Immunoelektrophoretische Untersuchungen an Hautkranken

Zusammenfassung Es wurden die Seren von insgesamt 54 Patienten mit chronischdiscoidem, chronisch-disseminiertem und akutem Erythematodes, Dermatomyositis und progressiver Sklerodermie mit der Immunoelektrophorese nach Grabar u. Williams in der Modifikation von Scheidegger untersucht. Da die Untersuchungen nicht immer in der gleichen Krankheitsphase durchgeführt werden konnten, sind die Ergebnisse nicht einheitlich. Dennoch wurden bestimmte Veränderungen des Serumeiweißbildes in auffälliger Häufigkeit gefunden.Beim Erythematodes, sowohl der chronischen wie der akuten Form, war in einem großen Teil der Fälle eine Vermehrung der Proteine des - ₂ einerseits, der Glykoproteine des ₂- und ₁, anzutreffen. Der akute Erythematodes, wie auch der chronischdisseminierte, zeigten darüber hinaus vielfach eine Verminderung des Albumins und eines ₁, das möglicherweise mit dem ₁A von Seligmann u. Hanau identisch ist.Bei der Dermatomyositis trat neben einer Vermehrung der -und die Zunahme der -Globuline stark in den Vordergrund.Die progressive Sklerodermie zeigte immunoelektrophoretisch außer einer gelegentlichen Vermehrung der -Globuline keine auffälligen Befunde.Bei einem subakuten Erythematodes und zwei Fällen von Dermatomyositis wurden im ₂ Globuline gefunden, die bei Verwendung eines Anti-Human-Kaninchenserums normalerweise in dieser Form nicht zur Darstellung kommen; ihre Funktion ist nicht bekannt.Immunologisch abartige Proteine waren in keinem der untersuchten Seren nachweisbar.Mit 6 Textabbildungen     

Absence of tumor necrosis factor-α in suction blister fluids and stratum corneum from patients with psoriasis

Summary Tumor necrosis factor (TNF)- is a cytokine with multiple biological properties, particularly proinflammatory, apart from the induction of tumor necrosis. In order to elucidate the role of TNF- in the pathogenesis of psoriasis, we have carried out bioassay and enzyme-linked immunosorbent assay for TNF- in suction blister fluids and horny tissue extracts from psoriatic skin. Although bioassay showed some activities in the suction blister fluids and horny tissue extracts, there were no significant differences between the levels of activities from normal and psoriatic skin. They were at the background level and pretreatment of the samples with anti-TNF- antiserum failed to abrogate the activities. ELISA confirmed the absence of TNF-. Therefore, the present study could not verify that TNF- plays a major role in the pathogenesis of psoriasis.     

Distribution of carbohydrate residues in normal skin

Summary Sections of biopsies of normal skin obtained from 11 individuals were incubated with 8 lectins using an avidin-biotin complex (ABC). All sections when incubated with the appropriate lectin showed the presence of the following carbohydrate residues: l-fucose, -(1–4)-d-GlcNAc)₂ (N-acetylglucosamine), acetylneuraminic acid, Gal--(1–3)-GalNAc (N-acetyl-galactosamine), -d-galactose, -d-glucose, and -d-mannose. In addition, sections of individuals with blood group A showed -d-GalNAc and sections of individuals with blood group B showed -d-galactose. In the stratum (str.) basale, carbohydrates were present in small quantities, but as the cells matured and moved upward, the incorporation of carbohydrates into the cell membranes increased considerably. In the str. granulosum, lectin reactivity was absent in many sections, probably due to masking by phospholipids. The dark cells in the eccrine glands showed reactivity with all lectins except in the one nonsecretor with blood group A₁, whose dark cells showed no l-fucose and -d-GalNAc. The endothelial cells of the blood vessels showed lectin reactivity except when incubated with concanavalin A. The sebaceous glands showed both cytoplasmic and membrane staining when incubated with various lectins.     

