Lymphocyte subsets and Langerhans cells in sun-protected and sun-exposed skin of immunosuppressed renal allograft recipients.
BACKGROUND
Patients who have received renal allografts experience early aging of the skin, opportunistic infections, and an increased incidence of skin cancer.


OBJECTIVE
We compared the density of lymphocyte subsets and Langerhans cells in normal-appearing skin of renal allograft recipients without skin cancer at 5 to 6 years (group 1) and 14 years after transplant (group 2) with a matched normal control group.


METHODS
Biopsy specimens of sun-protected and exposed areas from 18 white, kidney allograft recipients (10 in group 1 and 8 in group 2) with normal renal function and from 10 healthy volunteers were semiquantitatively analyzed for dermal lymphocyte subsets and Langerhans cells.


RESULTS
There was a statistically significant decrease in all dermal cell elements in the sun-protected skin of both groups of patients who had received grafts. The sun-exposed skin of group 2 also showed a significant decrease of dermal CD4+ and CD8+ lymphocytes, and group 1 had a significant decrease in dermal CD8+ lymphocytes. The dermal CD1a+ cell population in the sun-exposed skin from both grafted groups did not differ from the control group.


CONCLUSIONS
Kidney transplant recipients showed dermal depletion of cells related to immune surveillance against tumors even before skin cancer occurred, and this depletion seemed to become more marked with the duration of immunosuppression.
Galvão
M M
MM
Kidney Transplant Unit, University of São Paulo School of Medicine, Brazil.
Sotto
M N
MN
Kihara
S M
SM
Rivitti
E A
EA
Sabbaga
E
E
D000328:Adult; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D016022:Case-Control Studies; D002452:Cell Count; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy; D015994:Incidence; D016030:Kidney Transplantation / Q000276:immunology; D007801:Langerhans Cells / Q000473:pathology*; D018655:Lymphocyte Count; D008212:Lymphocyte Depletion; D016131:Lymphocyte Subsets / Q000473:pathology*; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology; D012867:Skin / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D015595:Skin Aging; D012874:Skin Diseases, Infectious / Q000209:etiology; D012878:Skin Neoplasms / Q000209:etiology; D013472:Sunlight / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000627:therapeutic use*; D013997:Time Factors; D014184:Transplantation, Homologous
D013473:Sunscreening Agents