Evidence for Eosinophil Degranulation in the Pathogenesis of Herpes Gestationis

Scheman, Andrew; Hordinsky, Maria D.; Groth, David W.; Vercellotti, Gregory M.; Leiferman, Kristin M.

doi:10.1001/archderm.1989.01670200055008

Cited by 29 publications

(4 citation statements)

References 27 publications

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“…Eosinophil granule proteins also directly provoke vasopermeability 46 and are found in several cutaneous disorders with urticarial lesions, now also HG and PEP. Furthermore, this study confirms the previous observation showing that MBP is deposited near developing blisters in HG 24 and extends the findings through comparisons of eosinophil, neutrophil and mast cell granule protein deposition in HG and PEP. This study also affords a comparison to findings in bullous pemphoid.…”

Section: Discussionsupporting

confidence: 91%

“…16 Extracellular deposition of the protein comprising the core of the specific eosinophil granule, major basic protein (MBP), has been demonstrated in lesions of chronic urticaria, 17 solar urticaria, 18 delayed pressure urticaria, 19,20 atopic dermatitis 21,22 and bullous pemphigoid. 23 MBP deposition has also been found in lesions of HG 24 suggesting a pathogenic role for the eosinophil in this disease. Striking deposition of eosinophil granule proteins occurs in the absence of tissue eosinophilia in these and other conditions, and electron microscopy shows loss of eosinophil integrity with release of largely empty membrane-bound granules.…”

Section: Introductionmentioning

confidence: 97%

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Polymorphic eruption of pregnancy and herpes gestationis: comparison of granulated cell proteins in tissue and serum

Borrego

Peterson

Diez

et al. 1999

Clinical and Experimental Dermatology

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Polymorphic eruption of pregnancy (PEP) and herpes gestationis (HG) are pregnancy-related dermatoses of unknown aetiology with eosinophil infiltration which, at early stages, may show similar clinical and histopathological features. To determine the relative contributions of eosinophils, neutrophils and mast cells to the pathogenesis of PEP and HG through deposition of granule proteins, we studied tissue and serum from 15 patients with PEP and 10 with HG. Using indirect immunofluorescence with antibodies to human eosinophil granule major basic protein (MBP), eosinophil-derived neurotoxin (EDN), eosinophil cationic protein (ECP), neutrophil elastase and mast cell tryptase, we determined and compared cellular and extracellular staining patterns in lesional skin biopsy specimens and, using immunoassay, measured MBP, EDN, and ECP in patients' sera. Eosinophil infiltration and extracellular protein deposition of all three eosinophil granule proteins were present in both PEP and HG indicating a pathogenic role for eosinophils in both diseases. Staining for eosinophil granule proteins was especially prominent in urticarial lesions and around blisters in HG. EDN and ECP serum levels in PEP and ECP serum levels in HG were significantly increased compared with those in normal pregnant and normal nonpregnant serum. Neutrophils were more prominent in HG specimens than in PEP specimens; extracellular neutrophil elastase was minimally present and similar in both diseases. Mast cell numbers and extracellular tryptase deposition did not differ between the two diseases and did not differ from mast cell counts in skin of normal pregnant women. This study shows that eosinophil granule proteins are deposited extracellularly in tissue and are increased in serum in both PEP and HG. Moreover, eosinophil involvement in the two diseases is more consistent than neutrophil and mast cell involvement. Comparatively, tissue eosinophil infiltration and extracellular protein deposition is more extensive in HG than in PEP, suggesting that eosinophil involvement is greater in the pathogenesis of HG than PEP and similar to that found in bullous pemphigoid.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 97%

Polymorphic eruption of pregnancy and herpes gestationis: comparison of granulated cell proteins in tissue and serum

Borrego

Peterson

Diez

et al. 1999

Clinical and Experimental Dermatology

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“…Eosinophil degranulation with the release of toxic granule proteins subsequently leading to keratinocyte damage and DES has long been suggested as a key pathogenic event in BP . Moreover, the deposition of granule proteins was shown to precede blister formation .…”

Section: Discussionmentioning

confidence: 99%

Evidence for a role of eosinophils in blister formation in bullous pemphigoid

Graauw

Sitaru

Horn

et al. 2017

Allergy

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Our results provide evidence that IL-5-activated eosinophils directly contribute to BP blister formation in the presence of BP autoantibodies. Dermal-epidermal separation by IL-5-activated eosinophils depends on adhesion and Fcγ receptor activation, requires elevated ROS production and degranulation and involves EET formation. Thus, targeting eosinophils may be a promising therapeutic approach for BP.

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“…Chemoattraction of eosinophils and their subsequent degranulation then take place 13 22. This presumably happens due to the release of proteolytic enzymes from eosinophilic granules that dissolves the bond between the dermis and epidermis 13…”

Section: Discussionmentioning

confidence: 99%

Pemphigoid gestationis

Lardenoije¹,

Water²,

Mertens³

et al. 2011

Case Reports

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A 39-year-old woman in the 39th week of her fifth pregnancy presented with severe itching. In recent weeks she had developed an increasingly itchy rash on her trunk and arms. Upon examination we observed multiple erythematous plaques and vesicles. Histological examinations of two skin biopsies confirmed the diagnosis of pemphigoid gestationis. Because the patient's complaints worsened we decided to deliver the baby, and as it was in transverse lie this was by caesarean section. A healthy son without rash was born. Although pemphigoid gestationis occurs in only 1 in 50,000 pregnancies, it is very important to be aware of this condition when a pregnant woman has itching. Not recognising pemphigoid gestationis may lead to inadequate maternal treatment and possible preterm birth and neonatal pemphigoid gestationis.

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Evidence for Eosinophil Degranulation in the Pathogenesis of Herpes Gestationis

Cited by 29 publications

References 27 publications

Polymorphic eruption of pregnancy and herpes gestationis: comparison of granulated cell proteins in tissue and serum

Polymorphic eruption of pregnancy and herpes gestationis: comparison of granulated cell proteins in tissue and serum

Evidence for a role of eosinophils in blister formation in bullous pemphigoid

Pemphigoid gestationis

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