Langerhans cells in Langerhans cell granulomatosis are not actively proliferating cells.

Pulmonary Langerhans cell granulomatosis (LCG), also called histiocytosis X, is a disorder of unknown etiology characterized by the presence of destructive granulomas containing numerous Langerhans cells (LCs). The process may be localized or multifocal, and it remains unclear whether the same pathogenic mechanism is involved in all forms of the disease. It is often assumed that the massive accumulation of LCs at the sites of the lesions results from the abnormal proliferation of these cells, although it has been suggested that LCG in adults, at least in the lung, could be a reactive disorder initiated by activated LCs. Little is known, however, concerning the mechanisms responsible for the accumulation of large numbers of LCs in the course of the disease, and the relative contribution of recruitment and local proliferation of these cells remains to be established. To investigate this question, the proportion of replicating LCs was evaluated in biopsied granulomas from patients with localized or diffuse form of LCG by means of several histopathological techniques currently used in assessment of cell proliferation. The findings demonstrate that, except for proliferating cell nuclear antigen (PCNA), all parameters measured are low in all forms of the disease. They are similar to those of renewing epithelial cells and clearly less than those of neoplastic cells. These data strongly suggest that LCs in LCG granulomas are not a rapidly dividing cell population and that local LC replication makes only a minimal contribution to granuloma maintenance. Caution appears to be necessary in the use of PCNA as a marker of growth fraction.     

Coated Langerhans cell granules in histiocytosis X cells

Histiocytosis X cells (HXC) and epidermal Langerhans cells (LC) are thought to be closely related because they share morphologic features and immunologic markers. One of these common markers, the LC granule, is an acknowledged morphologic criterion for the identification of these cell types, but its function and, thus, significance are as yet unknown. In this study, we report the presence of a fuzzy coat radiating from the cytoplasmic face of the LC granule membrane in HXC. This bristly coat is indistinguishable from that of coated vesicles and pits and, thus, represents a strong morphologic clue to the function of LC granules because coated structures have been shown to be involved in the selective transport of molecules in eukaryotic cells.     

Gene expression analysis of dendritic/Langerhans cells and Langerhans cell histiocytosis

Langerhans cell histiocytosis (LCH) is a neoplastic disorder that results in clonal proliferation of cells with a Langerhans cell (LC) phenotype. The pathogenesis of LCH is still poorly understood. In the present study, serial analysis of gene expression (SAGE) was applied to LCs generated from umbilical cord blood CD34+ progenitor cells to identify LC-specific genes and the expression of these genes in LCH was investigated. Besides the expression of several genes known to be highly expressed in LCs and LCH such as CD1a, LYZ, and CD207, high expression of genes not previously reported to be expressed in LCs, such as GSN, MMP12, CCL17, and CCL22, was also identified. Further analysis of these genes by quantitative RT-PCR revealed high expression of FSCN1 and GSN in all 12 LCH cases analysed; of CD207, MMP12, CCL22, and CD1a in the majority of these cases; and CCL17 in three of the 12 cases. Immunohistochemistry confirmed protein expression in the majority of cases. The expression of MMP12 was most abundant in multi-system LCH, which is the LCH type with the worst prognosis. This suggests that expression of MMP12 may play a role in the progression of LCH. These data reveal new insight into the pathology of LCH and provide new starting points for further investigation of this clonal proliferative disorder.     

Expression of cellular adhesion molecules in Langerhans cell histiocytosis and normal Langerhans cells.

Langerhans cell histiocytosis (LCH) is characterized by lesions with an accumulation and/or proliferation of Langerhans cells (LCs). Little is known of the etiology and pathogenesis of LCH. Although the relation between the LCH cell and normal LCs is currently uncertain, the localizations of the LCH cells is considered aberrant when compared with normal LCs. Cellular adhesion molecules (CAMs) are known to play an important role in a variety of cell functions such as migration, antigen presentation, and activation. Aberrant migration of LCs may play a role in the pathogenesis of LCH. We investigated CAMs in 27 tissue specimens of 20 patients with LCH retrieved from our files during the last 15 years. LCH cells showed strong expression of CAMs such as CD54, CD58, and the beta 1-integrin alpha 4 that are upregulated during activation of normal LCs. In contrast, CAMs not found on normal LCs could be demonstrated in a number of cases on LCH cells like CD2, CD11a, and CD11b. Also CD62L, normally expressed only by epidermal LCs, could be detected on LCH cells. The integrins alpha 5 and alpha 6, not or only weakly found on epidermal LCs and highly expressed by activated LCs, could not be demonstrated on LCH cells. Our data suggest abnormal expression of CAMs on LCH cells that may contribute to abnormal migration of LCs in LCH. The aberrant phenotype of LCH cells has characteristics of both epidermal LCs and activated LCs and may be indicative of an arrested state of activation and/or differentiation of LCs.     

