title: Activation of dendritic antigen-presenting cells expressing common heat shock protein receptor CD91 during induction of psoriasis.
abstract: BACKGROUND
  Psoriasis is a common and chronic relapsing inflammatory skin disorder. Although a role for T cells in mediating the induction and maintenance of psoriatic lesions is well established, mechanisms responsible for activation of T cells by antigen-presenting cells (APCs) during disease relapse are poorly understood.
  
  
  OBJECTIVE
  (i) To determine whether expression of the common heat shock protein (HSP) receptor CD91 correlated with development of psoriasis in a mouse model of psoriasis, (ii) to characterize the lesional cells on which CD91 was expressed, and (iii) to investigate whether CD91+ cells in psoriasis showed signs of activation.
  
  
  METHODS
  Two systems were used in order to study the above-mentioned objectives: (i) skin biopsies taken directly from patients with psoriasis (either psoriatic plaques or symptomless prepsoriatic skin) or from healthy donors, respectively, or (ii) (human) skin biopsies collected during development of psoriasis using a novel xenograft mouse model of psoriasis. The skin samples were then either processed for analysis by light microscopy, or labelled with fluorochrome-conjugated antibodies and analysed by confocal laser scanning microscopy.
  
  
  RESULTS
  We observed a markedly increased number of CD91+ cells which paralleled development of new psoriatic lesions in the psoriasis mouse model and in established psoriatic plaques compared with symptomless prepsoriatic or healthy skin. Morphology as well as cell-specific markers showed that CD91 was predominantly expressed by dermal dendritic APCs characterized by activation of nuclear factor-kappaB signalling and the presence of tumour necrosis factor-alpha, an important proinflammatory cytokine in the immunopathogenesis of psoriasis. In addition, HSP70, a ligand for CD91, was increased in keratinocytes in close vicinity to CD91-bearing APCs in psoriatic lesions.
  
  
  CONCLUSIONS
  These findings indicate massive presence of CD91+ dendritic cells juxtaposed to lesional keratinocytes expressing HSP70, and suggest a novel pathophysiological pathway and therapeutic target for this chronic inflammatory skin disease.
authors.affiliation: Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, CH-8091 Zurich, Switzerland.
authors.forename: O
authors.initials: O
authors.lastname: Boyman
authors.forename: C
authors.initials: C
authors.lastname: Conrad
authors.forename: C
authors.initials: C
authors.lastname: Dudli
authors.forename: E
authors.initials: E
authors.lastname: Kielhorn
authors.forename: B J
authors.initials: BJ
authors.lastname: Nickoloff
authors.forename: F O
authors.initials: FO
authors.lastname: Nestle
mesh_terms: D000818:Animals; D015703:Antigens, CD / Q000032:analysis / Q000276:immunology*; D001706:Biopsy; D016022:Case-Control Studies; D002908:Chronic Disease; D003713:Dendritic Cells / Q000276:immunology*; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D015603:Keratinocytes / Q000378:metabolism; D026503:Low Density Lipoprotein Receptor-Related Protein-1; D008213:Lymphocyte Activation; D051379:Mice; D008822:Mice, Transgenic; D018613:Microscopy, Confocal; D023421:Models, Animal; D011565:Psoriasis / Q000276:immunology* / Q000378:metabolism; D012008:Recurrence; D012867:Skin / Q000276:immunology*; D016038:Skin Transplantation; D014183:Transplantation, Heterologous
chemical_list: D015703:Antigens, CD; D018840:HSP70 Heat-Shock Proteins; C475476:LRP1 protein, human; D026503:Low Density Lipoprotein Receptor-Related Protein-1