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Biomedical subjects

A Claudy

Publications and source records attributed to A Claudy.

At least 127 records · Page 7Linked to original sources
PubMed1995

Comparative epidemiologic study of premalignant and malignant epithelial cutaneous lesions developing after kidney and heart transplantation.

BACKGROUND: Cutaneous carcinomas are the most frequent cancers in organ transplant recipients. OBJECTIVE: Our purpose was to compare the epidemiologic data of cutaneous premalignant and malignant epithelial lesions in kidney and heart transplant recipients. METHODS: A total of 580 kidney and 150 heart transplant recipients were examined for the presence of premalignant and malignant epithelial lesions. RESULTS: A twofold increase in incidence of premalignant and malignant epithelial lesions was found in heart compared with kidney transplant recipients. Heart transplant recipients were older at transplantation, received more intense immunosuppressive treatment, and had a shorter delay from transplantation to the development of the first lesion. The squamous cell carcinoma/basal cell carcinoma ratio was 2.37:1 in kidney and 1.08:1 in heart transplant recipients. The extracephalic location represented 60% of the premalignant and malignant epithelial lesions in kidney and 30% in heart transplant recipients. CONCLUSION: Cutaneous premalignant and malignant epithelial lesions in kidney and heart transplant recipients show epidemiologic differences that can tentatively be explained by the older age and the more intense immunosuppressive treatment of heart transplant recipients.

Adult↗
PubMed1995

Expression of elastase and fibrin in venous leg ulcer biopsies: a pilot study of pentoxifylline versus placebo.

The pathogenesis of venous leg ulcers is based on the leakage of fibrinogen leading to a pericapillary fibrin cuff and plugging of capillaries by white blood cells. On the basis of a previous work, we had assumed that the key event in the pathogenesis of venous leg ulcers is related to inflammation generated by activated white blood cells that accumulate under unrelieved blood pressure, because in ulcer biopsies we had detected the presence of tumor necrosis factor-alpha (TNF-alpha) in intracapillary monocytes, elastase in the polymorphonuclear leukocytes near the vessels, and a pericapillary undegraded fibrin cuff causing a diffusion barrier to oxygen. This concept was developed because TNF-alpha synthesized by activated monocytes is responsible for many deleterious effects. It has a potent mitogenic effect on fibroblasts, leading to new collagen deposition and angiogenesis, it induces an increase in collagenase production, it acts through upregulation of an intracellular adhesion molecule (ICAM-1), leading to leukocyte sequestration and consequently a release of toxic metabolites by the polymorphonuclear cells, an early step in chronic inflammation, it activates the coagulation pathway via a marked increase in monocyte-associated tissue factor (TF) procoagulant activity, and it inhibits fibrinolysis by promoting the release of PAI-1, contributing to undegraded fibrin deposition. Therefore, we were interested in evaluating, in patients with venous leg ulcers, the effect of pentoxifylline administered at 1,200 mg daily (versus placebo) for 2-months, as this drug induces a decrease in TNF-alpha synthesis and also blocks its activity. This pilot assay was performed in blind. Evolution of several parameters in ulcer biopsies are analyzed: TNF-alpha, intact fibrin, fibrin degradation products, ICAM-1, TF, and elastase. Pentoxifylline administration induced a decrease of local elastase and of fibrin deposit. These results support the hypothesis that accumulation of activated leukocytes is the key event in venous leg ulcers.

Antibodies, Monoclonal↗
PubMed1995

Expression of ICAM-3/CD50 in normal and diseased skin.

ICAM-3 is a newly recognized adhesion molecule, which is a member of the immunoglobulin supergene family of ICAMs, and has been shown to be identical with the CD50 antigen. Recent functional studies have shown that ICAM-3 is a ligand for LFA-1, and plays an important part in immune reactions. To date, very few data exist in the literature concerning its expression in the skin. In the present study, we investigated the expression of ICAM-3 in normal skin and in 98 biopsy specimens of various inflammatory and neoplastic dermatoses. ICAM-3 was found to be expressed by epidermal CD1a+ Langerhans cells, by cells of Langerhans cell histiocytosis, by T and B lymphocytes infiltrating the dermis in cutaneous lymphomas and in a wide spectrum of inflammatory dermatoses. Epidermal keratinocytes were consistently negative; endothelial expression of ICAM-3 was observed in six of the 98 cases. These results show that ICAM-3 is constitutively and widely expressed by cells participating in inflammatory dermatoses (including Langerhans cells and T and B lymphocytes), and that it can be, albeit rarely, induced on endothelial cells and dermal dendrocytes. These results highlight the important part that ICAM-3 may play in cutaneous inflammatory and immune reactions.

Antigens, CD↗
PubMed1995

In vitro T cell response to staphylococcal enterotoxin B superantigen in chronic plaque type psoriasis.