CD101 expression by Langerhans cell histiocytosis cells

AIMS: Our objective was to study the expression of a recently identified cell surface molecule, CD101 and in Langerhans cell histiocytosis (LCH) patients as CD101 has been shown to be present on dendritic cells. We wanted to determine if CD101 expression could be helpful for the diagnosis of LCH in conjunction with other markers (CD1a, S100 protein), and could be predictive of the evolution and dissemination of the disease. METHODS AND RESULTS: The expression of CD101 was studied by immunohistochemical technique in 11 cases of Langerhans cell histiocytosis on frozen sections. The expression of CD101 was positive in nine cases, high in six cases and low in three cases. There was no expression in the other two cases. No correlation with the evolution, the localization or the dissemination of the disease could be evidenced. CONCLUSIONS: CD101 is a new phenotypic marker that might be useful in combination with other markers for the diagnosis of LCH. However, as the anti-CD101 antibody works only in frozen sections, its value is limited compared to anti-CD1a antibody.     

Langerin在Langerhans组织细胞增生症和肺炎性与感染性疾病中的免疫组化分析

肺Langerhans组织细胞增生症（PLCH）是一种特发性间质性肺疾病，主要发生于30—40岁成人吸烟者。组织学上，PLCH表现为Langerhans细胞围绕远端呼吸道呈结节性间质性增生伴不同程度的嗜酸性粒细胞、淋巴细胞和巨噬细胞浸润，可见间质纤维化、水肿和支气管炎等病理改变。然而这些病理变化是非特异性的，可与其他的弥漫性间质性肺疾病如脱屑性间质性肺炎／呼吸性支气管炎相关性间质性肺疾病（DIP／RB．ILD）、普通性间质性肺炎、[第一段]     

“全国乳腺及生殖系统病理诊断与细胞学技术研讨会”将在深圳举办

目前，病理医师在外检工作中实际应用最新版《WHO肿瘤病理学及遗传学新分类》——乳腺和女性生殖系统病理分类标准时还存在一定难度，常造成病理诊断结果的差异，因此，深入探讨和系统理解WHO乳腺和女性生殖系统病变病理诊断的新进展、新标准具有重要现实意义。另外，近年来液基薄层细胞学检查技术方兴未艾，但实验方法及诊断标准较为混乱，也有待于进一步规范和统一。     

Intraluminal fibrosis and elastic fiber degradation lead to lung remodeling in pulmonary Langerhans cell granulomatosis (histiocytosis X).

To evaluate the morphogenesis of lung remodeling in pulmonary Langerhans cell granulomatosis (LCG; previously called histiocytosis X or eosinophilic granuloma), lung tissues obtained by open biopsy from 62 patients with pulmonary LCG were studied by light and electron microscopy. Tissues from 20 patients were also studied by immunohistochemical methods for the detection of fibronectin, elastin, and S-100 protein, and samples from six patients were studied using OKT6 monoclonal antibody. In early stages of pulmonary LCG, the epithelial lining cells were detached and Langerhans cells, inflammatory cells, and myofibroblasts migrated into intraluminal spaces through gaps in the epithelial basement membranes in and around the granulomatous lesions. In late stages, intraluminal fibrosis led to obstruction of alveolar spaces and airways and to coalescence of alveolar walls in and around the granulomatous lesions. Adjacent to these lesions, irregularly dilated alveoli were found with degraded and disrupted elastic fibers. Together, these observations suggest that intraluminal fibrosis and elastic fiber degradation are important processes of lung remodeling in pulmonary LCG.     

