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Pyostomatitis Vegetans: Cellular Immune Profile and Expression of IL-6, IL-8 and TNF-α

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Abstract

The aim of this study was to investigate the cellular immune profile and the expression of IL-6, IL-8 and TNF-α in tissue biopsies of pyostomatitis vegetans (PV). Working hypothesis was that knowledge of the cellular immune profile and role of mediators such as IL-6, IL-8 AND TNF-alpha may contribute to a better understanding of the pathogenesis of this rare entity. Archival tissues from three patients with clinically and histologically confirmed PV were studied. Analysis of the immune profile of the cellular infiltrate and expression of IL-6 and IL-8 were evaluated by immunohistochemistry. ISH was performed to evaluate the expression of TNF-α. Biopsy tissues from erythema multiforme, recurrent aphthous stomatitis, lichen planus and normal buccal mucosa were analyzed as controls. All patients were affected by multiple mucosal ulcerations and yellow pustules mainly located in the vestibular, gingival and palatal mucosa. Histopathologically, all specimens showed ulcerated epithelium with characteristic intraepithelial and/or subepithelial microabscesses containing abundant eosinophils plus a mixed infiltrate composed of lymphocytes and neutrophils. Cellular immune profile of the inflammatory infiltrate revealed a predominance of T-lymphocytes, mainly of cytotoxic (CD3+/CD8+) phenotype, over B-cells. CD20+ B-lymphocytes were also identified to a lesser degree among the lymphoid cells present in the lamina propria. Overexpression of IL-6 and TNF-α was found in both epithelial and inflammatory mononuclear cells. IL-8 expression was shown in the mononuclear cells scattered among the inflammatory infiltrate. Similar findings of overexpression of IL-6, IL-8 and TNF-α were, however, found in control tissues. In PV lesions, the inflammatory infiltrate shows a predominance of cytotoxic lymphocytes. Expression of IL-6, IL-8 and TNF-α, although not specific to PV, appears up-regulated thus these cytokines would represent a suitable therapeutic target. However, the complexity of the cytokine network and their numerous functions require further studies in order to confirm our findings.

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References

  1. Hansen LS, Silverman S Jr, Daniels TE. The differential diagnosis of pyostomatitis vegetans and its relation to bowel disease. Oral Surg Oral Med Oral Pathol. 1983;55:363–73.

    Article  CAS  PubMed  Google Scholar 

  2. Ficarra G, Cicchi P, Amorosi A, Piluso S. Oral Crohn’s disease and pyostomatitis vegetans. An unusual association. Oral Surg Oral Med Oral Pathol. 1993;75:220–4.

    Article  CAS  PubMed  Google Scholar 

  3. Storwick GS, Prihoda MB, Fulton RJ, et al. Pyodermatitis-pyostomatitis vegetans: a specific marker for inflammatory bowel disease. J Am Acad Dermatol. 1994;31:336–41.

    Article  CAS  PubMed  Google Scholar 

  4. Nigen S, Poulin Y, Rochette L, et al. Pyodermatitis-pyostomatitis vegetans: two cases and a review of the literature. J Cutan Med Surg. 2003;7:250–5.

    Article  PubMed  Google Scholar 

  5. Hegarty AW, Barrett AM, Scully C. Pyostomatitis vegetans. Clin Exp Dermatol. 2004;29:1–7.

    Article  CAS  PubMed  Google Scholar 

  6. Leibovitch I, Ooi C, Huilgol SC, et al. Pyodermatitis-pyostomatitis vegetans of the eyelids. Case report and review of the literature. Ophthalmology. 2005;112:1809–13.

    Article  PubMed  Google Scholar 

  7. Kethu SR. Extraintestinal manifestations of inflammatory bowel diseases. J Clin Gastroenterol. 2006;40:467–75.

    Article  PubMed  Google Scholar 

  8. Markieewicz M, Sursh L, Margarone J, et al. Pyostomatitis vegetans: a clinical marker of silent ulcerative colitis. J Oral Maxillofac Surg. 2007;65:346–8.

    Article  Google Scholar 

  9. Callen JP, Jackson JM. Pyoderma gangrenosum: an update. Rheum Dis Clin N Am. 2007;33:787–802.

    Article  Google Scholar 

  10. Powell FC, Hackett BC. Pyoderma gangrenosum. In: Wolff K, Goldsmith LA, Katz SI, et al., editors. Fitzpatrick’s dermatology in general medicine. 7th ed. New York: McGraw Hill; 2008. p. 296–302.

