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Biomedical subjects

S Jablonska

Publications and source records attributed to S Jablonska.

At least 217 records · Page 12Linked to original sources

Immune reactions in epidermodysplasia verruciformis.

Serum antibodies against human papilloma virus have been measured using immunodiffusion and enzyme linked immunosorbent assay in twelve patients with epidermodysplasia verruciformis (EV). The results were compared with those from sixty-six patients with other types of human papilloma virus diseases. Antibody prevalences were slightly lower in patients with EV than in the control patients. More remarkable was the difference between EV patiens and control subjects in tests of non-specific cell-mediated immunity, which was markedly depressed in the majority of patients with EV, but in the main preserved in patients with common warts. No specific immunological parameter was shown to be associated with malignant conversion of EV lesions, but malignancy was linked to the character of the inducing virus, and particularly to HPV type 5.

Adolescent↗

UV-induced DNA repair synthesis in patients with epidermodysplasia verruciformis.

Autoradiographic technique was utilized to measure UV-induced DNA repair synthesis in 8 patients with epidermodysplasia verruciformis: 2 infected with human papillomavirus 3 (HPV 3), 4 with HPV 4, and 2 simultaneously with HPV 3 and HPV 4. Two cell populations were compared, i.e., epidermal cells derived from light-exposed and covered skin, and peripheral lymphocytes. A control group consisted of 10 healthy subjects. DNA repair was found to be normal both in the peripheral lymphocytes and in the epidermal cells from exposed and unexposed skin. The values for covered skin were even somewhat higher but this was not statistically significant. The type of HPV infection and malignant conversion had no apparent effect on DNA repair. A certain reduction of the UV-DNA repair synthesis was demonstrated in 2 patients infected with both types of viruses.

Adolescent↗

Studies in immunodermatology. VIII. Immunofluorescence studies of stratum corneum antibodies.

Stratum corneum antibodies (SCAb) as detected by indirect immunofluorescence (IIF) can be absorbed from human sera with homogenates of normal human callus which contain stratum corneum antigen. Titers of concomitantly present antibodies remain unchanged in sera absorbed with callus, thus showing that this absorption is specific. SCAb reacting in a passive hemagglutination assay with an antigen derived from human callus by means of a trypsin-phenol-water extraction can be specifically absorbed with the homologous antigen. However, absorption with callus fails to remove the hemagglutinating antibodies and absorption with the trypsin-phenol-water antigen preparation fails to remove SCAb detected by IIF. These data indicate a nonidentity relationship between these antigen systems despite their similar histological and anatomical tissue distribution. Reactivity of immunoglobulins and complement only with areas of traumatized stratum corneum in skin explants cultured on sera containing SCAb provide some insight as to a possible normal physiologic role for these ubiquitous complement-fixing autoantibodies.

Animals↗

Immunopathology of psoriasis.

Immunofluorescence (IF) studies by the direct and indirect methods demonstrate immunoglobulins and complement bound in vivo in psoriatic scales. The IF pattern is comparable to that of stratum corneum antibodies (SCAb) bound in vitro on specific substrate, as visualized by the indirect IF method. Formation of immune complexes can be responsible for the "squirting papilla" phenomenon, and conversion of the stratum corneum - which is normally an inaccessible antigen - into its reactive form seems to be brought about by proteases of polymorphonuclear leukocytes. Stimulation of protease production by polymorphonuclears appears to be an important factor in the pathogenesis of psoriasis. The stratum corneum of the epidermis is probably the target, and becomes an antigen for SCAb present in the circulation.

Antibodies↗

Epidermodysplasia verruciformis versus disseminated verrucae planae: is epidermodysplasia verruciformis a generalized infection with wart virus?

