title: Characterization of monocyte/macrophage subsets in the skin and peripheral blood derived from patients with systemic sclerosis.
abstract: BACKGROUND
  Recent accumulating evidence indicates a crucial involvement of macrophage lineage in the pathogenesis of systemic sclerosis (SSc). To analyze the assembly of the monocyte/macrophage population, we evaluated the expression of CD163 and CD204 and various activated macrophage markers, in the inflammatory cells of the skin and in the peripheral blood mononuclear cells (PBMCs) derived from patients with SSc.
  
  
  METHODS
  Skin biopsy specimens from 6 healthy controls and 10 SSc patients (7 limited cutaneous SSc and 3 diffuse cutaneous SSc) were analyzed by immunohistochemistry using monoclonal antibody against CD68 (pan-macrophage marker), CD163 and CD204. Surface and/or intracellular protein expression of CD14 (marker for monocyte lineage), CD163 and CD204 was analysed by flow cytometry in PBMCs from 16 healthy controls and 41 SSc patients (26 limited cutaneous SSc and 15 diffuse cutaneous SSc). Statistical analysis was carried out using Mann-Whitney U test for comparison of means.
  
  
  RESULTS
  In the skin from SSc patients, the number of CD163+ cells or CD204+ cells between the collagen fibers was significantly larger than that in healthy controls. Flow cytometry showed that the population of CD14+ cells was significantly greater in PBMCs from SSc patients than that in healthy controls. Further analysis of CD14+ cells in SSc patients revealed higher expression of CD163 and the presence of two unique peaks in the CD204 histogram. Additionally, we found that the CD163+ cells belong to CD14brightCD204+ population.
  
  
  CONCLUSIONS
  This is the first report indicating CD163+ or CD204+ activated macrophages may be one of the potential fibrogenic regulators in the SSc skin. Furthermore, this study suggests a portion of PBMCs in SSc patients abnormally differentiates into CD14brightCD163+CD204+ subset. The subset specific to SSc may play an important role in the pathogenesis of this disease, as the source of CD163+ or CD204+ macrophages in the skin.
authors.affiliation: Department of Dermatology & Plastic and Reconstructive Surgery, Kumamoto University, Kumamoto, Japan. nobunobu18@hotmail.com
authors.forename: Nobuyo
authors.initials: N
authors.lastname: Higashi-Kuwata
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Jinnin
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Makino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukushima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Inoue
authors.forename: Faith C
authors.initials: FC
authors.lastname: Muchemwa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Komohara
authors.forename: Motohiro
authors.initials: M
authors.lastname: Takeya
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mitsuya
authors.forename: Hironobu
authors.initials: H
authors.lastname: Ihn
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D019070:Cell Lineage / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000378:metabolism; D008264:Macrophages / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism / Q000473:pathology*; D011956:Receptors, Cell Surface / Q000378:metabolism; D051117:Scavenger Receptors, Class A / Q000378:metabolism; D045745:Scleroderma, Limited / Q000276:immunology / Q000473:pathology; D012595:Scleroderma, Systemic / Q000276:immunology / Q000473:pathology*; D012867:Skin / Q000276:immunology / Q000473:pathology*; D000098902:CD163 Antigen
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D000098902:CD163 Antigen; D018950:Lipopolysaccharide Receptors; C495139:MSR1 protein, human; D011956:Receptors, Cell Surface; D051117:Scavenger Receptors, Class A