Density Of Langerhans Cells Research Articles

Langerhans cells in a dermoid cyst epithelium lining

Dermoid cysts are uncommon developmental anomalies that rarely occur in the oral cavity. Here, we report a case of a dermoid cyst at the midline of the floor of the mouth and evaluate the density of Langerhans cells in the epithelium lining of this dermoid cyst. A 7-year-old girl came to the dental department of our hospital for treatment of a sublingual swelling detected when she wasw2-years old. Intraoral examination revealed a large soft tissue mass in the midline of the floor of the mouth. There was no palpation pain, the consistency was soft, and the surface mucosa was intact (Figure 1A). The lateral facial view showed an infralingual swelling (Figure 1B) and the occlusal film revealed no sialolith. The clinical impression was a dermoid cyst. Thus, the cystic lesion was removed by surgery under general anesthesia. The surgical specimen measured approximately 2.5 cm 1.5 cm 1.2 cm. On section, it contained cheeselike materials. Histopathological examination showed a cystic lesion lined by orthokeratinized stratified squamous epithelium. The cystic lumen was filled with shreds of keratin and hair-follicle-like structures and sebaceous glands were found in the fibrous cystic wall (Figures 1C and D). Therefore, a dermoid cyst was confirmed.

Morphological and inflammatory changes in the skin of autopsied fetuses according to the type of stress

IntroductionThe fetal skin acts on the development and activation of the immune response via immune–neuroendocrine communication coordinated by corticotropin-releasing hormone. ObjectiveThis study aimed to evaluate the morphological and inflammatory changes in the skin due to acute stress and chronic stress, associated with perinatal asphyxia, ascending infection and congenital malformation. MethodsWe measured dermal and epidermal thickness, the diameter of keratinocytes, and the percentage of collagen and elastic fibers. Immunohistochemistry was used to evaluate both Langerhans cell and mast cell density, and corticotropin-releasing hormone expression in the epidermis, sebaceous gland, sebaceous duct, sudoriparous gland and in the hair follicle. ResultsThe epidermis was thinner in the cases with perinatal asphyxia, ascending infection and chronic stress. The diameter of keratinocytes was smaller in ascending infection and chronic stress. Mast cell density showed an indirect correlation with gestational age. Corticotropin-releasing hormone expression was significantly higher in ascending infection and chronic stress. ConclusionsChronic stress is associated with immunological and morphological changes in the skin of fetuses with perinatal asphyxia and ascending infection. Thus, corticotropin-releasing hormone seems to play a vital role in the differentiation and activation of innate and adaptive immune cells of the skin of fetuses.

In Vivo Confocal Microscopic Imaging of the Cornea After Femtosecond and Excimer Laser-assisted Penetrating Keratoplasty.

To examine the microstructure of the cornea after excimer and femtosecond laser-assisted penetrating keratoplasty (ELAK and FLAK) in eyes with Fuchs' dystrophy and keratoconus. Fifty-seven patients were divided into four groups according to corneal disease and surgical technique: Fuchs' dystrophy and ELAK (n = 9; mean age: 70.4 ± 10.6 years); Fuchs' dystrophy and FLAK (n = 13; mean age: 64.3 ± 11.2 years); keratoconus and ELAK (n = 9; mean age: 47.4 ± 13.9 years); and keratoconus and FLAK (n = 9; mean age: 43.5 ± 13.8 years). The control group comprised individuals without ocular disease (n = 17; mean age: 39.9 ± 17.3 years). In vivo investigation of the corneal graft and graft-host junction zone was performed with confocal corneal microscopy. All corneal grafts were transparent and no rejection reaction could be observed during the follow-up period. Confocal microscopy revealed no difference in basal epithelial cell density compared to controls. Anterior keratocyte density was lower than in the control group (818 ± 131 cells/mm(2)) in all four treatment groups (596 ± 174, 586 ± 113, 529 ± 75, 552 ± 91 cells/mm(2)). Langerhans cells could barely be seen; there was no difference in the cutting edge configuration and wound integrity. In vivo confocal microscopy provided evidence that good alignment of graft-host junction could be created with both techniques. The excimer laser was not inferior to the femtosecond laser in performing corneal cuts. The low density of Langerhans cells revealed well-controlled cellular immunological response and sustained corneal integrity in both laser groups.