Recent studies have demonstrated the important role of CD4+ T cells in the pathophysiology of psoriasis. One of the current hypotheses is that triggering of the psoriatic inflammatory process could be secondary to CD4+ T cell activation by bacterial superantigens in the skin. In this study, IL-2-derived T cell lines were recovered from the blood and the skin of 4 patients with chronic plaque type psoriasis and of 2 patients with allergic contact dermatitis (ACD). Blood and skin T cell lines were tested for their ability to proliferate in vitro to staphylococcal enterotoxin B (SEB) presented by MHC class II expressing antigen-presenting cells. The results showed a significantly higher SEB-induced T cell proliferation in skin T cell lines as compared to blood T cell lines in 3 out of 4 psoriatic patients and in one of the 2 ACD patients. No difference between the skin and blood T cells for their response to phytohemagglutinin was observed. Furthermore the blood T cell lines from both patients and control individuals responded equally well to SEB. Thus psoriatic skin T cell lines were characterized by an enrichment in SEB-responding T cells. Since similar enhancement of SEB-responsive T cells was occasionally found in ACD patients, we propose that SEB could be an environmental factor associated with rather than responsible for psoriatic inflammation.

Antigen-Presenting Cells↗
PubMed1995

Crossover study of thalidomide vs placebo in Jessner's lymphocytic infiltration of the skin.

BACKGROUND AND DESIGN: An effective therapy is still unavailable for Jessner-Kanof lymphocytic infiltration of the skin. Thalidomide's efficacy was suggested in an open study. Twenty-eight patients were randomly assigned to receive thalidomide (100 mg/d) or placebo over a period of 2 months and were then switched to the other treatment. RESULTS: After the first period, 11 of 13 patients treated with thalidomide were in complete remission (CR), and there were two failures. There was no CR in the patients who received placebo (chi y2 = 17.5; P < .0001). After the second period, nine of 14 patients who had received thalidomide were in CR. Eleven of the 13 patients who had received thalidomide during the first period were given placebo (two were unavailable for follow-up). Ten of them were in CR: four were still free of lesions at the end of the second period, and six experienced a relapse of their lesions after a mean duration of 26 +/- 10 (SD) days. A total of 25 patients participated in the two study periods; CR was observed in 19 (76%) after thalidomide therapy and in four (16%) after treatment with placebo (chi y2 = 11.1; P < .001). Of 27 patients who received thalidomide, 16 (59%) were in CR after 1 month and 20 (74%) were in CR after 2 months. Two patients treated with thalidomide experienced neurologic changes that were not consistent with typical thalidomide-induced neuropathy. CONCLUSIONS: A therapeutic regimen of thalidomide administered at a dosage of 100 mg/d for 2 months is able to suppress the clinical symptoms of Jessner-Kanof lymphocytic infiltration of the skin. The long-term risk-benefit has still to be evaluated.

Adult↗
PubMed1995

[Interactions of neuromediators and neurohormones on dendritic cells, monocytes and macrophages (out of the central nervous system)].

Immune cells are modulated by neurotransmitters and hormones. Apart Langerhans cells, studies about dendritic cells and these peptides are very rare. But their effects on monocytes or macrophages are known. Substance P, VIP, CGRP, prolactin, ACTH are among the most important. These effects are supported by an anatomical reality: connexions between nerve and immune cells. Immune cells are capable to product neuromediators and hormones. Neuroimmunology is probably the next great subject of research about dendritic cells.

Humans↗
PubMed1994

A novel therapeutic approach to psoriasis with combination calcipotriol ointment and very low-dose cyclosporine: results of a multicenter placebo-controlled study.

BACKGROUND: Recent advances in the treatment of psoriasis include both the topical vitamin D analogue calcipotriol and cyclosporine. Combined treatments have been sought to decrease the incidence of side effects while maintaining efficacy in the treatment of severe chronic plaque psoriasis. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of the combination of 2 mg/kg/day of cyclosporine with calcipotriol ointment (50 micrograms/gm) in the treatment of severe plaque psoriasis. METHODS: Sixty-nine patients were randomly selected for this double-blind, multicenter study to receive cyclosporine (2 mg/kg/day) combined with calcipotriol ointment (50 micrograms/gm) or cyclosporine (2 mg/kg/day) combined with placebo ointment (vehicle of calcipotriol) for a 6-week period. RESULTS: Complete clearing or 90% improvement in Psoriasis Area and Severity Index score occurred in 50.0% of patients in the calcipotriol/cyclosporine group in comparison with 11.8% of patients treated with placebo/cyclosporine (p = 0.0019). The confidence interval for the difference ranged from 17.8% to 58.7%. No difference was found between the two groups with respect to side effects. CONCLUSION: The calcipotriol/cyclosporine combination was more effective than placebo/cyclosporine. Further studies are needed to establish the long-term efficacy and safety profile of this combination therapy.

