title: In situ detection of inflammatory cytokines and apoptosis in pemphigus foliaceus patients.
abstract: BACKGROUND
  Endemic pemphigus foliaceus, or fogo selvagem, is a chronic autoimmune disease characterized by the formation of intraepidermal blisters that reduce adhesion between keratinocytes. Endemic pemphigus foliaceus is associated with the presence of autoantibodies and high levels of cytokines involved in the inflammatory response.
  
  
  OBJECTIVE
  To evaluate the expression of the proinflammatory cytokines interleukin 1, interferon gamma, and tumor necrosis factor alpha; the proapoptotic inducers Fas and inducible nitric oxide synthase; and the apoptosis inhibitor Bcl-2; and to evaluate the presence of apoptosis.
  
  
  METHODS
  Skin biopsies from 13 patients with endemic pemphigus foliaceus and controls were evaluated by immunohistochemistry and apoptosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay.
  
  
  RESULTS
  Proinflammatory cytokines were only detected in cells of the inflammatory exudate. Inducible nitric oxide synthase, Fas, and Bcl-2 were expressed by both epithelial and inflammatory cells. Epithelial apoptosis was observed in 12 cases (92.3%), and subepithelial apoptosis in 11 cases (85%).
  
  
  CONCLUSIONS
  This study suggests that apoptosis as well as the local production of proinflammatory cytokines are associated with endemic pemphigus foliaceus lesions. These results may contribute to the development of new therapeutic approaches to endemic pemphigus foliaceus.
authors.affiliation: Laboratory of Immunology, Universidade Federal do Triangulo Mineiro, 38025-180 Uberaba, Minas Gerais, Brazil.
authors.forename: Denise Bertulucci Rocha
authors.initials: DB
authors.lastname: Rodrigues
authors.forename: Sanivia Aparecida Lima
authors.initials: SA
authors.lastname: Pereira
authors.forename: Marlene Antônia
authors.initials: MA
authors.lastname: dos Reis
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
authors.forename: João Eduardo
authors.initials: JE
authors.lastname: Caixeta
authors.forename: Angélica Maeda
authors.initials: AM
authors.lastname: Chiba
authors.forename: Richard Atila
authors.initials: RA
authors.lastname: Sousa
authors.forename: Virmondes
authors.initials: V
authors.lastname: Rodrigues
mesh_terms: D017209:Apoptosis; D015415:Biomarkers / Q000378:metabolism; D002467:Cell Nucleus / Q000378:metabolism / Q000473:pathology; D016207:Cytokines / Q000378:metabolism*; D019353:Endemic Diseases; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D007371:Interferon-gamma / Q000378:metabolism; D007375:Interleukin-1 / Q000378:metabolism; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism; D010392:Pemphigus / Q000378:metabolism* / Q000473:pathology*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012867:Skin / Q000378:metabolism / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019014:fas Receptor / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007375:Interleukin-1; D019253:Proto-Oncogene Proteins c-bcl-2; D014409:Tumor Necrosis Factor-alpha; D019014:fas Receptor; D007371:Interferon-gamma; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II