An attempt to identify the nature of immunoglobulin-complement deposits in the skin in lupus erythematosus

Cross-reactivity of murine monoclonal anti-DNA antibodies with human and murine skin: a possible pathogenetic role in skin lesions of lupus erythematosus

Anti-DNA autoantibodies are known to cross-react with a wide variety of substances including cell-surface molecules. Thus, we examined cross-reactivities of 20 murine monoclonal anti-DNA antibodies with normal human and mouse skin tissues. Hybridomas producing these monoclonal antibodies were established from non-immunized spleen cells from autoimmune MRL-lpr/lpr mice, a strain characterized by spontaneous development of SLE-like disorders including skin changes. They were selected based on their reactivity to DNA in a typical enzyme-linked immunosorbent assay, in which nine monoclonal antibodies were reactive with both double-stranded DNA and single-stranded DNA, whereas nine monoclonals were reactive only with single-stranded DNA. Even though only seven of them were observed to stain nuclei, most of the monoclonal antibodies revealed strong and distinct cross-reactivities to various components of the skin tissues including the epidermal basement membrane, keratinocytes at different locations of the epidermis, melanocytes, Langerhans cells, Thy-1+ dendritic cells in the case of murine skin, and mast cells. Our results suggest a possible role of so-called anti-DNA antibodies with high or low affinities to DNA in the pathogenesis of cutaneous lesions of lupus erythematosus.

Pathogenesis of lupus dermatoses in autoimmune mice. IV. Association between cutaneous immunoglobulin deposition and anti-single-stranded DNA antibodies in sera

The skin of New Zealand, MRL and BXSB mice was immunohistopathologically examined in order to study the appearance of skin immunoglobulin (Ig) deposition and its correlation with the occurrence of anti-single-stranded (ss) DNA antibodies in sera. Our studies revealed Ig deposition at the dermoepidermal junction (DEJ) in non-lesional skin and a significant age-related correlation between skin Ig deposition and serum anti-ssDNA antibodies. However, immunofluorescent study of autoimmune mice using anti-ultraviolet-irradiated DNA antiserum failed to demonstrate DNA antigens at the DEJ.

Clq deposits at the dermoepidermal junction: a marker discriminating for discoid and systemic lupus erythematosus

Discoid lupus (DL) and systemic lupus erythematosus (SLE) patients have been comparatively evaluated for complement and immunoglobulin deposits at the dermoepidermal junction (DEJ) by immunofluorescence (IF). When IF was positive, Clq deposits were quasi-constantly found in SLE patients with or without skin lesions (90%), while Clq was found in only 29% of the DL patients. Of the 42 DL patients followed-up to at least 2 years, 4 have eventually evolved a systemic disease. In these 4, neither cryoglobulinemia nor significant titers of ANA had been found at the time of presentation. Only 1 of these 4 patients had initially circulating immune complexes (P.E.G) and a positive IF in a normal sunprotected area. Clq deposits at the DEJ were present in all these 4. Of the remaining 38 DL patients, none has progressed to SLE: 8 had had significant titers of ANA, 5 had had circulating immune complexes, and 3 others had had cryoglobulinemia. Thus Clq deposits in DL cases are associated with a relatively high incidence of eventual systemic disease. Taken together, these data suggest that Clq deposits in skin may be a marker for systemic lupus.

Lupus erythematosus

Lupus erythematosus (LE) is a multisystem disease. Genetic predisposition, altered immunity, hormones, drugs, viruses, and ultraviolet light all may play a role in etiology. A wide range of cutaneous lesions occur, and variants such as subacute cutaneous LE, complement-deficient LE, and neonatal LE have recently been emphasized. Management of the LE patient, including appropriate diagnostic studies and therapy relevant to the dermatologist, is discussed in the review.

Failure to detect specific gluten antigens associated with the immune aggregates in the skin in dermatitis herpetiformis

The univolved skin of 10 patients with dermatitis herpetiformis (DH) was examined for the presence of gluten antigens with the immunofluorescence technique using a rabbit anti-gliadin antiserum, human antibodies to wheat and to reticulin conjugated to fluorescein-isothiocyanate (FITC) and class-specific anti-human IgA immunoglobulin. In all patients, IgA deposits were found in the tips of the dermal papillae of the uninvolved skin. With the anti-wheat and anti-reticulin conjugates, as well as with the rabbit anti-gliadin antiserum, no specific immunofluorescence was observed in any of the skin specimens. Skin biopsy sections of three DH patients were treated with an acid solution (pH 3.2) in an effort to dissociate antigen-antibody complexes that might be present. After the elution procedure the sections showed undiminished IgA fluorescence, and retesting with the anti-wheat- and anti-reticulin antisera again gave negative results. The skin eluates, two of which contained IgA, had no antibodies to wheat or reticulin. These findings do not give support to the hypothesis that the antigens in the suspected immune complexes in the DH skin consist of gluten.