Immunohistology of skin and rectum biopsies in bone marrow transplant recipients

Abstract

of skin and rectum biopsies in bone marrow transplant recipients. APMIS 100: 11 15-1122, 1992. We have studied histological and immunohistological specimens of 39 skin biopsies from 21, and 30 rectal biopsies from 17 bone marrow transplant recipients. The biopsies were taken before transplantation, during acute and chronic graft-versus-host disease (GVHD), and at times with no GVHD. In biopsies taken during cutaneous aGVHD grade I to 111, epithelial changes were seen in 16/23 biopsies. The cutaneous infiltrates during aGVHD consisted of CD2-, CD4-, CD8-and FMC-33-positive cells both in the epithelium and in the dermis. CD57-positive NK cells were also detected in most biopsies. During chronic GVHD the cutaneous cellular infiltrates were similar to those seen in moderate aGVHD, i.e. both CD4-and CD8-positive lymphoid cells were present. When the biopsy was taken after the beginning of corticosteroid treatment for aGVHD, or at times when the patient did not have GVHD symptoms, the cellular infiltrates were considerably smaller in the dermis. During clinical intestinal aGVHD mucosal epithelial changes were relatively uncommon; instead, increased numbers of both CD4-and CD8-positive lymphocytes in the lamina propria (LP) were seen in 1 1 / 13 samples. During chronic GVHD the number of CD4-positive cells exceeded that of CDS-positive cells in the LP, and the large lymphoid infiltrates also reached the muscularis mucosae. In rectal biopsies the differences were not so prominent because most of the pretransplant biopsies showed CD2-, CD4-, CD8-and CD57-positive lymphocytes both in the lamina propria and epithelium.

Skin biopsies for early diagnosis and prognosis of graft-versus-host disease in recipients of allogeneic stem cells from blood or bone marrow

“…Unfortunately, the limited number of biopsies from patients with GVHD, in the BM group in particular, did not allow such assessment. Nevertheless, mainly based on previous studies of skin biopsies from BM recipients, [13][14][15][16][24][25][26] our study indicates that skin biopsies from normal skin and affected skin caused by acute GVHD do not show a different pattern in BSC-transplanted patients compared to BM when studied with histopathological and immunohistochemical methods.…”

Cutaneous Graft-versus-Host Disease

“…Unfortunately, the results do not always agree, as seen in Table 2. 8,[10][11][12][13][14][15][16][17][18][19][20][21][22] Briefly, the infiltrate is composed of T cells, with either both CD4 + and CD8 + or with 1 of these subsets predominating. Two investigations indicated that natural killer (NK) cells were present in acute GvHD skin lesions.…”

“…Two investigations indicated that natural killer (NK) cells were present in acute GvHD skin lesions. 8,22 B cells are not found and cells expressing the ␥␦ T-cell receptor (TCR) represented only a minority of infiltrating cells.…”

“…Only 2 studies showed dense CD4 + infiltrates. 12,22 A recent reverse transcription-polymerase chain reaction analysis of messenger RNA derived from skin biopsy specimens demonstrated the quasi-constant presence of interferon ␥. These observations suggest that the infiltrate in chronic GvHD could be composed of T helper 1 cells.…”

Acute graft-versus-host disease following hematopoietic stem-cell transplantation

“…While many studies have been conducted to determine the nature of the lymphocyte subpopulations found in the skin of patients with acute GVHD, unfortunately, the results are inconclusive at best (72–84). The infiltrate is composed of T cells, but both CD4+ and CD8+ subsets have shown to predominate (72–84).…”