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Pemphigus vulgaris: accumulation of apoptotic cells in dermis and epidermis possibly relates to pathophysiology through TNF-alpha production by phagocytes |
European Journal of Dermatology. Volume 21, Numéro 6, 874-88, November-December 2011, Investigative report
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Auteur(s) : Mariana Chiapa-Labastida, Alejandro Zentella-Dehesa, Gladys León-Dorantes, Ingeborg Becker |
Résumé : Apoptotic cells are present in the epidermis of pemphigus vulgaris (PV) patients and their accumulation has been linked to chronic inflammatory disorders. TNF-α is elevated in sera of PV patients and has only been detected in acantholytic and periacantholytic keratinocytes (KC), therefore another TNF-α source might exist. We analyzed, in lesional and perilesional skin of 5 active untreated PV patients, the presence of apoptotic cells, TNF-α and phagocytic infiltrate.
In vitro, we analyzed whether phagocytosis of apoptotic KCs by monocytes causes TNF-α release. We found a significant increase of apoptotic cells in the epidermis and dermis of PV patients, by TUNEL, and activated caspase-3. TNF-α was present in the skin of PV patients, especially in the dermis. Phagocytic CD14+ cells were increased, mostly in the dermis of PV patients.
In vitro phagocytosis of apoptotic KCs by monocytes caused enhanced TNF-α production, which correlated with the number of apoptotic KCs in the co-culture. Thus, accumulation of apoptotic cells in PV could promote TNF-α production by monocytes, which could, in turn, cause further apoptosis, closing a vicious circle. |
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