Effect of tumour necrosis factor alpha in vivo on human granulocyte oxidative metabolism

Summary Tumour necrosis factor alpha (TNF) effectively stimulates the oxidative metabolism of human PMN in vitro. Moreover, preincubation of PMN with TNF has been shown to result in an altered response of the target cells to subsequent stimulation. In the present study the response of PMN to stimulation in vitro was investigated in patients with metastasizing malignant melanoma receiving bolus injections of recombinant human TNF as therapy. TNF was given daily for 5 days. Blood samples were taken prior to TNF administration on days 1 to 4 and on day 8. Lucigenin-enhanced chemiluminescence (CL) was used as a sensitive measure of granulocyte oxidative metabolism. PMN were stimulated with TNF, TNF, GM-CSF, PMA, opsonized zymosan and f-met-leu-phe. A significant increase in CL responses was detected upon stimulation with TNF, TNF and PMA from day 1 to day 3, whereas no significant changes were observed for the background activity or when GM-CSF or opsonized zymosan were used as stimuli. On day 4 all CL responses returned to the day 1 starting level. A further significant decrease was observed on day 8 upon stimulation with TNF, TNF and GM-CSF. In contrast, the effect induced by f-met-leu-phe reached a maximum on day 4, but the CL response was found to be at the starting level on day 8. The results indicate that TNF induces significant changes in PMN response to distinct stimuli in vivo. Moreover, it may be possible that continous daily infusions with TNF induce a hyposensitization of PMN oxidative metabolism.     

Effects of tumor necrosis factor-α on connective tissue metabolism in normal and scleroderma fibroblast cultures

Recent studies have demonstrated that tumor necrosis factor-(TNF-) selectively decreases production of collagens I and III, the major types of collagen in the dermis, and increases production of collagenase in cultured dermal fibroblasts. The effects of TNF- on collagens I, III and VI, fibronectin and collagenase gene expression by fibroblasts derived from normal individuals and patients with systemic sclerosis (SSc) were studied. SSc is characterized by excessive accumulation of collagen in the skin and in certain organs. TNF- inhibited collagen production and mRNA levels of collagens I and III and of fibronectin, and stimulated collagenase activity and collagenase mRNA levels in SSs fibroblasts. Levels of mRNA for 1(VI) and 3(VI) collagen and for -actin were unaltered in SSc fibroblasts incubated with TNF-. Similar results were observed for mRNA levels in normal fibroblasts incubated with TNF-. These results suggest that TNF- could be expected to be beneficial in the treatment of SSc. In addition, our results indicated that collagen-VI expression is regulated independently from expression of collagens I and III, and expression of fibronectin and collagens I and III are regulated in parallel in fibroblasts treated with TNF-.     

Nature of collagen in dermatofibrosarcoma protuberans

Summary The nature of collagen from 2 cases of dermatofibrosarcoma protuberans was studied. For this purpose, the tumor tissue was carefully separated from adjacent normal dermis. The collagen types comprised in the tumor were identified by CM-cellulose chromatographic and SDS-gel electrophoretic analysis of the component -chains. Semiquantitative evaluation of the relative type III content was established by separation of the cyanogen bromide peptides on gels of 12% polyacrylamide in SDS. These studies showed that dermatofibrosarcoma protuberans contains 1(I)-, 2-, and 1(III)-chains as well, and corresponding type I- and type III-related CNBr peptides. Comparing the collagen from dermatofibrosarcoma protuberans to that of normal skin, the relatively increased type III content in the case of dermatofibrosarcoma protuberans becomes apparent.This study was supported by grants of the Deutsche Forschungsgemeinschaft, project Me 540/3.     