Recently it has been shown that epidermodysplasia verruciformis is induced by human papilloma/virus different from the papilloma/virus of warts, and that 2 distinct viruses-designated HPV-3 and HP-4--are responsible for it. Ten cases of epidermodysplasia verruciformis were found to have been caused by HPV-3. Clinically and histologically, as well as in the often depressed cell-mediated immunity they closely resembled long-standing verrucae planae, also caused by HPV-3. Contrariwise, in epidermodysplasia verruciformis caused by HPV-4 there are characteristic red, red-brown, and depigmented, pityriasis versicolor-like plaques, and malignant transformation seems almost inevitable. Cases due to HPV-3 may be abortive or even regressive, or stationary, and hard to distinguish from flat warts. No malignant conversion was seen in patients infected only with HPV-3, whereas it occurred in 2 patients infected with both viruses: HPV-3 and HPV-4. Pigmented plaques are the most important adverse prognostic sign in EV induced by HPV-3.

Animals↗

Comparative evaluation of skin atrophy in man induced by topical corticoids.

In this in-patient study, mild skin atrophy was observed clinically in 6 out of a total of 22 patients after fluocinolone acetonide and in one patient after flumethasone pivalate ointment applications (P less than 0,05). Investigations were discontinued prematurely on days 14 and 17 in 2 patients because they developed early atrophy due to fluocinolone acetonide applications. Histological findings indicating either moderate or marked skin atrophy were evident in 15 patients after flucinolone acetonide as against one patient after flumethasone pivalate ointment applications (P less than 0.001). In comparison with the controls the mean decrease in epidermal thickness was more marked after fluocinolone acetonide applications, namely 30.5% vs 21.3% after flumethasone pivalate applications. The ultrastructural tissue changes were less marked at the sites to which flumethasone pivalate was applied. In comparison with controls, the percentages of mean decrease in diameters of collagen fibrils measured in six volunteer patients ranged from 5.1% to 27.6% after fluocinolone acetonide and from 0% to 12.3% following flumethasone pivalate ointment applications, This difference was statistically significant (range P less than 0,01 to less than 0.001). This experimental study has demonstrated that flumethasone pivalate displays only a mild atrophogenic effect and it is clinically and histologically significantly less atrophogenic than fluocinolone acetonide. Flumethasone pivalate can therefore be reckoned as a suitable topical corticosteroid especially for the long-term treatment of corticoid-responsive dermatoses.

Administration, Topical↗

IgA linear dermatosis of childhood (chronic bullous disease of childhood).

Of twenty-seven cases of subepidermal blistering disease of children twelve corresponded clinically, histologically and immunologically to dermatitis herpetiforms of adults, six to bullous pemphigoid, and eight to chronic bullous disease of childhood (CBDC), i.e. IgA linear dermatosis. This latter disease seems to be a distinct entity, different from both dermatitis herpetiformis and bullous pemphigoid, and is characterized immunopathologically by linear IgA deposits at the basement membrane zone. These cases usually do not show intestinal involvement and respond well to combined treatment with sulphones and corticosteroids, whereas sulphones or sulphapyridine alone are, even in very high doses, not sufficient for full control of the disease. CBDC or IgA linear dermatosis of childhood may be regarded as a counterpart of IgA linear dermatosis of adults.

Child↗

[New developments relating to papillomaviruses].

Molecular hybridization technique and immunofluorescence studies with use of specific immune sera against the purified virions isolated from various types of warts and wart-like lesions of epidermodysplasia verruciformis (EV) made it possible to detect four different types of human papilloma viruses (HPV). The recognition of the viruses is important because of the different morphology of the lesions induced and their various oncogenic potentials. HPV1 is mainly responsible for plantar warts, HPV2 for common (hand) warts, HPV3 has been found both in flat warts and in the variety of EV in which skin lesions are of flat wart type, the course is relatively more benign, and usually malignant transformation is not to be expected. HPV4 was up to now found exclusively in the cases of EV with prevalent red and red-brownish plaques and hyper- and depigmentations similar to those of pityriasis versicolor. In all cases of this variety of EV malignancies occured invariably. In patients with EV, as also in--to a lesser extent--longstanding flat and/or common warts cell mediated immunity was in general lowered, but humoral specific anti-HPV antibodies were usually present. HPV type seems to be of a decisive significance for potential oncogenesis, because in a vast majority of cases EV due to HPV3 no malignancies occured in spite of anergy, whereas malignant transformation has been found in all cases due to HPV4, even in a patient with still preserved, although lowered, CMI.

