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In Situ Immunophenotype of the Inflammatory Infiltrate in Eosinophilic Fasciitis
CLAIRE TOQUET, MOHAMED AMINE HAMIDOU, KARINE RENAUDIN, ANNE JARRY, PHRYNÉ FOULC, SÉBASTIEN BARBAROT, CHRISTIAN LABOISSE, and JEAN-MARIE GILBERT MUSSINI
ABSTRACT.
Methods. In 11 cases of EF, we determined the phenotype of inflammatory cells, expression of MHC class I and class II antigens, and C5b9 membranolytic attack complex (MAC) deposits by immunohistochemistry analysis of fascia tissue. Muscle biopsies from 9 patients with active dermatomyositis and 5 with active polymyositis were used as controls. Results. In all patients but one, the inflammatory infiltrate was mainly composed of macrophages associated with CD8+ T lymphocytes (CD4/CD8 ratio < 1) and few eosinophils. Cytotoxic properties were found in 14% of CD8+ T lymphocytes, as shown by granzyme B expression. MHC Class I antigens were overexpressed (5/7) by muscle fibers, with a paratrabecular reinforcement in 4 cases. MHC class II antigens were not expressed by muscle fibers except in one case. C5b9 MAC deposits were not detected. Conclusion. Our in situ characterization of inflammatory infiltrate demonstrates the predominancy of macrophages and CD8+ T lymphocytes. Some of these CD8+ lymphocytes contain granzyme B, thus suggesting a cytotoxic cellular immune response in EF, which could be triggered by infectious or environmental agents. (J Rheumatol 2003;30:1811-5) Key Indexing Terms:
SHULMAN
From the Departments of Pathology, Internal Medicine, INSERM U539, and Dermatology, University Hospital of Nantes, Nantes, France. C. Toquet, MD, Department of Pathology; M.A. Hamidou, MD, Senior Physician, Department of Internal Medicine; K. Renaudin, MD, Department of Pathology; A. Jarry, PhD, INSERM U539; P. Foulc, MD; S. Barbarot, MD, Department of Dermatology; C. Laboisse, MD, Professor of Pathology; J-M.G. Mussini, MD, Department of Pathology. Address reprint requests to Dr. C. Toquet, Department of Pathology A, CHU Hôtel Dieu, 44093 Nantes Cédex, France. E-mail: claire.toquet@chu-nantes.fr Submitted June 20, 2002; revision accepted January 17, 2003. |