Langerhans cells in vulvar lichen sclerosus and vulvar squamous cell carcinoma

Introduction: Langerhans cells (LCs), specializing in antigen presentation, are a very important part of the skin immune system (SIS). Materials and Methods: Skin biopsies from 22 women with vulvar lichen sclerosus (LS): 15 patients with early and 7 with the late stage of the disease, were evaluated. Five women with vulvar squamous cell carcinoma (SCC) were also examined. The control group consisted of 9 women who underwent plastic surgery of the vulvar region. Immunohistochemical staining was performed on formalin-fixed paraffin-embedded tissues samples using antihuman CD1a antibody (NCL-CD1a-235, Novocastra). Results: Increased numbers of LC stainings were present in early LS, whereas decreased numbers of these cells were present in late LS and in SCC compared with the control group. Conclusions: This study showed that dysregulation of the SIS may lead to suppression of LCs in the vulvar epithelium and may be one of the reasons for a higher tendency for carcinogenesis in the vulvar region.     

The Langerhans cell

In all mammalian species so far examined, Langerhans cells or their precursors are the only epidermal cells expressing Ia antigens or their equivalents. In man, xeno-antisera raised in rabbits against purified B-lymphocyte cell membrane antigens were utilized to stain the Langerhans cells by either fluorescent or immunoferritin methods. As high proportion of the indeterminate cells in the epidermis also expressed HLA-DR antigens, and a relationship to Langerhans cells is suggested. Confirmation of these results was obtained in mouse. Alloantisera raised against I-A and I-EC subregion products again stained only Langerhans cells. Fluorescent, immunoperoxidase, and immunoferritin methods were used and confirmation of the specificity of the reaction was achieved at the electron microscope level. Langerhans cells were shown by ATPase staining to be absent from the epithelium of the central cornea, but present in the limbus. Population of the entire corneal epithelium surface was induced by application of irritants or contact sensitizing agents such as DNCB. Grafting of corneas either deficient or populated with Langerhans cells, to skin beds, may answer the question of the influence of such cells on allograft rejection.     

Langerhans cell histiocytosis

Langerhans cell histiocytosis (LCH) is a rare clonal disorder that consists of single or multiple mass lesions composed of cells with an abnormal Langerhans cell phenotype. Its etiology remains unknown, despite extensive searches for evidence of consistent cytogenetic abnormalities, gene rearrangements, or viral genomes. Similarly, the pathogenesis of the disease is enigmatic, although the altered expression of cytokines and cellular adhesion molecules, important for migration and homing of the activated normal Langerhans cell, may play an important role. The biologic behavior of LCH ranges from spontaneous remission to lethal dissemination, and such behavior cannot be predicted on the basis of histologic features. The presence and degree of organ dysfunction, together with the patient's age at diagnosis, remain the most reliable indicators of prognosis. Treatment of severe, refractory disease continues to be controversial and, in many cases, ineffectual. The revised classification scheme for LCH and related disorders recognizes the uncertain biological potential of LCH and its relation to other processes of dendritic and macrophage origin.     

The morphofunctional changes in the Langerhans cells of the human epidermis in inflammatory and cancerous diseases

Using ATPase reaction Langerhans cells were studied in human epidermis obtained from healthy volunteers, corpses of people who died from trauma and were autopsied during first 3 postmortem hrs and patients operated for inflammatory and oncological diseases of different localization. The extent of Langerhans cells alteration was shown to correlate directly with the severeness of the disease the patients has been operated for. Least changes of Langerhans cells developed in people operated for hernia of the anterior abdominal wall while most pronounced changes were found in those operated for stomach cancer of IV stage. The studying of Langerhans cells may be used in clinical practice for evaluation of efficiency of the treatment and in prognostic purposes.     

Insights into Langerhans cell function from Langerhans cell ablation models

Langerhans cells (LC) are the principal dendritic cell (DC) population in the epidermis of the skin. Owing to their prominent position at the environmental barrier, LC have long been considered to be prototypic sentinel DC. More recently, the precise role of LC in the initiation and control of cutaneous immune responses has become debatable. To elucidate their contribution to immune regulation in the skin, our laboratories have generated genetically modified mice in which LC can be followed in situ by expression of enhanced green fluorescent protein and can be either inducibly or constitutively depleted in vivo. This review highlights the similarities and differences between these mouse models, discusses the discovery and functional significance of Langerin(+) dermal DC, and examines some recent data that help to shed light on LC function.     

