Our study supports the finding that in LPP, the inflammatory infiltrate mainly involves the bulge region, where the stem cells reside. Once this area is damaged, the hair loses its potential of regrowth with resulting scarring alopecia. This is in contrast with inflammatory non-scarring alopecias such as alopecia areata, where the bulb region is targeted, sparing the stem cells.

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Cicatricial pemphigoid (CP) is a chronic autoimmune blistering disease affecting multiple mucous membranes derived from stratified squamous epithelium and occasionally the skin. CP has a wide spectrum of disease manifestations. Patients with oral pemphigoid (OP) have a benign self-limited disease in which pathological changes are restricted to the oral mucosa. On the other hand, patients with ocular cicatricial pemphigoid (OCP), a chronic condition marked with relapses and remissions, have ocular involvement and also perhaps involvement of other mucous membranes. AU clinical subsets are characterized by the presence of a similar antibasement zone autoantibody. The factors that determine the development of one form of CP or the other are not known. In a previous study, we described the asiation between OCP and the DQBI*0301 allele (P = 0.006). In this study, we have analyzed 22 Caucasian patients with OP and their family members for major histocompatibility complex DRB generic, DQA1, and DQBI allele associations by PCR-sequence-speciflc oligonucleotide probe hybridization. The results were compared to those obtained from 17 Cancasian patients with OCP and to control Caucasian alleles and haplotypes. The DQBI*0301 allele frequency was 38.6% in OP, 52.9% in OCP, and 17.8% in controls. Statistically siificant associations were detected between the DQB1*0301 allele and both OP (P = 0.0047) and OCP (P < 0.0001). In addition, DRB1*04 showed a statistically significant association (P = 0.005) with OCP when compared to controls. Analysis of major histocompatibility complex class H haplotypes showed sgfant statistical associations between both OCP and OP and the HLA-DRB1*04, DRB4*0101, DQA1*03, DQB1*0301 haplotype (P < 0.0001 and P = 0.0012, respectively). Our results indicate that DQBJ*0301 is a marker of both oral and ocular forms of CP. The analysis ofthe amino acid sequence oftheDQBl alleles present in both OP and OCP suggested that amino acid residues at position 57 and positions 71-77 may also be markers of CP.Cicatricial pemphigoid (CP) is an autoimmune blistering disease that involves multiple mucous membranes and occasionally the skin (1). The pathogenesis is attributed to the deposition in vivo of an anti-basement membrane antibody and complement leading to blister formation and subsequent progressive subepithelial fibrosis (2). CP has various clinical manifestations. When only the oral mucosa (oral pemphigoid, OP) is involved, the condition is usually benign and selflimited. In contrast, ocular CP (OCP) frequently involves other mucous membranes and has severe clinical manifestations and a chronic course requiring the use of high doses of corticosteroids and immunosuppressive agents to prevent blindness.In previous studies, we showed (3) an association between theDQBl *0301 allele and OCP (P < 0.003; relative risk = 9.6) when compared to a large population of healthy normal Caucasians. In that study, 19 out of 20 OCP patients carried DQ7 (DQBI*0301) (3). In addition, the presence ofHLA DQ7 was not due t...

SUMMARYWe investigated the role of T helper (Th)1-and Th2-type cytokines in delayed-type hypersensitivity to soluble protein antigens elicited early postimmunization. Mice were sensitized by intradermal injection without adjuvants, or subcutaneously with complete Freund's adjuvant, and subsequently ear challenged intradermally. As soon as day 3, antigen-speci®c eosinophil-rich responses were elicited in wild-type mice, but not in T-cell receptor-a ±/± mice without adjuvant. Draining lymph node T cells stimulated with antigen secreted interleukin (IL)-4, IL-5 and interferon-g (IFN-g). IFN-g-dependent speci®c immunoglobulin G (IgG)2a and IL-4-dependent IgG1 were also generated. Delayed-type hypersensitivity ear swelling and local eosinophil recruitment were decreased in IL-5 ±/± , IL-4 ±/± and signal transducer and activator of transcription-6 (STAT-6) ±/± mice, and with anti-IL-4 treatment of wild-type mice, suggesting Th2 mechanisms. Interestingly, responses were also decreased in IFN-g ±/± mice, and IFN-g protein and the IFN-g-inducible CXC chemokine, IP-10, were present in 24-hr ear tissue extracts, suggesting Th1 effects. Finally, ear swelling, total histology and eosinophils were decreased in mice de®cient in CXCR3, the chemokine receptor for IP-10. These results suggest that both a Th2-like (IL-5, IL-4 and STAT-6) and a Th1-like (IFN-g, IP-10, CXCR3) pathway contribute to eosinophil recruitment in early delayed-type hypersensitivity.