IMMUNOHISTOCHEMICAL CHARACTERIZATION OF INTRAEPIDERMAL IN VIVO IgG DEPOSITS IN PATIENTS WITH PRIMARY SJÖGREN'S SYNDROME

Abstract

Immunohistochemical characterization of intraepidermal in vivo IgG deposits in patients with primary Sjogren's syndrome. Acta path. microbiol. immunol. scand. Sect. A. 95: 239-244, 1987. 68% of patients with primary Sjogren's syndrome have previously been found to have intra-epidermal in vivo IgG deposits in clinically unaffected skin. In this investigation, we examined immunohistologically skin biopsies from 5 patients with primary Sjogren's syndrome and from 5 normal controls in order to characterize further the intra-epidermal IgG deposits. Employing direct immunofluorescence and peroxidase-antiperoxidase (PAP) techniques, IgG was localized to epidermal cell surfaces. Double-labelling immunofluorescence experiments showed IgG to be bound to OKT6-positive Langerhans cells, and to some degree also to keratinocytes. Only IgG1, IgG3 and in one patient IgA were deposited, whereas IgG2, IgG4, IgM, IgD, IgE, Clq, C~C , C3d, C4, p-2 microglobulin, albumin, fibrinogen and C-reactive protein were not found deposited in the intra-epidermal area. The epidermal IgG deposits were reactive with anti-Fcfragment antibodies and with staphylococcal protein-A. These results are compatible with, although not definitive proofs of, the hypothesis that the in vivo deposited IgG is found in the form of IgG-containing immune complexes.

Beneficial effect of sodium sucrose‐sulfate on the ocular surface of patients with severe KCS in primary Sjögren's syndrome

“…The ocular surface of a dry eye with its persistent dry spots, epithelial ulcers, excessive mucin plaques and corneal filaments is the result of both local epithelial disease and regional glandular dysfunction. In 1"SS it is the result of a generalized exocrinopathy (Frost-Larsen et al 1980) which also involves the tear glands resulting in KCS, but the disease seems to involve all epithelia (Oxholm et al 1987) including the epithelia of the ocular surface (Prause et al 1989). Despite the systemic nature of the disease, only few systemic drugs have proven to have an effect Prause et al 1984;Oxholm et al 1986).…”

CIRCULATING IgG FROM PATIENTS WITH PRIMARY SJÖGREN'S SYNDROME DEPOSITED IN THE EPIDERMIS OF NORMAL HUMAN SKIN TRANSPLANTED TO ATHYMIC NUDE MICE

“…The observation that subclasses IgGl and IgG3 only are deposited, in graft epidermis as well as in patient skin (9), is of interest in view of the fact that Fc-receptors on mononuclear cells bind only these subclasses (10). Epidermal Fc-receptors are predominantly found on LC, but keratinocytes have also been shown to exhibit these IgG-binding receptors (9).…”

“…Furthermore, we have shown that IgG is predominantly attached to the surface of Langerhans cells (LC) (9), that only IgGl and IgG3 are deposited (7,9) and that such deposits seems to be of diag-nostic significance (8). We have suggested that IgG-containing immune complexes (IC) may be involved in the epidermal IgG deposits (8).…”