Identification of a cell layer containing α-smooth muscle actin in the connective tissue sheath of human anagen hair

Summary Immunohistochemical and immunoelectron microscopy studies revealed the presence of -smooth muscle (-SM) actin in fibroblasts located in the connective tissue sheath (CTS) of human anagen hair follicles. Immunostaining was positive from the base of the bulb to the upper part of the lower portion of the mature anagen hair follicles. The late catagen hair follicles did not stain. Ultrastructurally, -SM actin was detected only in the fibroblasts located in the innermost layer of the transverse collagenous fibres. Since -SM actin is located in cells with contractile potential, this newly identified layer may play an important role in the morphological changes of the lower portion of the hair follicle during the hair growth cycle.     

Histochemistry of complex carbohydrates in the ceruminous glands of the goat

The localization and chemical nature of complex carbohydrates in the ceruminous glands of the Japanese miniature (Shiba) goat were studied using light and electron microscopic histochemical methods, particularly lectin histochemistry. The epithelial cells and luminal secretion of the caprine ceruminous glands contained large amounts of neutral and smaller amounts of acidic glycoconjugates with different terminal sugars (-d-mannose, -l-fucose, -N-acetyl-d-galactosamine, -d-galactose, -N-acetyl-d-glucosamine, and N-acetyl-neuraminic acid). Several sugars (-l-fucose, -d-galactose, -N-acetyl-d-glucosamine, and N-acetyl-neuraminic acid) were also detectable in the secretion of the sebaceous glands. The results obtained are discussed with regard to the specific function of the glandular secretion mixture. The complex glycoconjugates found in the ceruminous gland secretion may control viscoelasticity of and bacterial proliferation within the cerumen in order to protect the external auditory canal against physical damage or microbial attacks.     

Effect of UVB radiation on the biosynthesis of HLA-DR antigens

Summary HLA-DR molecules on the surface of immunocompetent cells are thought to represent target structures for the immunomodulating effects of UV radiation during the induction of an immune response. We therefore investigated the effect of UVB radiation on the de novo synthesis of HLA-DR--chains in the cytoplasm and the expression of - and -chains on the surface of the human lymphoblastoid B-cell line Raji. Raji cells were UVB irradiated before biochemical experiments were performed. Cells were then metabolically labeled or radioiodinated and detergent lysates immunoprecipitated using antibodies directed against the - or the - and -chain of the HLA-DR molecule. Over a wide dose range, UVB-irradiated Raji cells were shown to still express HLA-DR determinants on their surface and, even more importantly, to be capable of synthesizing HLA-DR-, - and -chains in a normal fashion. Despite this, the functional capacity of Raji cells was impaired in a dose-dependent manner. UV radiation thus seems to exert its immunomodulating effects primarily at a different level than the incriminated immune-response-associated antigens, which are expressed as recognition structures on the surface of immunocompetent cells.     

Thalidomide upregulates macrophage inflammatory protein-1α in a herpes simplex virus-induced Behçet’s disease-like animal model

The mechanism of action of thalidomide in the treatment of patients with Behçets disease (BD) is poorly understood. There is some evidence to suggest that certain immunological abnormalities are associated with the pathogenesis of BD. A BD-like mouse model induced by herpes simplex virus (HSV) inoculation shows similar immunological abnormalities. In this study, thalidomide was administered in order to understand the mechanism for the improvement in symptoms in BD-like mice. Eight out of ten thalidomide-treated mice showed improvement but none of ten placebo-treated mice (P<0.005). The improvements were seen in mucocutaneous symptoms. The mice were sacrificed on the 6th day, and the spleens subjected to RT-PCR, FACS, Western blot and immunohistochemical analysis. IL-2, IL-4, IL-6, IL-10, IFN-, TNF, TGF, MCP-1, RANTES, perforin, IP-10, FasL, FasR and MIP-1 were determined. Among these, TNF, MIP-1, perforin and Fas were influenced by thalidomide treatment. These results suggest that thalidomide can attenuate HSV-induced BD-like symptoms in mice through the downregulation of TNF (P<0.005) and the upregulation of MIP-1 (P<0.005), perforin (P<0.05) and FasR (P<0.1).Abbreviations BD Behçets disease - COX Cyclooxygenases - FasL Fas ligand - FasR Fas receptor - MIP-1 Macrophage inflammatory protein-1 - HSV Herpes simplex virus - IFN Interferon - IL Interleukin - iNOS Inducible nitric oxide synthase - IP-10 Interferon-gamma-inducible protein-10 - LPT Lymphotactin - MCP Monocyte chemotactic protein - PI Propidium iodide - RANTES Regulated on activation normal T-cell expressed and secreted - TGF Tumor growth factor - TNF Tumor necrosis factor     