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract.

Epidemiological evidence suggests an association between the use of hormonal contraception and an increased risk of acquiring sexually transmitted diseases including HIV-1. We sought to elucidate the biological mechanisms underlying the effect of hormonal contraception on the immune system. Cross-sectional study. To delineate the biological mechanisms underlying the effect of hormonal contraceptives on the immune system, we analyzed the functional capacity of circulating plasmacytoid dendritic cells (pDCs), the distribution of vaginal immune cell populations, and the systemic and genital levels of immune mediators in women using depot medroxyprogesterone acetate (DMPA), NuvaRing, or combined oral contraceptives (COC). The use of DMPA or NuvaRing was associated with reduced capacity of circulating pDCs to produce interferon (IFN)-α and tumor necrosis (TNF-α) in response to TLR-9 stimulation. Systemic levels of IFN-α and cervicovaginal fluid levels of IFN-α, CXCL10, monocyte chemotactic protein-1, and granulocyte-colony stimulating factor were significantly lower in DMPA users compared to control volunteers not using hormonal contraception. The density of CD207 Langerhans cells in the vaginal epithelium was reduced in NuvaRing and combined oral contraceptive users but not in DMPA users. The presented evidence suggests that the use of some types of hormonal contraception is associated with reduced functional capacity of circulating pDCs and altered immune environment in the female reproductive tract.

Oral administration of paeoniflorin attenuates allergic contact dermatitis by inhibiting dendritic cell migration and Th1 and Th17 differentiation in a mouse model.

Allergic contact dermatitis (ACD) is a hapten-specific CD4(+) T-cells mediated inflammatory response of the skin. Its pathomechanism involves 2 phases, an induction phase and an elicitation phase. Langerhans cells (LCs) and dendritic cells (DCs) in the skin play key roles in presenting low molecular weight chemicals (haptens) to the lymph nodes. Therefore, inhibition of the migration of LCs or DCs and T-cell proliferation is each expected to control ACD disease. To explore the effectiveness of paeoniflorin (PF) on the migration of LCs and T-cell proliferation in vivo, we establish a murine model of ACD, promoted by repeated exposure to an allergen (specifically 1-Chloro-2,4-dinitrobenzene (DNCB)). Administration of PF inhibits DC migration in this DNCB-induced model in the induction phase. As a result, epidermal LC density in the elicitation phase increased in PF-treated mice when compared to PF-untreated mice. At the same time, PF reduced IFN-γ(+)CD4(+) and IL-17(+)CD4(+) T cells proliferation (but not IL-4(+)CD4(+) T cells proliferation), leading to an attenuated cutaneous inflammatory response. Consistent with this T-cell proliferation profile, secretions of IFN-γ and IL-17 were reduced and IL-10 secretion increased in PF-treated mice, but production of IL-4 and IL-5 remained unchanged in the skin and blood samples. These results suggest that oral administration of PF can treat and prevent ACD effectively through inhibition of DC migration, and thus decrease the capacity of DCs to stimulate Th1 and Th17 cell differentiation and cytokine production.

Cutaneous immunopathology of long-standing complex regional pain syndrome.

Both increased mast cells numbers and raised immune mediator concentrations indicate immune activation in the affected skin of patients with early complex regional pain syndrome (CRPS), but little is known about regional immune cell involvement in late-stage CRPS. The aim of the current study was to determine skin immune cell populations in long-standing CRPS. Using 6-mm skin punch biopsies from CRPS-affected and non-affected tissues, and a combination of chemical and immunofluorescence staining, we examined the density and function of key cell populations including mast cells, epidermal Langerhans cells (LCs) and tissue resident T-cells. We found no significant differences in either overall immune cell infiltrates, or mast cell density between CRPS-affected and non-affected sub-epidermal tissue sections, contrasting recent findings in early CRPS by other groups. However, CD1a(+) LC densities in the epidermal layer were significantly decreased in affected compared to non-affected CRPS limbs (p<0.01). T-cell clones isolated from CRPS-affected sub-epidermal tissues displayed a trend towards increased IL-13 production in ELISPOT assays when compared to T-cells isolated from non-affected areas, suggesting a Th2 bias. Immune cell abnormalities are maintained in late-stage CRPS disease as manifest by changes in epidermal LC density and tissue resident T-cell phenotype.

