title: Inducible nitric oxide synthase and proinflammatory cytokine expression by human keratinocytes during acute urticaria.
abstract: BACKGROUND
  IgE/allergen-dependent activation of skin mast cells is involved in acute urticaria and leads to their IL-4 release. Previously we have demonstrated in vitro the induction of the low-affinity receptor for IgE (CD23/Fc epsilon RII) in human keratinocytes (HK) upon stimulation with IL-4. In addition, we have observed that ligation of CD23 on keratinocytes induced type II nitric oxide synthase (iNOS), leading to the release of nitric oxide (NO) and proinflammatory cytokines (TNF-alpha, IL-6). According to these in vitro data, we explored whether keratinocytes could also express iNOS, TNF-alpha, IL-6, and CD23 in acute urticaria, an in vivo model in which activation of mast cells by IgE/allergen immune complexes is involved.
  
  
  METHODS
  INOS, TNF-alpha, IL-6, and CD23 expression by keratinocytes was studied in acute urticaria (n = 11) in biopsies from lesional and autologous normal skin by immunohistochemistry, in situ hybridization, or RT-PCR. Nitrites and TNF-alpha synthesis were assayed in supernatants of cultured lesional keratinocytes.
  
  
  RESULTS
  INOS mRNA expression was demonstrated with RT-PCR in 10 biopsies out of 11 sections of acute urticaria lesional skin. Immunohistochemistry showed that this iNOS positivity originated from keratinocytes located close to the dermoepidermal junction; TNF-alpha and IL-6 mRNA transcription was observed in all but one iNOS+ biopsy. Immunostaining and in situ hybridization with CD23-specific probes were strong in all but one iNOS+ skin biopsy. Noninflamed autologous skin was negative for iNOS (except for a weak positivity in one case), cytokines, and CD23.
  
  
  CONCLUSIONS
  The colocalization of iNOS, proinflammatory cytokines, and CD23 within keratinocytes in acute urticaria demonstrates that these cells play an important role in the initiation and maintenance of the inflammatory reaction during this disease in humans through activation of the iNOS pathway by CD23 ligation with IgE/allergen immune complexes.
authors.affiliation: Department of Immunology (Molecular Immuno-Hematology Group), University of Paris VI, College of Medicine, France.
authors.forename: P A
authors.initials: PA
authors.lastname: Bécherel
authors.forename: O
authors.initials: O
authors.lastname: Chosidow
authors.forename: L
authors.initials: L
authors.lastname: Le Goff
authors.forename: C
authors.initials: C
authors.lastname: Francès
authors.forename: P
authors.initials: P
authors.lastname: Debré
authors.forename: M D
authors.initials: MD
authors.lastname: Mossalayi
authors.forename: M
authors.initials: M
authors.lastname: Arock
mesh_terms: D000208:Acute Disease; D016207:Cytokines / Q000096:biosynthesis* / Q000235:genetics; D004790:Enzyme Induction; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis / Q000235:genetics; D015603:Keratinocytes / Q000378:metabolism*; D018448:Models, Immunological; D019001:Nitric Oxide Synthase / Q000096:biosynthesis*; D052247:Nitric Oxide Synthase Type II; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis; D017455:Receptors, IgE / Q000096:biosynthesis / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000235:genetics; D014581:Urticaria / Q000378:metabolism* / Q000473:pathology
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D012333:RNA, Messenger; D017455:Receptors, IgE; D014409:Tumor Necrosis Factor-alpha; C496319:NOS2 protein, human; D019001:Nitric Oxide Synthase; D052247:Nitric Oxide Synthase Type II