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Efficacy of ultraviolet A1 phototherapy on the expression of bcl‐2 in atopic dermatitis and cutaneous T‐cell lymphoma in vivo : a comparison study
Author(s) -
Breuckmann F.,
Von Kobyletzki G.,
Avermaete A.,
Kreuter A.,
Altmeyer P.
Publication year - 2002
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1034/j.1600-0781.2002.02740.x
Subject(s) - atopic dermatitis , cutaneous t cell lymphoma , medicine , apoptosis , lymphoma , mycosis fungoides , immunohistochemistry , monoclonal antibody , in vivo , t cell , staining , pathology , antibody , dermatology , immunology , biology , immune system , biochemistry , microbiology and biotechnology
Background/Purpose: Atopic dermatitis (AD) is characterized immunohistochemically by a high number of skin infiltrating T‐helper cells (CD4 + ). In most cases cutaneous T‐cell lymphoma (CTCL) is characterized by a malignant proliferation of CD4 + T‐helper lymphocytes. The purpose of our study was to evaluate the extent of anti‐apoptotic effects in patients suffering from AD or CTCL, respectively, which may contribute to the prolonged inflammation. Furthermore, we investigated whether medium‐dose ultraviolet A1 (UVA1) phototherapy is able to modulate the expression of bcl‐2 within the dermal inflammatory infiltrate. Methods: In order to enumerate bcl‐2 + cells pre‐ and post‐therapeutic punch skin biopsies of ten patients with AD and five patients with CTCL were stained immunohistochemically for features of apoptosis using a monoclonal antibody detecting bcl‐2. Results: Both AD and CTCL sections revealed a high percentage of bcl‐2 + cells within the dermal perivascular infiltrate before therapy. After the successful treatment using medium‐dose UVA1 phototherapy this percentage could be decreased significantly. Conclusion: Both T‐cell‐derived skin diseases exhibit an increased pre‐therapeutic number of bcl‐2 + cells. After medium‐dose UVA1 phototherapy the substantial improvement of the skin condition was linked to a significant decrease of the dermal bcl‐2 + cell count. Moreover, we could demonstrate a remarkable correlation referring to the decrease and staining pattern of bcl‐2 between these two groups as well as within each group. Because the bcl‐2 protein is known to act as an apoptosis inhibitor, its pre‐therapeutic increase may provide the persistent cutaneous inflammatory reaction in T‐cell‐derived skin diseases. Additionally, the post‐therapeutic reduction of bcl‐2 + cells might represent a key mechanism of medium‐dose UVA1 phototherapy.