Regional differences in the density of Langerhans cells, CD8-positive T lymphocytes and CD68-positive macrophages: a preliminary study using elderly donated cadavers.

To provide a better understanding of the local immune system in the face and external genitalia, i.e., the oral floor, lower lip, palpebral conjunctiva, anus and penis, we examined the distribution and density of CD1a-positve Langerhans cells, CD8-positive suppressor T lymphocytes and CD68-positive macrophages using specimens from 8 male elderly cadavers. The density of Langerhans cells showed an individual difference of more than (or almost) 10-fold in the lip (oral floor). In the oral floor, Langerhans cells were often spherical. Submucosal or subcutaneous suppressor lymphocytes, especially rich in the oral floor and penile skin, migrated into the epithelium at 4 sites, except for the anus. In the conjunctiva, macrophage migration into the epithelium was seen in all 8 specimens. The density of suppressor lymphocytes showed a significant correlation between the oral floor and the lip (r=0.78). In contrast, the anal and penile skins showed no positive correlation in the density of all three types of immunoreactive cells examined. Overall, irrespective of the wide individual differences, the oral floor and conjunctiva seemed to be characterized by a rich content of all three cell types, whereas the penile skin was characterized by an abundance of suppressor lymphocytes. Based on the tables, as mean value, the relative abundance of three different cell types were as follows; CD1a-positive Langerhans cells (anus), CD8-positive lymphocytes (penis), and CD68-positive macrophages (lip). The present observations suggest that the local immune response is highly site-dependent, with a tendency for tolerance rather than rejection.

Dry eye and corneal langerhans cells in systemic lupus erythematosus.

Purpose. Investigation of dry eye and corneal Langerhans cells (LCs) in systemic lupus erythematosus (SLE). Methods. Prospective consecutive case series of 27 SLE patients and 27 control subjects. Dry eye was evaluated by lid-parallel conjunctival folds (LIPCOF), Schirmer test, tear break-up time (TBUT), and ocular surface disease index (OSDI) questionnaire. In vivo investigation of corneal LCs density and morphology (LCM) was performed with confocal corneal microscopy (Heidelberg Retina Tomograph with Rostock Cornea Module). Results. Tear production and stability were pathological in SLE subjects compared to control (Schirmer: 8.45 ± 9.82 mm/5 min versus 11.67 ± 3.21 mm/5 min; TBUT: 6.86 ± 3.53 s versus 11.09 ± 3.37 s). OSDI was significantly greater in SLE patients (25.95 ± 17.92) than in controls (11.06 ± 7.18). Central LC density was greater in SLE patients (43.08 ± 48.67 cell/mm2) than in controls (20.57 ± 21.04 cell/mm2). There was no difference in the peripheral LC density (124.78 ± 165.39 versus 78.00 ± 39.51 cell/mm2). LCM was higher in SLE patients in the centre (1.43 ± 0.79) and in the periphery (2.89 ± 0.42) compared to controls (centre: 1.00 ± 0.69, periphery: 2.35 ± 0.54). Conclusions. Significant changes in dry eye parameters and marked increase of central LCs could be demonstrated in SLE patients. SLE alters not only the LC density but also the morphology, modifies corneal homeostasis, and might contribute to the development of dry eye.

In vivo confocal microscopy of meibomian glands and palpebral conjunctiva in vernal keratoconjunctivitis.