Langerhans cell histiocytosis

Langerhans cell histiocytosis (LCH) is a rare disorder affecting predominantly children and manifesting as bone pains, bony swellings and lytic lesions. Involvement of vertebrae as presenting manifestation is unusual. Here we have presented three cases of LCH, two of multifocal eosinophilic granuloma (MEG) and one of Hand Schuller Christian disease (HSC). One of the patients with MEG; had vertebral involvement as the presenting manifestation.     

Tacrolimus ointment causes inflammatory dendritic epidermal cell depletion but no Langerhans cell apoptosis in patients with atopic dermatitis

BACKGROUND: The topical immunomodulators tacrolimus and pimecrolimus are novel therapeutic options for atopic dermatitis (AD). The inhibition of nuclear factor of activated T cell-dependent proinflammatory cytokine production in cutaneous lymphocytes is an established effect of topical immunomodulators, which additionally influence mast cells, eosinophils, and dendritic cells (DCs). The latter include a reduced expression of the high-affinity IgE receptor FcepsilonRI, a reduced stimulatory capacity of lesional DCs, and a selective depletion of the inflammatory dendritic epidermal cells (IDECs) but not of Langerhans cells (LCs) from the lesional skin. OBJECTIVE: Because induction of apoptosis in lymphocytes is a reported tacrolimus effect, we asked whether tacrolimus ointment induces apoptosis of LCs or IDECs in AD lesions. METHODS: Epidermal single-cell suspensions were prepared from AD lesions of 9 tacrolimus-treated and 5 hydrocortisone butyrate-treated patients with AD before and after 1 week of treatment. Cell numbers, apoptosis rate, and immunophenotype were assessed by using the standardized FACS technique with terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling, Annexin V, and 3-color immunophenotyping. Freshly isolated LCs and monocyte-derived DCs served as in vitro controls. RESULTS: Tacrolimus and steroid ointment induced a selective depletion of IDECs from the epidermis and reduced the expression of the costimulatory molecules CD80 and CD86. Tacrolimus ointment did not increase the rate of apoptotic DCs, whereas steroid ointment did so. The isolation-induced high apoptosis rate of freshly isolated LCs was unaffected by both drugs. CONCLUSION: Tacrolimus ointment selectively depletes IDECs and alters the immunophenotype of epidermal DCs in AD lesions, but there is no evidence for tacrolimus-induced DC apoptosis in this phenomenon.     

人外周血单核细胞源性朗格汉斯细胞和表皮炎症样树突状细胞的诱导及表型分析

目的利用人外周血单核细胞体外诱导培养朗格罕氏细胞(Mo-LC)和炎症性树突状表皮细胞(Mo-IDEC)并观察其表型特点。方法联合应用LymphoPrepTM梯度离心试剂和CD14+磁珠分离和筛选外周血CD14+单核细胞;在重组人粒细胞-巨噬细胞集落刺激因子(GM-CSF)和重组人白介素4(IL-4)的基础上分别于第0、2、4天加入人天然TGF-β1或β-巯基乙醇(β-ME)。培养第6天时收集细胞,通过相差显微镜观察其形态,并利用单克隆抗体和流式细胞术对诱导细胞亚群检测细胞表面分子的表达水平。结果 CD14+单核细胞体外诱导培养6 d后可形成具有树突状外观的Mo-LC和Mo-IDEC,2种细胞均不同程度表达CD1a、FcεRI、FcεRII、TLR1、TLR2;Mo-LC表达CD207,Mo-IDEC表达CD206。特应性皮炎患者来源的Mo-IDEC表面CD1a表达高于Mo-LC,且CD23、TLR2、FcεRI的表达水平显著高于健康对照组。结论利用外周血单核细胞可在体外成功诱导Mo-LC和Mo-IDEC,这2种细胞表型特点与体内分离的细胞在形态和表型上类似,为体外进一步研究这2类细胞的功能打下基础。