    Google Scholar 

  11. Sartor RB. Mechanisms of diseases: pathogenesis of Crohn’s disease and ulcerative colitis. Nature Clin Practice. 2006;3:390–407.

    Article  CAS  Google Scholar 

  12. Brooklyn TN, Williams AM, Dunnill MGS, et al. T-cell receptor in pyoderma gangrenosum: evidence for clonal expansion and trafficking. Clin Lab Invest 2007. doi 10.1111/i.1365.2133.2007.08211x .

  13. Dinarello CA. Historical insights into cytokines. Eur J Immunol. 2007;37:S34–45.

    Article  CAS  PubMed  Google Scholar 

  14. Kobayashi Y. The role of chemokines in neutrophils biology. Frontiers Biosci. 2008;13:2400–7.

    Article  CAS  Google Scholar 

  15. Modlin RL, Kim J, Maurer D. Innate and adaptive immunity in the skin. In: Wolff K, Goldsmith LA, Katz SI, et al., editors. Fitzpatrick’s dermatology in general medicine. 7th ed. New York: McGraw Hill; 2008. p. 95–114.

    Google Scholar 

  16. Tayal V, Kalra BS. Cytokines and anti-cytokines as therapeutics-an update. Eur J Pharmacol. 2008;579:1–12.

    Article  CAS  PubMed  Google Scholar 

  17. Charo IF, Ranshoff RM. The many roles of chemokines and chemokines receptors in inflammation. N Engl J Med. 2006;354:610–21.

    Article  CAS  PubMed  Google Scholar 

  18. Oka M, Berking C, Nesbit M, et al. Interleukin-8 overexpression is present in pyoderma gangrenosum ulcers and leads to ulcer formation in human skin xenografts. Lab Invest. 2000;80:595–604.

    CAS  PubMed  Google Scholar 

  19. Oka M. Pyoderma gangrenosum and interleukin 8. Br J Dermatol. 2007;157:279–81.

    Google Scholar 

  20. Bister V, Makitalo L, Jeskanen L, et al. Expression of MMP-9, MMP-10 and TNF-α and lack of epithelial MMP-1 and MMP-26 characterize pyoderma gangrenosum. J Cutan Pathol. 2007;34:889–98.

    Article  PubMed  Google Scholar 

  21. Bens G, Laharie D, Beylot-Barry M, et al. Successful treatment with infliximab and methotrexate of PV associated with Crohn’s disease. Br J Dermatol. 2003;149:181–4.

    Article  CAS  PubMed  Google Scholar 

  22. Brinkmeier T, Frosch PG. Pyodermatitis-pyostomatitis vegetans: a clinical course of two decades with response to cyclosporine and low-dose prednisolone. Acta Derm Venereol. 2001;81:134–6.

    Article  CAS  PubMed  Google Scholar 

  23. Rogge FJ, Pacifico M, Kang N. Treatment of pyoderma gangrenosum with the anti-TNF-alpha drug-Etanercept. J Plastic Reconstr Aest Surg. 2008;61:431–3.

    Article  Google Scholar 

  24. Werchniak AE, Storm CA, Punkett RW, et al. Treatment of pyostomatitis vegetans with topical tacrolimus. J Am Acad Dermatol. 2005;52:722–3.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Reference Center for the Study of Oral Diseases, Florence, Italy

    Giuseppe Ficarra

  2. Department of Human Pathology and Oncology, University Hospital of Careggi, Florence, Italy

    Gianna Baroni & Daniela Massi

  3. Department of Odonto-Stomatology, University of Florence, Viale Morgagni 85, 50134, Florence, Italy

    Giuseppe Ficarra

Authors
  1. Giuseppe Ficarra
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  2. Gianna Baroni
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  3. Daniela Massi
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Correspondence to Giuseppe Ficarra.

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Ficarra, G., Baroni, G. & Massi, D. Pyostomatitis Vegetans: Cellular Immune Profile and Expression of IL-6, IL-8 and TNF-α. Head and Neck Pathol 4, 1–9 (2010). https://doi.org/10.1007/s12105-009-0149-7

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  • DOI: https://doi.org/10.1007/s12105-009-0149-7

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