A case of episodic angioedema associated with eosinophilia

Background Gleich et al. first described 4 cases of episodic angioedema associated with eosinophilia as a distinct entity in 1984. Since then, several cases of this disorder have been reported in the United States, Europe and Japan. Observations We report a case of a 22-year-old pregnant Japanese woman with this disorder. She had no fever and her general condition was good except the angioedema which was limited to her limbs. During an acute episode, her white blood cell count increased to 29,500/mm3 with 50% eosinophils, following an elevated serum interleukin-5 (IL-5) level. Spontaneous resolution occurred in 1 month after the onset. In a 5 month follow-up, no evidence of cardiac or other visceral organ involvement was found, and no recurrence occurred. Conclusions Our case, combined with those reported in the literature, suggests that Japanese cases of episodic angioedema associated with eosinophilia differ from Caucasian cases in clinical symptoms and some other points

スイホウセイ シッカン

Some autoimmune bullous disorders are not uncommon among elderly people. We reaported 2 cases of autoimmune bullous disorders of elderly people with complications. Case 1 was a 64 year-old man with pemphigus vulgaris. He was complicated with acquired hemophilia A due to factor VIII inhibitor. Case 2 was an 80 year-old man with bullous pemphigoid. He had huge liver tumor. We should keep in mind that autoimmune bullous disorders in elderly persons may be complicated with other systemic disease, especially internal malignancy

コウレイシャ ノ ヒフ シュヨウ

Skin tumors in aged patients consist of benign tumors, precancerous lesions or carcinomas in situ, and skin cancers. We reviewed the clinical characteristic and treatment for each of them, and the molecular pathogenesis and protection for skin cancers. Exposure to ultra-violet (UV) radiation is the most common cause of skin cancers. In particular, UV-B radiation is mainly involved in the mutagenesis in the skin by two major photoproducts of a cyclobutane pyrimidine dimer and a (6-4) photoproduct. Recently, the ozone layer of the earth has been destroyed, and the increase in UV-B radiation on the earth surface can be expected in the next years. Therefore, we should add special attention to patients with skin cancers that are predicted to increase in number, and UV protection by sunscreens from childhood should be essential for the prevention against skin cancers in the 21st century

p53 gene mutation analysis in porokeratosis and porokeratosis-associated squamous cell carcinoma

In this and previous studies, we have shown p53 overexpression immunohistochemically in 14 of 17 porokeratotic specimens obtained from 14 lesions of nine cases, and in all six specimens of squamous cell carcinoma (SCC) arising on porokeratotic lesions of two cases. We screened mutations in exons 5 to 10 of the p53 gene in all these specimens by polymerase chain reaction-single strand conformation polymorphism analysis. Mutations of the p53 gene were detected in two of the six SCCs but not in any of the 17 porokeratotic specimens. These two mutations were C to T transitions at codons 146 and 175 in exon 5, which were a nonsense mutation at a dipyrimidine site and a missense mutation at a CG site, respectively. To our knowledge, neither of these mutations has been identified in skin cancers before. Our observations indicate that mutations of the p53 gene are not the major molecular etiology for porokeratosis, but are related to its skin carcinogenesis, and that p53 overexpression in porokeratosis is not due to p53 gene mutations

Immunohistochemical localization of thyroid hormone nuclear receptors in human hair follicles and in vitro effect of L-triiodothyronine on cultured cells of hair follicles and skin

To investigate the cellular basis of the action of thyroid hormone on hair follicles, we studied the immunohistochemical localization of thyroid hormone receptors (TRs) in human scalp skin using a mouse monoclonal antibody, TRα1 (C4) against TRs. Immunoreactive TRs were detected in the nuclei of the outer root sheath cells (ORSCs), dermal papilla cells (DPCs), fibrous sheath cells of hair follicles, hair arrector pili muscle cells and sebaceous gland cells. However, nuclei of hairmatrix cells were not clearly stained with TRα1 (C4). The epidermis showed positive nuclear staining by the antibody. Ductal and secretory portions of eccrine sweat glands were also stained with the antibody as we had expected. In the dermis, almost all the cell components including fibroblasts, vascular endothelial and smooth muscle cells, and Schwann cells were positively stained. Immunofluorescence also showed TRs expression in cultured ORSCs, DPCs, epidermal keratinocytes and dermal fibroblasts. L-triiodothyronine stimulated the proliferation and / or metabolism of all these four types of cells significantly, although there was variation at the rate of stimulation. Whereas, structurally similar, but metabolically inactive analog, reverse T3 had no effect. These results demonstrate the presence of thyroid hormone nuclear receptors in human hair follicles. Furthermore, the presence of TRs in different cell types in the skin suggests numerous direct effects of thyroid hormone on this target tissue

Identification of the P-TEFb complex-interacting domain of Brd4 as an inhibitor of HIV-1 replication by functional cDNA library screening in MT-4 cells

AbstractWe conducted a phenotypic cDNA screening using a T cell line-based assay to identify human genes that render cells resistant to human immunodeficiency virus type 1 (HIV-1). We isolated potential HIV-1 resistance genes, including the carboxy terminal domain (CTD) of bromodomain-containing protein 4 (Brd4). Expression of GFP-Brd4-CTD was tolerated in MT-4 and Jurkat cells in which HIV-1 replication was markedly inhibited. We provide direct experimental data demonstrating that Brd4-CTD serves as a specific inhibitor of HIV-1 replication in T cells. Our method is a powerful tool for the identification of host factors that regulate HIV-1 replication in T cells

Frequent p53 Accumulation in the Chronically Sun-Exposed Epidermis and Clonal Expansion of p53 Mutant Cells in the Epidermis Adjacent to Basal Cell Carcinoma

p53 expression was studied immunohistochemically to identify a precursor lesion of basal cell carcinoma (BCC) in the epidermis adjacent to BCC. With two different anti-p53 antibodies of CM1 and DO7, p53 expression was frequently detected in the epidermis adjacent to BCCs arising on the face and in the normal epidermis with usual sun exposure. In the epidermis adjacent to BCC, stained cells were occasionally clustered in a small area, but no cluster was found in the normal epidermis with usual sun exposure. The expression was less frequent in the normal epidermis with rare sun exposure. Ten cases of normal skin with usual sun exposure, showing CM1 staining in the epidermis, were screened for p53 gene mutations with polymerase chain reaction-single- strand conformation polymorphism analysis using DNAs obtained from the epidermis. No mutation was detected in exons 2 to 10 of the p53 gene in these 10 cases. The epidermis flanking three BCCs that was stained with CM1, on the other hand, carried a missense mutation of C to G transversIon at a dipyrimidine site of codon 249. This alteration replaced arginine with threonine. The mutation of codon 249 was not detected in the three BCCs. Our results first suggest that ultraviolet light irradiating the skin in a daily life induces p53 accumulation in the epidermis and secondly that the frequent clonal expansion of p53 mutant cells occurs in the epidermis adjacent to BCCs. This clonal expansion of mutant p53 may provide a molecular basis for high risk of developing subsequent new skin cancers in patients with BCC