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The CD40/CD40 ligand system is expressed in the cutaneous lesions of erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum.
Br J Dermatol. 2006 Feb; 154(2):319-24.BJ

Abstract

BACKGROUND

Erythema multiforme (EM) and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are determined by a dysregulation of cellular immunity.

OBJECTIVES

To evaluate the effector role of cellular immunity and the involvement of the CD40/CD40 ligand (CD40L) system in the pathogenesis of EM and SJS/TEN.

METHODS

Biopsy specimens from eight patients with EM and six with SJS/TEN were stained for immunohistochemical examination using the alkaline phosphatase/antialkaline phosphatase method. The monoclonal antibodies used included those to CD1a, CD4, CD8, CD40, CD40L, CD68, Fas, Fas ligand (FasL) and myeloperoxidase.

RESULTS

The cellular infiltrate in both EM and SJS/TEN lesions was composed mainly of T lymphocytes and CD68+ macrophages. We also detected large amounts of neutrophils. Fas and FasL were very highly expressed in SJS and TEN, but weakly in EM. CD40 staining was strong in all tissue sections; there were numerous CD40L+ cells in SJS/TEN but much fewer in EM.

CONCLUSIONS

Activated T lymphocytes and macrophages, but also neutrophils, are presumably the main triggers of mucocutaneous damage in the SJS/TEN disease spectrum. The Fas/FasL system is significantly expressed in SJS/TEN lesions, but not in EM, where this apoptotic pathway presumably does not play a pivotal role in the epidermal damage. We suggest that the CD40/CD40L system may represent an important pathway of induction of SJS/TEN lesions, while in EM it would contribute to the immunoinflammation only as a second-line mechanism.

Authors+Show Affiliations

Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16433803

Citation

Caproni, M, et al. "The CD40/CD40 Ligand System Is Expressed in the Cutaneous Lesions of Erythema Multiforme and Stevens-Johnson Syndrome/toxic Epidermal Necrolysis Spectrum." The British Journal of Dermatology, vol. 154, no. 2, 2006, pp. 319-24.
Caproni M, Torchia D, Schincaglia E, et al. The CD40/CD40 ligand system is expressed in the cutaneous lesions of erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum. Br J Dermatol. 2006;154(2):319-24.
Caproni, M., Torchia, D., Schincaglia, E., Volpi, W., Frezzolini, A., Schena, D., Marzano, A., Quaglino, P., De Simone, C., Parodi, A., Barletta, E., & Fabbri, P. (2006). The CD40/CD40 ligand system is expressed in the cutaneous lesions of erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum. The British Journal of Dermatology, 154(2), 319-24.
Caproni M, et al. The CD40/CD40 Ligand System Is Expressed in the Cutaneous Lesions of Erythema Multiforme and Stevens-Johnson Syndrome/toxic Epidermal Necrolysis Spectrum. Br J Dermatol. 2006;154(2):319-24. PubMed PMID: 16433803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The CD40/CD40 ligand system is expressed in the cutaneous lesions of erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum. AU - Caproni,M, AU - Torchia,D, AU - Schincaglia,E, AU - Volpi,W, AU - Frezzolini,A, AU - Schena,D, AU - Marzano,A, AU - Quaglino,P, AU - De Simone,C, AU - Parodi,A, AU - Barletta,E, AU - Fabbri,P, PY - 2006/1/26/pubmed PY - 2006/6/9/medline PY - 2006/1/26/entrez SP - 319 EP - 24 JF - The British journal of dermatology JO - Br J Dermatol VL - 154 IS - 2 N2 - BACKGROUND: Erythema multiforme (EM) and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are determined by a dysregulation of cellular immunity. OBJECTIVES: To evaluate the effector role of cellular immunity and the involvement of the CD40/CD40 ligand (CD40L) system in the pathogenesis of EM and SJS/TEN. METHODS: Biopsy specimens from eight patients with EM and six with SJS/TEN were stained for immunohistochemical examination using the alkaline phosphatase/antialkaline phosphatase method. The monoclonal antibodies used included those to CD1a, CD4, CD8, CD40, CD40L, CD68, Fas, Fas ligand (FasL) and myeloperoxidase. RESULTS: The cellular infiltrate in both EM and SJS/TEN lesions was composed mainly of T lymphocytes and CD68+ macrophages. We also detected large amounts of neutrophils. Fas and FasL were very highly expressed in SJS and TEN, but weakly in EM. CD40 staining was strong in all tissue sections; there were numerous CD40L+ cells in SJS/TEN but much fewer in EM. CONCLUSIONS: Activated T lymphocytes and macrophages, but also neutrophils, are presumably the main triggers of mucocutaneous damage in the SJS/TEN disease spectrum. The Fas/FasL system is significantly expressed in SJS/TEN lesions, but not in EM, where this apoptotic pathway presumably does not play a pivotal role in the epidermal damage. We suggest that the CD40/CD40L system may represent an important pathway of induction of SJS/TEN lesions, while in EM it would contribute to the immunoinflammation only as a second-line mechanism. SN - 0007-0963 UR - https://www.unboundmedicine.com/medline/citation/16433803/The_CD40/CD40_ligand_system_is_expressed_in_the_cutaneous_lesions_of_erythema_multiforme_and_Stevens_Johnson_syndrome/toxic_epidermal_necrolysis_spectrum_ L2 - https://doi.org/10.1111/j.1365-2133.2005.07023.x DB - PRIME DP - Unbound Medicine ER -