Permeability barrier disruption alters the localization and expression of TNFα/protein in the epidermis

Previous studies have shown that (1) epidermal TNF mRNA levels are increased following acute disruption of the cutaneous permeability barrier; (2) this increase is maximal at 1 h and decreases to control levels by 8 h; and (3) in essential fatty acid-deficient (EFAD) mice, a chronic model of barrier perturbation, TNF mRNA levels are also elevated several-fold over controls. In the present study we determined, using immunocytochemical procedures, epidermal TNF protein levels following either acute of chronic barrier disruption and the localization of any increase. Frozen, paraffin and Antibed sections of skin were incubated with polyclonal anti-mouse TNF antisera and detection was accomplished by either immunoperoxidase or fluorescence procedures. We found that (1) TNF-immunoreactive protein was present in normal mouse epidermis, and was primarily localized to the upper nucleated layers where it displayed a diffuse cytosolic pattern; (2) acute disruption of the barrier with acetone or tape-stripping resulted in TNF staining that was more intense throughout all of the nucleated epidermal cell layers in comparison with normal epidermis; (3) the increase in TNF staining occurred as early as 2 h after barrier disruption; and (4) increased TNF staining was also observed in the stratum corneum of EFAD mice. These results indicate that epidermal TNF protein levels increase after both acute and chronic barrier disruption, and are consistent with the hypothesis that TNF may signal and/or coordinate portions of the cutaneous response to barrier disruption.     

Arzneimittelexanthem durch pegyliertes Interferon-α<Subscript>2b</Subscript>

Zusammenfassung Im Vergleich zu rekombinantem "Standard"-Interferon-_2b führt die Anwendung von pegyliertem Interferon-_2b zu einer signifikant erhöhten Ansprechrate in der Therapie der chronischen Hepatitis C. Häufige Nebenwirkungen der Interferontherapie sind lokale, entzündliche Hautreaktionen an der Injektionsstelle. Wir beschreiben den Fall einer 57-jährigen, an Hepatitis C erkrankten Patientin, die im Rahmen einer Therapie mit pegyliertem Interferon-_2b ein generalisiertes, makulopapulöses Arzneimittelexanthem entwickelte. In der allergologischen Testung induzierten nur pegyliertes Interferon-_2b, nicht aber herkömmliches "Standard"-Interferon-_2b eine Hautreaktion vom Spättyp.

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Pegylated interferon-_2b-induced drug eruption

In comparison to recombinant "standard"-interferon-_2b, treatment with pegylated interferon-_2b significantly improves the therapeutic response of patients suffering from chronic hepatitis C. The most common side effect of interferon-_2b therapy is localized inflammatory skin lesions at sites of injection. A 57-year-old woman with hepatitis C infection developed a generalized maculopapular exanthem during the treatment with pegylated interferon-_2b. In contrast to recombinant "standard"-interferon-_2b, only pegylated interferon-_2b induced a delayed-type skin reaction during allergy testing.

