Abstract
AIMS—To understand the immunopathogenesis of the corneal conjunctivalisation in Stevens-Johnson syndrome. METHODS—Conjunctivalised corneas from five patients with Stevens-Johnson syndrome were studied immunohistochemically for several cell surface antigens and two cytokines. Chemical injury specimens were also studied. RESULTS—In all cases, immunohistochemistry revealed LFA-1, CD4, CD8, and CD68 on subepithelial infiltrating cells. Also, HLA-DR and ICAM-1 were found on the surfaces of epithelial cells, subepithelial infiltrating cells, subepithelial fibroblasts, and endothelial cells in blood vessels. IFN-γ was found in basal epithelial cells; subepithelial cells and subepithelial extracellular matrix CD19 and IL4 were not detected. CONCLUSIONS—The infiltrating cell population in the Stevens-Johnson syndrome samples includes macrophages, CD4 positive T cells, and CD8 positive T cells. The cytokine expression pattern suggests CD4 positive T cells are Th1 cells. The infiltrating cell population is similar in Stevens-Johnson syndrome and chemical injury conjunctivalised corneas.
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Figure 1 .
Representative serial sections from Stevens-Johnson conjunctiva (patient No 4). Immunohistochemical sections are stained by the ABC method with DAB (counterstained with methyl green). (A) Haematoxylin and eosin (HE). Conjunctivalised corneal epithelium moderately thickened and subepithelial infiltrating cells notable. (B) Anti-LFA-1. Many immunopositive cells seen in the substantia propria of the conjunctiva. (C) Anti-CD4. Immunopositive cells seen in the substantia propria of the conjunctiva. (D) Anti-CD8. Immunopositive cells seen in the substantia propria of the conjunctiva. (E) Anti-CD19. No positive staining is seen in this section except for some polymorphonuclear cells in the vascular lumen. (F) Anti-CD68. Many subepithelial infiltrating cells are immunostained. (G) Anti-HLA-DR. Basal cells of conjunctival epithelium, subepithelial infiltrating cells, and endothelial cells of blood vessels are immunostained. (H) Anti-ICAM-1. Basal cells of conjunctival epithelium, subepithelial infiltrating cells, and endothelial cells of blood vessels are weakly immunostained. (I) Anti-IFN-γ. Basal cells of conjunctival epithelium, subepithelial infiltrating cells, and endothelial cells of blood vessels are weakly immunoreactive. (J) Anti-IL-4. No positive staining is seen in this section except for some polymorphonuclear cells in the vascular lumen. (K) A negative control section incubated with IgG1 in lieu of a primary antibody. Scale bar (upper right) 100 µm.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
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