Basophils are increased and express increased levels of interleukin-4 in the parotid lesions of Kimura disease

Abstract

BackgroundKimura disease (KD) is a systemic soft-tissue disease that leads to formation of painless masses in lymph nodes, with the highest predilection for the head and neck and especially the parotid gland. KD lesions are characterized by marked eosinophil infiltration, production of IgE and increased expression of T-helper type 2 (Th2) cytokines (interleukin [IL]-4, IL-5, etc.). Skewing to a Th2 inflammation is also demonstrated in the peripheral blood, with elevated eosinophils and high IgE levels. It is thought that basophils may play important roles in orchestrating this Th2 inflammation via IL-4 production leading to the induction of IgE synthesis as well as eosinophil infiltration. However, there are no reports as yet on the role of basophils in KD.ObjectiveThe present study was performed to investigate the potential role of basophils in the pathogenesis of KD. In this context we also examined the expression of IL-4 in basophils in the KD lesions.MethodsBy immunohistochemistry using a monoclonal antibody against a basophil marker ProMBP1 we investigated the number and distribution of basophils in the KD lesions. By double immunohistochemistry we analyzed the colocalization of IL-4 in basophils.ResultsThere was an increased number of basophils infiltrating the KD parotid gland lesions as compared to that in normal control parotid tissue. By double-immunofluorescence we found that approximately 7% of IL-4-positive cells in KD patients' parotid glands were basophils.ConclusionBasophils may also play a role in the pathogenesis of KD, leading to the induction of IgE synthesis and eosinophil infiltration.

The role of basophils as innate immune regulatory cells in allergy and immunotherapy

“…For example in the Kimura disease, where parotid glands are involved and a more systemic disease leading to the formation of painless masses in enlarged lymph nodes occur, basophils greatly enhance the production and release of IL4 and increase their number in the bloodstream. 92 One of the major physiological role of basophils is B cell maturation, which should lead to the specific IgE production. 93 This evidence may shed a light on why during autoimmune disease the role of basophils is imbalanced.…”

Case Report: Hyper IgE, but Not the Usual Suspects–Kimura Disease in an Adolescent Female

“…The pathophysiology of KD remains unclear. There is consideration that KD is a dysregulation of the immune system that results from an aberrant response following a normal stimulus, perhaps originally triggered by an infection or allergy (6)(7)(8)(9). Diagnosis is confirmed by pathological analysis of the affected tissue, which typically displays dense inflammatory infiltrates including eosinophils and lymphoid follicles with germinal centers containing IgE (10).…”

Computerized tomography features and clinicopathological analysis of Kimura disease in head and neck

“…The cause of Kimura disease is unclear, but it may be associated with autoimmunity, insect bites or infections and allergies caused by parasites (3). As Kimura disease often results in an increase of lesions, peripheral blood eosinophils and elevated serum immunoglobulin E (IgE) levels, it is considered the result of inflammation caused by immune dysfunction (4). IgE-mediated type I allergy caused by abnormal regulation of CD4 + cells may describe the major pathogenic mechanism (5).…”

“…A majority of reports on Kimura disease focus on clinical findings from China, Korea and Southeast Asian countries, with few computerized tomography (CT) reports published (3,4). Gopinathan and Tan (6) examined CT features of 13 patients with Kimura disease and divided Kimura disease into two categories: Type I and type II.…”