Adult↗

Pre-pin-point papules. Changes preceding pin-point lesions of psoriasis.

Skin areas of 10X10 cm were marked out and closely observed during 14 days in 22 patients with active and 18 cases with less active psoriasis. The first changes - minute papules, slightly erythematous, almost flush with the skin (pre-pin-point papules) appeared within this period and transformed after several days into pin-point lesions. Histological examinations performed in 25 pre-pin-point and 10 pin-point papules, as well as cytochemical studies have shown significant differences. In the pre-pin-point papules inflammatory infiltrates were in a great part polymorphonuclear, and the epidermis had no features characteristic of psoriasis. The performed studies have shown that the earliest changes preceding the appearance of spontaneous psoriatic papules are very much like those of provoked Koebner phenomenon.

Female↗

[IgA linear dermatosis (author's transl)].

Besides the typical forms of dermatitis herpetiformis (DH) and bullous pemphigoid (BP) of adults and children, there are cases combining clinical, histological and electronmicroscopic features of both. Linear continuous IgA deposits along basement membrane zone (BMZ) are a most characteristic finding. They differ from the granular IgA deposits in DH, even if these are also distributed along the BMZ (however, preserving as a rule their granular pattern). IgG circulating anti-BMZ antibodies are absent, whereas in some cases IgA anti-BMZ antibodies may be found. In contrast to DH, there is no gluten-sensitive enteropathy, and the gluten-free diet is ineffective. The recognition of this bullous disease as a distinct entity is of practical significance because these cases respond well to combined treatment with sulfones and corticosteroids, all in small doses. Because of diagnostic importance of linear IgA deposits at BMZ we have proposed the name IgA linear dermatosis. In children a counterpart of IgA linear dermatosis of adults is chronic bullous disease of childhood (CBDC), which we propose to call IgA linear dermatosis of childhood.

Humans↗

Autoimmunity in psoriasis. A complement immunofluorescence study.

The stratum corneum (SC) antibodies are present in all human sera as seen by indirect immunofluorescent (IF) staining. They appear to bind in vivo to the stratum corneum of psoriatic lesions. They fix complement in vitro in a two step complement IF test system using either anti C4 or anti C3 conjugates as indicators. IF tests with proper controls showed that the SC antigen in psoriatic scales is coated not only with IgG but in a majority of the lesions also with complement. In the present studies in fully developed lesions complement was detectable in 88% of the specimens studies and in about 50% of very fresh linear lesions of unintentional Köbner type. These as well as some previously published observations afford indirect evidence for the participation of SC antibodies and the ensuing fixation of complement in the development of psoriatic lesions.

Antibody Formation↗

Autoimmunity in psoriasis. Relation of disease activity and forms of psoriasis to immunofluorescence findings.

Immunofluorescence (IF) studies using the test providing information on the reactivity of stratum corneum (SC) antibodies and their in vivo binding have been performed in 193 cases of psoriasis and 89 cases with other dermatoses. It has been shown that: 1. Essentially all fully developed, active psoriatic lesions had IgG deposits in the stratum corneum at the sites of the SC antigen, presumably due to in vivo binding of SC antibodies. 2. In various forms of psoriasis SC antigen sites appeared to be completely or almost completely satured with in vivo deposits of IgG as seen in tests with SC antibodies. 3. In most but not all lesions complement components C3 and/or C4 was found in a comparable pattern in the SC, especially when multiple specimens of single cases were studied. Partial or complete saturation of the SC antigen could be observed by the performance of complement indirect IF tests for SC antibodies in such specimens. 4. In lesions with typical histology of psoriasis the above-mentioned immunologic characteristics appeared to be a constant finding. However, in specimens of recent lesions which had not yet developed typical histology a proportion (2 of 17) were negative both for IgG and complement deposits. In receding lesions weak deposits of IgG were present only in a few specimens and complement deposits were as a rule negative. 5. In a group of 89 control specimens of other dermatoses only occasional cases gave the psoriasiform IF pattern, but about 30% of the specimens gave positive reactions in the SC though these were usually of a different pattern.

Antibody Formation↗