Mikozis Fungoides Mikroçevresinde Bulunan Dermal Fibroblastların Anti-Tümör İmmün Yanıta Etkisi

Mycosis fungoides (MF) is the most common primary cutaneous T-cell lymphoma. The interaction of the neoplastic lymphocytes with their microenvironment is of crucial importance in disease progression. Cancer associated fibroblasts are activated fibroblasts located in the tumor microenvironment which affect tumor growth and anti-tumor immune response. In this study, it was aimed to investigate the role of fibroblasts in the growth of MF cells and in anti-tumor immune response. In this context, fibroblasts from MF lesions and perilesional healthy skin, CD4+ T-cells from peripheral blood and neoplastic cells from MF lesions were isolated and the effects of fibroblasts on lymphocytes were investigated through co-culture experiments. It was found that fibroblasts show inhibitory effect on CD4+ T-helper cells and stimulatory effect on malignant T-cells in proliferation experiments. This effect was more prominent with normal dermal fibroblasts in both types of lymphocytes. The proliferation assays performed with MF cell lines showed comparable results with primary lymphocytes isolated from skin. The levels of interferon-gamma and interleukin-13 in co-culture supernatants were found to be higher in co-culture of CD4+ T-cells with cancer associated fibroblasts compared to that with normal fibroblasts. The opposite of this result was obtained in co-culture experiments of the cells isolated from skin. Interleukin-4 and interleukin-10 which are other Th2 cytokines were also found to be higher with cancer associated fibroblasts compared to normal fibroblasts in co-culture experiments performed with CD4+ T-cells. These results point out that normal dermal fibroblasts may have a role in MF etiopathogenesis and that fibroblasts in tumor microenvironment may exert a slowing effect on tumor growth, thus contributing to the fact that MF is a slowly progressing malignancy.TÜBİTAK SBAG 114S443Mikozis fungoides (MF), en sık görülen primer kutanöz T-hücreli lenfomadır. Hastalığın ilerleyişinde, neoplastik lenfositlerin tümör mikroçevresindeki diğer hücrelerle etkileşimi büyük önem taşır. Kanserle ilişkili fibroblastlar, tümör mikroçevresinde bulunan, tümör büyümesi ve anti-tümör immün yanıta etki eden aktive fibroblastlardır. Bu çalışmada, MF hücrelerinin büyümesi ve anti-tümör immün yanıtta fibroblastların rolünün araştırılması amaçlanmıştır. Bu kapsamda, MF lezyonları ve perilezyonel sağlam deriden fibroblastlar; periferik kandan CD4+ yardımcı T-hücreler ve MF lezyonlarından neoplastik T hücreler elde edilmiş, ko-kültür deneyleriyle fibroblastların lenfositler üzerine etkileri araştırılmıştır. Proliferasyon deneylerinde fibroblastların, CD4+ yardımcı T-hücrelerin üzerinde baskılayıcı, malign T-hücreler üzerinde uyarıcı etkisi olduğu saptanmış; bu etkinin her iki lenfosit tipi için normal dermal fibroblastlarla daha belirgin olduğu görülmüştür. MF hücre hatları kullanılarak yapılan proliferasyon deneyleri, deriden elde edilen primer lenfositlerle benzer sonuç vermiştir. Ko-kültür üst sıvılarında interferon-gama ve interlökin-13 düzeylerinin, CD4+ T-hücrelerin kanserle ilişkili fibroblastlarla ko-kültüründe normal fibroblastlara göre daha yüksek olduğu saptanmış, deriden elde edilen lenfositlerde bunun tersi sonuç elde edilmiştir. Diğer Th2 sitokinleri olan interlökin-4 ve interlökin-10 miktarları da CD4+ T-hücrelerle gerçekleştirilen ko-kültür deneylerinde kanserle ilişkili fibroblastlarla normal dermal fibroblastlara göre daha yüksek sonuç vermiştir. Bu bulgular MF etyopatogenezinde normal dermal fibroblastların rolü olabileceğine ve tümör mikroçevresindeki fibroblastların tümör büyümesini yavaşlatıcı etki göstererek MF’nin yavaş seyirli bir malignite olmasında rol oynayabileceğine işaret etmektedir

Total Blood Lymphocyte Count Alteration During and after Pregnancy

Objective: To investigate the impact of gestational changes on blood lymphocyte count in healthy pregnancies. Study Design: This retrospective study is consisted of 108 consecutive normal pregnancies who delivered at our department in December 2015. High-risk pregnancies with poor neonatal outcome and pregnancies with maternal disorders which may affect lymphocyte counts were excluded from the study. “Complete blood count” results of the patients were obtained from the computerized data base system of Hacettepe University Hospital. Blood samples of patients which were withdrawn a) prior to pregnancy (1-6 months before getting pregnant), b) during pregnancy (11-14th gestational weeks) and c) post-partum first day were used in this study. Results: The mean blood lymphocyte count was 2049.07 (±758.69) in patients before their pregnancies. The mean lymphocyte count decreased to 1850.93 and 1625 during pregnancy and after delivery respectively. A statistically significant decrease was found between three periods (before, during, and postpartum 1st day) (p:0.003). Conclusion: We have shown a significant decrease in total lymphocyte levels during pregnancy, consistent with the data presented in the literature. Pregnancy and related hormones have a negative impact on total blood lymphocyte level

Clinical characteristics of pediatric hidradenitis suppurativa: a cross-sectional multicenter study of 140 patients

International audienceHidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases