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CD 34 stromal expression is inversely proportional to smooth muscle actin expression and extent of morphea
Author(s) -
Lee J.S.,
Park H.S.,
Yoon H.S.,
Chung J.H.,
Cho S.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15120
Subject(s) - myofibroblast , cd34 , medicine , pathology , morphea , stromal cell , fibrosis , stain , immunohistochemistry , pathogenesis , scleroderma (fungus) , staining , biopsy , biology , stem cell , inoculation , genetics
Background Fibrosis is thought to be the main pathophysiology of scleroderma, and myofibroblasts play the main role in abnormal fibrotic pathologies. Altered distribution of dermal dendritic cells ( DDC s) and vascular abnormalities has been reported to relate to the pathogenesis of scleroderma. Objective To investigate fibrotic pathogenesis of morphea (localized scleroderma) by demonstrating the relative expression and distribution of DDC s and myofibroblasts, we performed immunohistochemical stains using several relevant antibodies. Methods Skin lesions of 50 patients with morphea and age‐, sex‐ and site‐matched normal skin of 50 subjects were evaluated for the following antibodies: CD 34, factor XIII a ( FXIII a), smooth muscle actin ( SMA ), CD 31 and vascular cell adhesion molecule‐1 ( VCAM ‐1). Results CD 34 stromal stain was significantly lower in patients than controls ( P = 0.000), while FXIII a, SMA and VCAM ‐1 stains were significantly higher in patients than controls ( P = 0.043, P = 0.000 and P = 0.027, respectively). In subtype analysis within patients, CD 34 stromal stain showed decreasing trends with increasing disease extent and increasing fibrosis, respectively. CD 34 stromal stain showed an inverse correlation and mutually exclusive spatial expression pattern with SMA stain ( r = −0.286, P = 0.044). The inverse relationship was maintained in each dermal layer analysis, upper and lower dermis ( r = −0.397, P = 0.004 and r = −0.281, P = 0.048, respectively). Conclusions Mutually exclusive staining patterns of CD 34 stromal and SMA stains suggest a phenotypic change of CD 34+ DDC s into SMA + myofibroblasts with increasing disease extent and fibrosis in morphea. Degree of loss of CD 34+ DDC s can be a useful marker in predicting the extent and severity of morphea.