Eosinophil granule proteins expressed in ocular cicatricial pemphigoid

Abstract

Background-Blister formation and tissue damage in bullous pemphigoid have been attributed to the release of eosinophil granule proteins-namely, to eosinophil derived cationic protein (ECP) and major basic protein (MBP). In the present investigation these eosinophil granule proteins were studied in the conjunctiva of patients with ocular cicatricial pemphigoid (OCP). Methods-Conjunctival biopsy specimens obtained from patients with subacute (n=8) or chronic conjunctival disease (n=13) were analysed histologically and immunohistochemically using antibodies directed against EG1 (stored and secreted ECP), EG2 (secreted ECP), MBP, CD45 (common leucocyte antigen), CD3 (pan T cell marker), and HLA-DR (class II antigen). Results-Subepithelial mononuclear cells, mast cells, and neutrophils were detected in all specimens. The number of mononuclear cells, neutrophils, CD45+ cells, CD3+ cells, and the HLA-DR expression were significantly higher in the subacute than in the chronic disease group. Some eosinophils were found in specimens from five of eight patients with subacute OCP, but in none of the patients with chronic disease. The eosinophil granule proteins (ECP and MBP) were found in the epithelium and substantia propria in patients with subacute conjunctivitis. Conclusions-Subepithelial cell infiltration in the conjunctiva greatly diVers between subacute and chronic ocular cicatricial pemphigoid specimens. The findings suggest that eosinophil granule proteins may participate in tissue damage in acute phase of inflammation in OCP. (Br J Ophthalmol 1998;82:312-317)

Eosinophils in lichen sclerosus et atrophicus

“…Although traditionally associated with allergic reactions, eosinophils have a role in tissue remodeling and are found in biopsy specimens from several dermatologic and extracutaneous fibrosing or sclerosing disorders, including ocular pemphigoid, morphea profunda, eosinophilic fasciitis, granuloma faciale, immunoglobulin G4‐related sclerosing diseases, endomyocardial fibrosis associated with hypereosinophilic syndrome, eosinophilic angiocentric fibrosis of the upper respiratory tract and orbit, idiopathic retroperitoneal fibrosis, sclerosing mediastinitis, sclerosing cholangitis and pulmonary fibrosis . Thus, the common presence of tissue eosinophils in LS may be less a diagnostic marker for coexistent allergic or autoimmune disease than a reflection of the sclerosis that is integral to LS.…”

Biology of interleukin-5 in ocular cicatricial pemphigoid

“…The numbers of eosinophil granules, rather than eosinophils themselves, were found to be increased in the substantia propria of inflamed conjunctiva during the acute stage of OCP in previous studies [6,7], suggesting degranulation of eosinophils in the target tissue of the disease. The average number of eosinophils found in the cellular infiltrate of the conjunctiva in the present study was statistically significantly higher than in normal controls.…”

Role of immune cells in the ocular manifestations of pemphigoid diseases

“…Furthermore, tear samples of OCP patients have revealed elevated levels of IL-8, matrix metalloproteinase (MMP)-8, MMP-9, and myeloperoxidase (MPO), and this abundance of inflammatory molecules is associated with neutrophilic infiltration in these patients. 30,31,[39][40][41][42][43][44] The propensity of immune cells in different OCP conditions The spectrum of involvement of different immune cells is described in Figure 1. 23,42,[45][46][47][48][49] The two prominent cell populations that are modulated in the pemphigoid diseases with ocular manifestations are neutrophils and T-helper (T H ) 17 cells in humans, and a coordinated, balanced mechanism between neutrophils and Tregs has been observed in mice.…”