Adult↗
PubMed1994

Disseminated superficial porokeratosis in a patient with AIDS.

We report the case of a 50-year-old male homosexual suffering from AIDS, who developed diffuse annular hyperkeratotic lesions on the arms and legs. Histopathological examination revealed typical features of porokeratosis, which clinically was of the disseminated superficial type. Ultrastructural examination showed a paucity of keratohyalin granules and lamellar bodies. Immunohistochemical studies showed an almost complete absence of Langerhans cells in lesional epidermis. Involucrin and filaggrin expression were altered in areas of cornoid lamella formation, whereas basal keratinocytes in these areas expressed PCNA/cyclin and, to a lesser degree, p53 protein. Porokeratosis may affect immunocompetent patients, but has also been reported in the setting of immunosuppression following organ transplantation. As far as we are aware, the development of porokeratosis during the course of HIV infection has not been reported previously.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Linear IgA bullous dermatosis of childhood with autoantibodies to a 230 kDa epidermal antigen.

Linear IgA bullous dermatosis (LABD) is an autoimmune, subepidermal disease defined on the basis of direct immunofluorescence findings. However, more recent techniques used to study bullous dermatoses suggest that LABD may be heterogeneous. A patient with LABD of childhood (chronic benign disease of childhood, CBDC) was studied by indirect immunofluorescence on salt-split skin and by Western blot in an attempt to characterize the involved autoantigen. This young girl's periorificial (mouth, genitalia), erythematovesicular lesions were diagnosed initially as herpes simplex. Histologic examination revealed eosinophilic spongiosis, suggesting the diagnosis of an autoimmune blistering disease. Direct immunofluorescence showed an exclusive linear IgA deposit at the dermoepidermal junction. Indirect immunofluorescence revealed circulating IgA autoantibodies that reacted with the epidermal side of salt-split skin; these reacted by Western blot with a 230 kDa epidermal antigen, as in bullous pemphigoid. This case, fulfilling the diagnostic clinical and direct immunofluorescence criteria for LABD/CBDC, seems to represent IgA bullous pemphigoid. It further underscores the nosologic heterogeneity of LABD, which probably includes, apart from bullous pemphigoid, epidermolysis bullosa acquisita and cicatricial pemphigoid.

Autoantibodies↗
PubMed1994

[Pemphigoid in children].

INTRODUCTION: Bullous pemphigoid is rare during the childhood. The authors report the 51st case. CASE REPORT: Jeremie, a seven-month-old baby, had atypical bullous lesions. Histological examination, direct and indirect immunofluorescence were in favor of bullous pemphigoid. COMMENTS: Clinical and biological features of bullous pemphigoid are similar in the adult and in the infant. First treatment is represented by corticosteroids. Evolution is generally very good.

Facial Dermatoses↗
PubMed1994

[Adhesion molecules and inflammatory dermatoses].

In inflammatory dermatoses, adhesion molecules are involved in the interaction of leukocytes with endothelial cells, extra-cellular matrix and epidermal cells. In dermatosis where epidermal cells are the main targets of inflammation, the keratinocytes are activated and participate to the local immune reaction through the secretion of cytokines and the expression of the adhesion molecule ICAM-1 and the HLA-DR antigens. Induction of ICAM-1 by IFN gamma or TNF alpha on keratinocytes that do not express this molecule in normal skin may account for the recruitment of T cells into the epidermis. In the dermis, an up-regulation of ICAM-1 expression occurs on endothelial cells activated by cytokines (IL-1, TNF alpha...) and is usually correlated with an induction of ELAM-1 and less frequently VCAM-1. These adhesion molecules are involved in the recruitment of inflammatory cells but also in the control of their retention and migration through the skin.

Cell Adhesion Molecules↗
PubMed1994

Topical application of isotretinoin did not modify human Langerhans cell allostimulatory function.

The beneficial effect of isotretinoin on the repair of photodamaged skin is well documented. Little is known, however, on the action of this compound on immunological functions of epidermis. In a double-blind study, we analyzed the effect of topical applications of isotretinoin on human Langerhans cell (LC) function by using the mixed epidermal cell lymphocyte reaction (MELR). Isotretinoin cream (0.1%) was applied daily for 4 months on the back of one hand of 5 healthy volunteers, 50-60 years of age. The back of the other hand received vehicle alone and was used as control. Skin biopsy specimens were taken at the end of treatment. Epidermal cell (EC) suspensions were obtained by the use of trypsin and allogeneic T cells were purified from the peripheral blood of allogeneic donors. MELR was performed in microtiter plates and T cell proliferation was assessed by 3H-thymidine incorporation during the last 18 h of culture. Results did not show any differences between allogeneic T cell responses to EC from isotretinoin-treated or nontreated skin. These results therefore suggest that isotretinoin, applied topically onto photodamaged skin, did not alter human LC antigen-presenting function.

Administration, Cutaneous↗