Purpose:To investigate the correlations between conjunctival inflammatory status and meibomian gland (MG) morphology in vernal keratoconjunctivitis (VKC) patients by using in vivo confocal microscopy (CM).Materials and Methods:Nineteen VKC patients (7 limbal, 7 tarsal, and 5 mixed forms) and 16 normal volunteers (controls) were enrolled. All subjects underwent CM scanning to obtain the images of upper palpebral conjunctiva and MGs. Inflammatory cell (IC) density in palpebral conjunctival epithelial and stromal layers, Langerhans cell (LC) density at lid margins and the stroma adjacent to the MG, and MG acinar unit density (MGAUD) were recorded. The longest and shortest diameters of MG acinar were measured. The Kruskal-Wallis test was used to compare the parameter differences whereas the Spearman's rank correlation analysis was applied to determine their correlations.Results:Among all groups, no significant statistical differences were found in epithelial and stromal IC densities, mean values of MG acinar unit densities, or longest and shortest diameters. Both LC parameters in the tarsal-mixed groups were significantly higher than those in the limbal and control groups. All LC densities of VKC patients showed a positive correlation with MGAUD and shortest diameter.Conclusions:In VKC patients, the conjunctival inflammatory status could be associated with the MG status. In vivo CM is a noninvasive, efficient tool in the assessment of MG status and ocular surface.

Sjogren`s syndrome and ocular surface changes by laser-scanning in vivo confocal microscopy

Introduction : Dry eye disease (DED) and ocular allergy are common conditions in the eye practice. They have more than 20% of prevalence and that fact increases healthcare problems and affects life quality. Rheumatologic diseases such as Sjogren’s syndrome (SS) are often associated with ophthalmic findings, and belong to the dry eye but with decreased tear film production. Material and Methods : The laser-scanning confocal microscopy (LSCM) was performed to 16 eyes of 8 patients with subjective complains and objective clinical signs of DED and SS. The results of examinations were compared with control group of 28 eyes of 14 healthy patients. The qualitative analysis was performed to calculate the cell density in all cornea layers. The presence and distribution of Langerhans cells (LCs) in cornea was estimated. The quantitative survey understood monitoring of inflammation signs and corneal changes such as a presence of leukocytes. Changes in subbasal nerve plexus (SNP) and Meibomian glands (MGs) were evaluated over time. Results : The quantitative analysis presented calculations of cell density of all cornea layers. The most important finding was the reduction of epithelium cell density. In healthy patients it was 5048.6±56 cells/mm2 compared to 4603±70 cells/mm2 in DED-SS patients, but also the keratocyte number was significantly lower. The density of corneal LCs was compared to the healthy patients: 71±8 cells/mm2 and 19±3cells/mm2 respectively. The quantitative observation showed visible changes in SNP especially in tortuosity and destiny of sub-basal nerves. Conclusion : The ability of LSCM technology to examine different components of the ocular surface has opened new doors for studying the physiology and pathology. LSCM allows understanding the pathological changes of DED and SS. Our study proved that these diseases affect all structures of the anterior ocular surface.

Investigation of anterior chamber flare and corneal Langerhans cells in rheumatoid arthritis and in dry eye

AbstractPurpose To examine the anterior chamber flare and corneal Langerhans cells (LC)in rheumatoid arthritis (RA) and compare the results to those found in patients with dry eye disease (DED) and in age matched control (C).Methods 15 patients with RA (11 women, és 4 men, mean age: 67.3±8.6 years), 20 DED patients (11 women, 9 men, mean age: 57.2±14.4 years) and 15 control subjects (8 women, 7 men, mean age: 49.6±19.1 years) were enrolled in this study. Anterior chamber flare was evaluated using Kowa FC‐600 laser flare meter and corneal LC densities were investigated at the corneal centre with confocal microscopy (Heidelberg Retina Tomograph with Rostock Cornea Modul (HRT II RCM)) in all groups.Results There was a significant difference in the flare values between RA and DED patients (6,65 f/ms in RA and 4,75 f/ms in DED (p&lt;0.01). Central LC density was: 57.6±34.4/mm2 in RA and 52.3±31.3/mm2 in DED respectively. Both values were significantly lower than that of in control (24.6±18.6/mm2, p&lt;0.05)Conclusion The blood aqueous barrier might be altered in RA even without signs of clinically significant ocular inflammation. This alteration in the blood aqueous barrier might contribute to the accumulation of LCs at the corneal centre. The greater LC density and flare values found in RA might represent novel players in the pathogenesis of dry eye.

