Abstract | BACKGROUND: Borrelia burgdorferi can be isolated from the skin of patients with acrodermatitis chronica atrophicans (ACA), a late-stage manifestation of Lyme borreliosis; despite a marked T-cell infiltrate in lesional skin and high antibody titres in patients' sera. OBJECTIVES: To determine whether antigen-presenting Langerhans cells (LCs), which reportedly show signs of injury in erythema chronicum migrans (ECM), the early stage of disease, are altered in ACA. PATIENTS/METHODS: We studied the immunophenotype of cutaneous leucocytes on cryostat sections of lesional skin from both ECM and ACA patients. RESULTS: The total number of CD1a+ cells evaluated by semiautomatic image analysis was lower in ECM (594 +/- 263 cells mm(-2) epidermis) than in ACA (835 +/- 317 cells mm(-2) epidermis). HLA-DR expression was remarkably downregulated on CD1a+ LCs to 29% in ECM and 18% in ACA, whereas in normal skin, most of the epidermal CD1a+ dendritic cells were HLA-DR+. The inflammatory infiltrate was mainly composed of CD68+ macrophages and CD45RO+ memory T cells, with a predominance of CD4+ helper T cells. CONCLUSIONS: It is conceivable that the downregulation of major histocompatibility complex class II molecules on LC in both the early and late skin manifestations of Lyme borreliosis is indicative of a poorly effective anti-B. burgdorferi immune response and thus at least partly responsible for the insufficient elimination of this micro-organism from ACA skin.
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Authors | M Silberer, F Koszik, G Stingl, E Aberer |
Journal | The British journal of dermatology
(Br J Dermatol)
Vol. 143
Issue 4
Pg. 786-94
(Oct 2000)
ISSN: 0007-0963 [Print] England |
PMID | 11069457
(Publication Type: Journal Article)
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Chemical References |
- Antigens, CD1
- HLA-DR Antigens
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Topics |
- Acrodermatitis
(immunology)
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD1
(metabolism)
- Chronic Disease
- Down-Regulation
- Epidermis
(immunology)
- Female
- Fluorescent Antibody Technique
- HLA-DR Antigens
(metabolism)
- Humans
- Immunoenzyme Techniques
- Immunophenotyping
- Langerhans Cells
(immunology)
- Lyme Disease
(immunology)
- Male
- Middle Aged
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