Comparative immunoreactivity of the eosinophil constituents MBP and ECP in different types of urticaria

Abstract

In order to elucidate the role of eosinophil constituents in urticaria, we investigated major basic protein expression immunohistologically in comparison with that of eosinophilic cationic protein and the low-affinity IgE receptor in lesional and uninvolved skin of different types of urticaria. Eosinophil activation was studied with the markers EG1 and EG2. Different eosinophil constituents were found in all urticarial lesions except those of urticaria pigmentosa. MBP staining tended to be distributed diffusely throughout the tissue, whereas EG1 and EG2 antibodies were located at or close to individual cells. Staining with the low affinity IgE receptor antibody was rare. In uninvolved skin, major basic protein and particularly eosinophilic cationic protein reactivity was found in chronic recurrent urticaria, delayed pressure urticaria and, to a minor degree, in cholinergic urticaria. No correlation was found between antibody reactivity and eosinophil counts. Reactivity with either of the eosinophil constituents is thus a better marker for eosinophil involvement than routine H&E staining of the cells. The demonstration of eosinophil constituents in non-lesional skin of some urticaria patients suggests generalized eosinophil activation in certain subtypes of the disease.

Differential Endothelial Adhesion Molecule Expression in Early and Late Whealing Reactions

“…In accordance with these findings, no or, as previously reported by us [4], hardly any leukocytic infiltrates were detectable in these lesions [4]. While the infiltrates in ChU are also generally scanty [4, 5, 15, 16], the condition is associated with a generalized urticarial eruption, and histamine, eosinophil and neutrophil chemotactic activities have been measured in the circulation after exercise challenge [17, 18]. The latter holds also for CU after cold exposure of the lower extremity [19].…”

“…Recently, we have demonstrated that lesions of acute (AU), chronic recurrent (CRU) and delayed pressure urticaria (DPU) have statistically significant increases of neutrophilic and eosinophilic infiltrates in lesional skin, whereas infiltrating leukocytes in more fleeting wheals of cholinergic (ChU), dermographic and cold urticaria (CU) as well as in prick test reactions (PTR) biopsied after 10 min are scarce, although monocytes and lymphocytes are distinctly increased [4, 5]. These leukocytic infiltrates have furthermore been shown by us to exhibit a striking up-regulation of β 2 -integrins [6].…”

Microscopic Morphology of Different Types of Urticaria

“…The same holds for the infiltration of blood leukocytes, although deposits of the eosinophil proteins (major basic protein and eosinophil cationic protein) have been identified also in uninvolved skin of patients with delayed pressure, chronic, or cholinergic urticaria. 39 Infiltrates of neutrophils, eosinophils or eosinophil products, activated macrophages, and T-helper lymphocytes have been described before in lesions of chronic and cholinergic urticaria and in DPU, with the last involving primarily the lower dermis. [2][3][4]10,17,18,39 In about half of our patients with chronic urticaria and also those of Monroe et al, 5 mononuclear cells were predominant.…”

Urticária

“…8 All tissue mast cells express FceRI on their surface, which bind to the Fc portion of the IgE antibodies. 9,10 After the immune stimulus, the mast cells undergo a refractory period, thus enabling regeneration of the mediators associated to their granules. 8 The degranulation process can be inhibited by adrenalin, theophylline and dibutyl cyclic AMP (AMPc), which act on the cyclic nucleotides, and by cytochalasin B and colchicine, which, in turn, interfere with the functioning of the microtubules and formation of the protein tubuline.…”

“…In chronic urticarias, 10,42 management should include general information given to patients (directions) and drug therapy. Various drug and non-pharmacological interventions are possible; however, none of them is consistently successful.…”