Confocal Microscopy of Epithelial and Langerhans Cells of the Cornea in Patients Using Travoprost Drops Containing Two Different Preservatives

The recently developed confocal cornea microscopy offers the opportunity to examine pathologies of the cornea and to gain insight into the activity of innate immunity. We aimed to investigate the corneal epithelial and Langerhans cell (LC) densities along with dry eye parameters in primary open-angle glaucoma (POAG) subjects, treated with either of two commercially available travoprost 0.004 % topical medications containing different preservatives. (1: benzalkonium chloride 0.015 % (TravBAK) and 2: polyquaternium-1 (PQ) 0.001 % (TravPQ). Consecutive case series of nineteen POAG patients on TravBAK (mean age: 64.8 ± 13.6 years), nineteen POAG patients on TravPQ (mean age: 66.8 ± 11.3 years) and nineteen age-matched healthy control subjects (63.8 ± 8.2 years). Ocular surface disease index (OSDI), lid parallel conjunctival folds (LIPCOF), Schirmer test (ST) and tear break up time (TBUT) were assessed, and then corneal epithelial and LC densities were investigated with confocal microscopy. Tear production was significantly reduced in both glaucoma patient groups compared to healthy individuals (p < 0.05). TBUT was significantly reduced and epithelial cell densities were significantly greater in patients treated with TravBAK compared to healthy individuals (p < 0.05 for all). LC densities were greater in both glaucoma groups compared to control subjects (p < 0.05 for all). Travoprost therapy may compromise ocular surface. The limited alertness of the corneal immune system found in patients with TravPQ can be considered as indicators of a less disturbed ocular surface and better controlled corneal homeostasis.

Pronounced Reduction of Cutaneous Langerhans Cell Density in Recently Diagnosed Type 2 Diabetes

Immune-mediated processes have been implicated in the pathogenesis of diabetic polyneuropathy. Langerhans cells (LCs) are the sole dendritic cell type located in the healthy epidermis and exert tolerogenic immune functions. We aimed to determine whether alterations in cutaneous LC density and intraepidermal nerve fiber density (IENFD) are present in patients with recently diagnosed type 2 diabetes. Skin biopsy specimens from the distal leg from 96 type 2 diabetic patients and 75 healthy control subjects were used for quantification of LC density and IENFD. LCs and IENFs were labeled using immunohistochemistry. Nerve conduction studies, quantitative sensory testing, and neurological examination were used to assess peripheral nerve function. LC density was markedly reduced in the diabetic group compared with the control group, but did not correlate with reduced IENFD or peripheral nerve function. Multivariate linear regression analysis revealed a strong association between LC density and whole-body insulin sensitivity in women but not in men with diabetes. Prospective studies should establish whether the pronounced reduction of cutaneous LCs detected in recently diagnosed type 2 diabetes could promote a cutaneous immunogenic imbalance toward inflammation predisposing to polyneuropathy and foot ulcers.

Origin of Langerhans cells in normal skin and chronic GVHD after hematopoietic stem‐cell transplantation

Chronic graft-versus-host disease (cGVHD) is a common complication following allogeneic stem-cell transplantation (SCT). Past studies have implicated the persistence of host antigen-presenting cells (APCs) in GVHD. Our objective was to determine the frequency of host Langerhans cells (LCs) in normal skin post-SCT and ask if their persistence could predict cGVHD. Biopsies of normal skin from 124 sex-mismatched T-cell-replete allogenic SCT recipients were taken 100 days post-transplant. Patients with acute GVHD and those with <9 months of follow-up were excluded and prospective follow-up information was collected from remaining 22 patients. CD1a staining and X and Y chromosome in-situ hybridization were performed to label LCs and to identify their host or donor origin. At 3 months, 59 ± 5% of LCs were host derived. The density of LCs and the proportion of host-derived LCs were similar between patients that did or did not develop cGVHD. Most LCs in the skin remained of host origin 3 months after SCT regardless of cGVHD status. This finding is in line with the redundant role of LCs in acute GVHD initiation uncovered in recent experimental models.

