title: Frequency and characteristics of circulating CD4(+) CD28(null) T cells in patients with psoriasis.
abstract: BACKGROUND
  Psoriasis is a chronic inflammatory disease that affects the skin. CD4(+) CD28(null) cells are a subset of T lymphocytes associated with systemic inflammation and increased cardiovascular disease risk, and may be involved in the pathogenesis of psoriasis.
  
  
  OBJECTIVE
  To study the features of circulating CD4(+) CD28(null) cells in patients with psoriasis, adjusted for the influence of known cardiovascular disease risk factors.
  
  
  METHODS
  Forty-two patients with psoriasis and 42 controls entered the study. Peripheral blood mononuclear cells were analysed for the frequency of CD4(+) CD28(null) T lymphocytes and their expression of cytotoxic granules and homing receptors. Immunostaining for cutaneous cytotoxic granules was assessed in skin biopsies from 11 patients.
  
  
  RESULTS
  There were no differences in the frequency of CD4(+) CD28(null) T cells between groups in all situations analysed. However, there was an increased number of cells expressing cytotoxic granules and a decreased number expressing CXCR3 in ex vivo samples of patients with psoriasis. A negative correlation was observed between the frequency of ex vivo CD4(+) CD28(null) cells and psoriasis severity. After clinical remission in nine patients, ex vivo CD4(+) CD28(null) lymphocytes expressing cytotoxic granules decreased. Perforin-, granzyme B- and granulysin-containing cells were found in skin lesions. Patients with psoriasis also had increased plasma levels of C-reactive protein.
  
  
  CONCLUSIONS
  These data suggest that cytotoxic cells, such as CD4(+) CD28(null) lymphocytes, within an inflammatory environment may play a role in the pathogenesis of psoriasis.
authors.affiliation: Department of Clinical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.|Department of Dermatology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.|School of Medicine, University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil.
authors.forename: X T
authors.initials: XT
authors.lastname: Lima
authors.affiliation: Department of Clinical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: M L
authors.initials: ML
authors.lastname: Cintra
authors.affiliation: Department of Clinical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Piaza
authors.affiliation: Department of Clinical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: R L
authors.initials: RL
authors.lastname: Mamoni
authors.affiliation: Department of Clinical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: R T
authors.initials: RT
authors.lastname: Oliveira
authors.affiliation: Department of Dermatology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: R F
authors.initials: RF
authors.lastname: Magalhães
authors.affiliation: Department of Clinical Pathology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: M H
authors.initials: MH
authors.lastname: Blotta
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D018106:CD28 Antigens / Q000378:metabolism*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy / Q000276:immunology*; D054367:Receptors, CXCR3 / Q000378:metabolism; D012074:Remission Induction; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D018106:CD28 Antigens; C515187:CXCR3 protein, human; D054367:Receptors, CXCR3; D002097:C-Reactive Protein