Where does the antigen of cutaneous sarcoidosis come from?
BACKGROUND
The antigen pathway of cutaneous sarcoidosis remains obscure. We have investigated topographic involvement of inflammatory cells and lymphatic vessels.


METHODS
Eleven cutaneous biopsies from eight patients were studied, along with controls from other granulomatous disorders and various skin lesions. Markers for lymphocytes, dendritic cells (DCs), and lymphatic vessel endothelial cells were detected using immunohistochemistry.


RESULTS
S100(+) and CD1a(+) immature DCs (Langerhans cells) occurred more frequently within the epidermis, whereas S100(+), fascin(+), or CD83(+) maturing DCs occurred more frequently beneath the epithelium in cutaneous sarcoidosis cases than in controls (e.g. CD83, cutaneous sarcoidosis vs. other granulomatous disorders: r = 0.557, p = 0.011). Fascin(+) and CD83(+) mature DCs were often closely attached to CD3(+) T-lymphocytes around dermal granulomas. D2-40(+) lymphatic vessels were often found surrounding dermal granulomas, especially those located in the deeper dermis, in contrast to fascin(+) blood vessels.


CONCLUSIONS
Antigen-capturing by immature DCs seems to take place initially in the epidermis, followed by maturation of DCs. These mature DCs may present the processed antigen to T-lymphocytes that cause dermal granulomas either in the interstitium of the upper dermis, or in or around lymphatic vessels of the lower dermis. Environmental antigen could be verified by skin test.
Kurata
Atsushi
A
Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan. akurata@ks.kyorin-u.ac.jp
Terado
Yuichi
Y
Izumi
Miki
M
Fujioka
Yasunori
Y
Franke
Folker Ernst
FE
D000328:Adult; D000368:Aged; D018949:Antigens, CD1 / Q000378:metabolism; D002452:Cell Count; D016009:Chi-Square Distribution; D042783:Endothelial Cells / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007801:Langerhans Cells / Q000276:immunology / Q000378:metabolism; D008213:Lymphocyte Activation / Q000276:immunology; D008214:Lymphocytes / Q000276:immunology* / Q000378:metabolism; D008875:Middle Aged; D009418:S100 Proteins / Q000378:metabolism; D012507:Sarcoidosis / Q000276:immunology* / Q000378:metabolism; D012867:Skin / Q000276:immunology* / Q000378:metabolism; D012871:Skin Diseases / Q000276:immunology* / Q000378:metabolism
D018949:Antigens, CD1; C419393:CD1a antigen; D009418:S100 Proteins