In vivo confocal microscopy of bulbar conjunctiva in patients with Graves' ophthalmopathy

To investigate the bulbar conjunctival changes in patients with Graves' ophthalmopathy (GO) using in vivo confocal microscopy. A total of 15 GO patients and 15 control patients were recruited. Images of the superior site and temporal bulbar conjunctivas were taken by the Heidelberg Retina Tomograph/Rostock Corneal Module. The conjunctival thickness and cell density of superior epithelium, basal epithelium, Langerhans cells, and goblet cells were analyzed. Conjunctival impression cytology was performed to assess the grading of squamous metaplasia of the conjunctival epithelium. The superficial epithelial cell density in the superior bulbar conjunctiva of the GO group was 856.93 ± 461.68 cells/mm(2), which was significantly lower than that in the control group (1581.13 ± 556.34 cells/mm(2); p = 0.002). However, the difference in superficial epithelial cell density in the temporal bulbar conjunctiva between the two groups was not statistically significant. No significant differences in conjunctival thickness and the basal epithelial cell density were noted between the two groups. Increased Langerhans cell density and reduced goblet cell density were noted in the GO group. Impression cytology of the conjunctival epithelium revealed significantly higher degree of squamous metaplasia in the GO group. The superficial epithelial cell density in the upper bulbar conjunctiva showed negative correlation with marginal reflex distance in the GO group. GO patients suffered from more severe bulbar conjunctival damage and inflammation with the superior site than the temporal site. In vivo confocal microscopy can be a rapid and noninvasive tool for the quantitative evaluation of ocular surface changes in patients with GO.

Corneal Langerhans cell and dry eye examinations in ankylosing spondylitis

APCs of the ocular surface, including corneal Langerhans cells (LCs), offer the opportunity to gain insight into the activity of innate immunity. We examined corneal LCs and dry eye parameters in ankylosing spondylitis (AS). Twenty-four AS patients with varying degrees of disease activity and 24 healthy participants were enrolled. Central and peripheral LC numbers, and Langerhans cell morphology (LCM) were assessed with invivo laser confocal microscopy. In addition, ocular surface disease index, lid parallel conjunctival folds, tear break up time, and Schirmer test were evaluated. LC densities and central LCM were greater in AS patients than in the controls. Moreover, LCM was significantly greater in patients with higher systemic inflammation according to elevated C-reactive protein (CRP). Also, tear production was greatly suppressed in patients with more severe onset of the systemic inflammation according to the Bath Ankylosing Spondylitis Disease Activity Index and elevated CRP. Greater corneal LC density and LCM in AS may reflect an increased activation state of the innate immune system of the cornea in AS, which correlates with the systemic activity of AS even without ocular symptoms. Nonetheless, higher systemic inflammation might impair tear production, and it might partly explain the dry eye mechanism.

Corneal Langerhans cell and dry eye examinations in ankylosing spondylitis

AbstractPurpose To examine the density and the distribution of corneal Langerhans cells (LCs) and to compare the results with dry‐eye related parameters and disease activity in ankylosing spondylitis(AS).Methods Twenty four AS patients (mean age: 41.8±9.8 years) with various degree of disease activity and twenty four healthy subjects (mean age: 47.9 ± 16.4 years) were enrolled. Ocular surface disease index (OSDI), lid parallel conjunctival folds (LIPCOF), tear break up time (TBUT), and Schirmer test (ST) were evaluated. In addition, central and peripheral LCs numbers and Langerhans cell morphology (LCM) were assessed with in vivo laser confocal microscopy.Results Tear production was greatly suppressed in patients with more severe systemic inflammation according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C‐reactive protein (CRP) (BASDAI≤4.0 vs BASDAI&gt;4.0 10.2±8.5 vs 4.0±5.3; CRP≤5.0 vs CRP&gt;5.0 17.2±4.2 vs 3.9±5.5 p&lt;0.05 for all). LCs densities and central LCM were greater in AS patients than in the controls (LC density: 77.5±44.9 vs 23.8±33.8 and central LCM: 1.7±0.7 vs 0.95±0.75 p&lt;0.05 for all).Conclusion Greater corneal LC density and LCM may reflect an increased activation of the corneal innate immune system, which correlates with the systemic activity of AS even without ocular symptoms. Higher systemic inflammation might impair tear production, and it might partly explain the dry eye mechanism.

