T6⁺ and HLA‐DR⁺ cell numbers in epidermis of immunosuppressed renal transplant recipients

Abstract

The increased susceptibility of the skin of chronically immunosuppressed individuals to viral infections and sunlight-induced malignancies suggests specific drug-induced, dysfunction of local immune mechanisms within the sun-exposed skin of these individuals. To help understand the effect of immunosuppressive therapy alone in the absence of ultraviolet light on the immune system of skin, biopsies were collected from non-sun-exposed buttock skin of control, healthy volunteers and kidney transplant recipients immunosuppressed with either azathioprine/prednisone or cyclosporin A/prednisone and examined for incidences of T6+, and HLA-DR+ cells. No significant differences in the incidences of these 2 cell types were found (a) between control individuals and transplants recipients, (b) between transplant recipients receiving either of the immunosuppressive drug regimes, or (c) between transplant recipients who either had or had not developed skin cancer.

Quantitative and morphometric analysis of Langerhans cells in non‐exposed skin in renal transplant patients

“…These results are in agreement with those reported by Sontheimer et al (9), and suggest a major and direct effect of immunosuppressive therapy in the density of epidermal LC. Our findings are in apparent contradiction with those of Kelly's report (12). These authors used a direct immunofluorescence technique to evaluate LC density.…”

“…They further suggested that the reduction in the number of LC in RTP could explain the high incidence of skin cancer in sun exposed areas observed in these patients (1)(2)(3). More recently, Kelly et al (12), have restudied this topic in non-exposed skin, but they were not able to find any decrease in the number of epidermal LC in RTP compared with normal controls. These results could suggest that immunosuppressive drugs have no direct effect on LC density.…”

“…Since ultraviolet radiation has a well-documented depressor effect on epidermal LC population (10,11), it has been suggested that immunosuppressive therapy increases the sensitivity of LC to solar radiation (9). Further studies performed in non-exposed skin (12) failed to demonstrate any difference in the density of epidermal LC between RTP and controls, suggesting that immunosuppressive drugs have no direct effect in the development of LC alterations.…”