title: Differential expression of cornified cell envelope precursors in normal skin, intraorally transplanted skin and normal oral mucosa.
abstract: BACKGROUND
  Skin flaps have routinely been used as substitutes for oral mucosa after extensive resection of oral tissues. However, it remains unknown how the transplanted skin flaps perform as a host defence in the new environment of the oral cavity.
  
  
  OBJECTIVE
  To evaluate the expression of cornified cell envelope (CCE) precursors in pretransplanted (normal) skin, intraorally transplanted skin and normal oral mucosa, because CCEs are highly responsible for a protective barrier in each type of epithelium.
  
  
  METHODS
  We used immunohistochemistry and immunoelectron microscopy to examine the expression of CCE precursors, small proline-rich protein (SPR) 2 and 3 and loricrin, in biopsy specimens of normal skin, transplanted skin and normal oral mucosa, including buccal and lingual (non-keratinized) mucosae, and palatal (keratinized) mucosa.
  
  
  RESULTS
  Transplanted skin flaps were classified into two groups. About two-thirds of the transplanted skin flaps displayed a reddish appearance and were devoid of the stratum corneum (SC) together with a psoriasiform inflammatory tissue reaction. Others showed a native appearance, retaining the SC. While SPR2 expression was limited to the stratum granulosum (SG) in both normal and transplanted skin retaining the SC, it extended to the stratum spinosum (SS) of the transplanted skin lacking the SC and that of the normal oral mucosa. Although SPR3 expression was not found in normal skin or in the transplanted skin retaining the SC, it was strongly expressed in the SS of the transplanted skin lacking the SC and the non-keratinized oral mucosa, and in the SS and SG of the keratinized oral mucosa. Loricrin, which was expressed in the SG of normal skin, the transplanted skin retaining the SC and the keratinized oral mucosa, was not detected in the transplanted skin lacking the SC or in the non-keratinized oral mucosa. Immunoelectron microscopy confirmed the ultrastructural localization of SPR3 directly under the cytoplasmic membrane of keratinocytes of the transplanted skin lacking the SC and that of the oral mucosa.
  
  
  CONCLUSIONS
  The altered expression of SPR2, SPR3 and loricrin reflects the possible adaptation of epidermal keratinocytes in the new environment of the oral cavity.
authors.affiliation: Department of Maxillofacial Surgery, Tohoku University Schools of Dentistry and Medicine 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. katou@hama-med.ac.jp
authors.forename: F
authors.initials: F
authors.lastname: Katou
authors.forename: N
authors.initials: N
authors.lastname: Shirai
authors.forename: S
authors.initials: S
authors.lastname: Kamakura
authors.forename: H
authors.initials: H
authors.lastname: Tagami
authors.forename: H
authors.initials: H
authors.lastname: Nagura
authors.forename: K
authors.initials: K
authors.lastname: Motegi
mesh_terms: D002610:Cheek; D055233:Cornified Envelope Proline-Rich Proteins; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007381:Intermediate Filament Proteins / Q000032:analysis; D015603:Keratinocytes / Q000737:chemistry*; D008565:Membrane Proteins / Q000032:analysis; D016253:Microscopy, Immunoelectron / Q000379:methods; D009061:Mouth Mucosa / Q000737:chemistry*; D009062:Mouth Neoplasms / Q000601:surgery*; D010159:Palate; D010455:Peptides; D055232:Proline-Rich Protein Domains; D011506:Proteins / Q000032:analysis*; D012867:Skin / Q000737:chemistry*; D013524:Surgical Flaps; D014059:Tongue
chemical_list: D055233:Cornified Envelope Proline-Rich Proteins; D007381:Intermediate Filament Proteins; D008565:Membrane Proteins; D010455:Peptides; D011506:Proteins; C491986:SPRR2B protein, human; C491987:SPRR2D protein, human; C112254:SPRR3 protein, human; C064554:loricrin