title: Expression of IFN-γ, IL-4, and IL-17 in cutaneous schistosomal granuloma.
abstract: OBJECTIVE
  Cutaneous schistosomal granuloma (CSG) is a rare dermatological disease, the clinical and histopathological features of which are well defined. Although a panoramic picture of its immunopathogenesis in humans is not yet available, it is believed to be induced by T helper 1 (Th1), Th2, or Th17 cytokines in animals. This study evaluated the expression of different types of Th cytokines, including Th1 cytokine interferon-γ (IFN-γ), Th2 cytokine interleukin-4 (IL-4), and Th17 cytokine IL-17, in human CSG.
  
  
  METHODS
  This study included nine patients with CSG. Dermatological examinations were conducted in all subjects. Skin biopsy specimens were stained with hematoxylin and eosin (H&E). Immunohistochemical examination was performed using three monoclonal anti-human antibodies against IFN-γ, IL-4, and IL-17 to evaluate Th1, Th2, and Th17 cytokines, respectively.
  
  
  RESULTS
  The most common site of CSG manifestation was the paraumbilical area, which was affected in 66.7% of patients. All lesional skin biopsy specimens revealed multiple dermal granulomas surrounding schistosomal eggs. Positive immunoreactivity for IFN-γ, IL-4, and IL-17 was present in dermal inflammatory infiltrate in 88.9, 11.1, and 88.9% of subjects, respectively. There were statistically significant negative correlations between the duration of disease and both IFN-γ and IL-17 (P ≤ 0.05), and a statistically significant positive correlation between IFN-γ and IL-17 (P ≤ 0.05).
  
  
  CONCLUSIONS
  This study suggests that CSG is formed by the action of both Th1 (IFN-γ) and Th17 (IL-17) cytokines, which have been shown to be directed against the schistosomal egg to induce a cell-mediated immune response.
authors.affiliation: Department of Dermatology, Sexually Transmitted Diseases and Andrology, Al-Minya University Hospital, Al-Minya University, Al-Minya, Egypt.
authors.forename: Sameh K
authors.initials: SK
authors.lastname: Attia
authors.forename: Noha H
authors.initials: NH
authors.lastname: Moftah
authors.forename: Eman S
authors.initials: ES
authors.lastname: Abdel-Azim
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D005260:Female; D006099:Granuloma / Q000276:immunology* / Q000469:parasitology / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000032:analysis*; D020381:Interleukin-17 / Q000032:analysis*; D015847:Interleukin-4 / Q000032:analysis*; D008297:Male; D010063:Ovum / Q000276:immunology; D012189:Retrospective Studies; D012547:Schistosoma / Q000276:immunology; D012552:Schistosomiasis / Q000150:complications*; D012867:Skin / Q000276:immunology* / Q000473:pathology; D012876:Skin Diseases, Parasitic / Q000276:immunology* / Q000473:pathology
chemical_list: D020381:Interleukin-17; D015847:Interleukin-4; D007371:Interferon-gamma