both epidermal LCs and MIP-3α expression reappeared in inflammatory warts, associated with dermal infiltrates composed of many cytotoxic T cells and various subsets of DCs, while cellular infiltrates in HPV-Bowen contained many B cells and plasma cells with sparse infiltration of DCs. The upregulation of MIP-3α gene expression was confirmed in the inflammatory warts and HPV-Bowen by ISH and RT-qPCR. CONCLUSIONS The depletion of LCs in the non-inflammatory warts and HPV-Bowen is associated with a down-regulation of expression levels of MIP-3α and E-cadherin in the lesional keratinocytes. MIP-3α expression is upregulated in lesional keratinocytes of inflammatory warts, with the subsequent recruitment of various DC subsets and cytotoxic T cells, whereas plasma cell-rich infiltration was induced in HPV-Bowen.

Ichthyosiform eruptions in association with primary cutaneous T-cell lymphomas

Background  Malignant lymphoma is occasionally complicated by ichthyosiform eruptions.

A mutilating arthropathy, “rhupus hands” associated with multiple synovial cysts in a patient with Systemic Lupus Erythematosus

“Rhupus hands” is a phrase coined to describe one of the deforming arthropathies associated with systemic lupus erythematosus (SLE), because the clinical features are indistinguishable from those of rheumatoid arthritis. Herein, we report a case of rhupus hands with multiple synovial cysts arising in a 60‐year‐old woman with SLE.

Increase of DC-LAMP+ mature dendritic cell subsets in dermatopathic lymphadenitis of mycosis fungoides

BackgroundLittle is known about the immunological milieu of the skin-draining lymph nodes (LNs) in mycosis fungoides (MF).ObjectivesWe studied dendritic cell (DC) subsets in the dermatopathic lymphadenitis of MF patients.MethodsWe immunohistochemically examined DC subsets and their distribution in 16 LN samples from 14 patients with MF (N1 LN, eight patients; N2, four; and N3, four), and we compared them with non-metastatic sentinel LNs from eight patients with melanoma.ResultsThe number of S-100 protein+ DCs was markedly increased in the LNs from the MF patients and the major component was DC-LAMP+ mature DCs in the outer and paracortex areas, where DC-SIGN+ immature DCs were relatively decreased in proportion. In contrast, DC-SIGN+ cells were relatively increased in proportion compared to DC-LAMP+ cells in the medulla. Although no significant difference was observed in the proportions of CD1a+ or Langerin+ DCs among the N1, N2, and N3 nodes, CD163+ M2-type macrophages were increased in number in the N2 and N3 nodes.ConclusionsOur observations indicate that mature DCs accumulate in the outer and paracortex areas in dermatopathic lymphadenitis and M2-type macrophages might increase in number during disease progression.

Novel TGM1 missense mutation p.Arg727Gln in a case of self-healing collodion baby.

Collodion babies are newborns encased in a glistening membrane that cracks in a characteristic manner within 48 h and desquamates in large lamellae after a few days. Most collodion babies later develop one of the several types of autosomal recessive congenital ichthyoses (ARCI), such as lamellar ichthyosis (LI) or congenital ichthyosiform erythroderma; however, about 10% heal spontaneously (1). This healing condition is known as “self-healing collodion baby” or “self-improving collodion baby” (SHCB/SICB). Raghunath et al. (1) showed that this phenotype is possibly a hydrostatic pressuresensitive phenotype of TGM1 mutations. The SHCB/ SICB phenotype was subsequently reported in patients with ALOX12B and ALOXE3 mutations (2). To date, few reports on SHCB/SICB cases with TGM1 mutations have been published (1–4). TGM1 is the most commonly involved gene in ARCI, and encodes transglutaminase-1 (TGase-1) (1, 5–8). Here, we describe an ARCI patient with a novel TGM1 mutation who presented at birth with a collodion membrane but spontaneously healed within 2 months without any skin manifestations.