Effects of TNF-alpha inhibitors on the number of epidermal Langerhans cells in uninvolved skin of psoriatic patients: A pilot study

Only limited data are available on the effects of TNF-alpha inhibitors on dendritic cells. However, TNF-alpha plays a central role in the biology of dendritic cells, both with regard to their maturity process and mobilization to secondary lymphoid organs. In particular, the effects of TNF-alpha inhibitors on Langerhans cells in healthy skin have never been investigated. In this pilot study, we aimed to assess the change of the density of Langerhans cells within the normal, not photo-exposed, skin of 17 psoriatic patients, before and after 16 weeks of treatment with TNF-alpha inhibitors. Most of the patients (88%) showed an increase or a similar density of Langerhans cells after 16 weeks of therapy with TNF-alpha inhibitors compared with baseline values. Only 2 patients (12%) showed a reduction of these cells following therapy with TNF-alpha inhibitors.

Association between langerhans cells population and histological grade of oral squamous cell carcinoma

Context:Langerhans cells (LCs) are a unique population of antigen processing cells in the epidermis and mucous membrane, which may play a role in the defence mechanism against epithelial tumors.Aims:To compare the distribution of LCs in oral squamous cell carcinomas (OSCC) and normal oral epithelium; and to determine whether the population of LCs in OSCC has any correlation with histological grading of these malignancies.Settings and Design:A cross-sectional immunohistochemical analysis of OSCC cases.Materials and Methods:Forty-eight randomly selected paraffin tissue blocks of OSCC cases and 30 cases of normal oral epithelium were included. Hematoxylin and eosin-stained sections of the OSCC cases were reviewed and categorized as high-grade malignant tumors or low-grade malignant tumors. Tissue sections were analyzed for density of LCs using CD1a antibody expression.Statistical Analysis Used:Data are expressed as percentages compared by Chi-square statistics; mean ± standard deviation, compared by Mann-Whitney-U test and Spearman's correlation tests.Results:LCs population was significantly higher in normal oral epithelium when compared with OSCC cases (P = 0.001). There was also a significant difference in the number of LCs per millimetre square area of tissue section between well-differentiated tumors and poorly-differentiated tumours (P = 0.03). There was a negative correlation between the population density of LCs and the grade of OSCC.Conclusions:These findings suggest that oral mucosal LCs are involved in immune-surveillance and immunologic impairment may characterize invasive OSCC. In addition, LCs density characterizes histological grades of OSCC, which may be of a prognostic value.

In vivoconfocal microscopic evaluation of corneal Langerhans cell density, and distribution and evaluation of dry eye in rheumatoid arthritis

Corneal Langerhans cells (LCs) offer the opportunity to gain insight into the activity of the innate immunity. We examined the density and the distribution of LCs and compared the results with dry-eye parameters in rheumatoid arthritis (RA). Fifty-two RA patients with various degrees of disease activity and 24 healthy subjects were enrolled. Peripheral and central LC number and morphology were assessed with invivo laser confocal microscopy. In addition, ocular surface disease index (OSDI), lid parallel conjunctival folds, Schirmer test, and tear break-up time (TBUT) were evaluated. The prevalence of central and peripheral LC, and the central LC morphology values (LCM) were higher than normal in RA. Within the RA group, LC prevalence and morphology were not affected by disease activity. However, patients on anti-TNF or glucocorticosteroid (GCS) therapy exhibited normal LCM, and normal central and peripheral LC density. OSDI was higher and TBUT was lower than normal in RA. The alteration of LC in RA suggests an active inflammatory process in the cornea, which may reflect an increased activation state of the innate immune system-even in inactive stages of RA and without ocular symptoms. The results also indicate ocular effects of GCS therapy in RA.