     

Human interferon-γ induces expression of HLA-DR on keratinocytes and melanocytes

Summary Primary human epidermal cell cultures composed of keratinocytes and melanocytes were exposed to supernatants of phytohaemagglutinin (PHA)-stimulated T cells, various lymphokines and interferon-, and checked for the emergence of HLA-DR antigen using immunofluorescence and immunoelectron microscopy. HLA-DR expression was induced by the supernatants and human recombinant interferon- (rIFN-), whereas recombinant ₂, interleukin-2 and non-recombinant human interferon- had no such effect. The threshold concentration of rIFN- required to induce this phenomenon was 10 IU/ml; no further increase of reaction intensity was observed using doses of more than 100 IU/ml. Maximum reaction intensity was achieved after 72 h of incubation; a minimum of 3 h of incubation with rIFN- followed by 72 h incubation in rIFN--free medium proved sufficient to induce HLA-DR expression. The inductive effect of the supernatants and rIFN- could be completely abrogated by pretreatment with excess doses of the monoclonal antibody GZ4 specific for human IFN-. Keratinocytes and melanocytes reacted in an identical fashion both qualitatively and quantitatively in all experiments. These data indicate that IFN- possesses specific signal functions in the induction of HLA-DR expression on epidermal cells.Abbreviations IFN- interferon- - rIFN- recombinant interferon- - r IFN-₂ recombinant interferon-₂ - nrIFN- nonrecombinant interferon- - IL-2 interleukin-2 - EC epidermal cells - K keratinocytes - M melanocytes     

Histochemische Untersuchungen über die Phosphomonoesterasen der gesunden Haut mit Hinweis auf Befunde bei Hauterkrankungen

Zusammenfassung Mit Hilfe der -Naphthol-Diazotat-Kupplungsmethode im Vergleich zu der bekannten histochemischen Ph'asedarstellung über Calcium-bzw. Bleiphosphat (klassisches Gomori-Prinzip) wurde gesunde (und erkrankte) formolfixierte, gefriergeschnittene Menschenhaut und Schleimhaut auf (alkalische) Phosphomonoesterase (Ph'ase I p_H 9,2) und (saure) Ph'ase II (p_H 5,0) untersucht. Neben den üblichen Substraten (-Naphthylphosphat bz.. -Glycerophosphat) wurden 3-Adenosinphosphorsäure, 5-Adenosinphosphorsäure sowie 1,6-Fructosediphosphat (Harden-Young-Ester) als Substrat nach dem Gomori-Prinzip angewendet, ferner 5-AMP auch bei p_H 7,5 geprüft. Den Untersuchungen liegen über 100 Gewebsentnahmen zugrunde.     

A Review of the Use of Infliximab to Manage Cutaneous Dermatoses

Background Infliximab is a chimeric monoclonal antibody that binds specifically to human tumor necrosis factor-alpha (TNF-), decreasing the effect of the cytokine in inflammatory diseases.Objective The aim of this study was to review the efficacy and safety of infliximab in the treatment of dermatological diseases.Methods A MEDLINE search (1966–January 2003), using the keyword infliximab was performed to find relevant articles pertaining to the use of infliximab in dermatology.Results Infliximab has been used in the following dermatological diseases: psoriasis, Behçets disease, graft versus host disease, hidradenitis suppurativa, panniculitis, pyoderma gangrenosum, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome, sarcoidosis, subcorneal pustular dermatosis, Sweets syndrome, toxic epidermal necrolysis, and Wegeners granulomatosis. There is a generally good safety profile for infliximab, which is similar to that when it is used to treat Crohns disease and rheumatoid arthritis.Conclusion Although not approved for use in dermatological diseases, there have been numerous reports of the efficacy of infliximab in cutaneous inflammatory diseases. The most promise lies in those diseases that have increased amounts of TNF- in the cutaneous lesions, such as psoriasis.

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SommaireAntécédents Linfliximab est un anticorps monoclonal chimérique qui se lie au facteur de nécrose des tumeurs alpha (TNF-), réduisant ainsi leffet de la cytokine dans les maladies inflammatoires.Objectif Passer en revue lefficacité et linnocuité de linfliximab dans le traitement des maladies de la peau.Méthodes Une recherche dans MEDLINE (de 1966 à janvier 2003) a été effectuée afin de trouver les articles pertinents à lusage de linfliximab en dermatologie, au moyen du terme clé « infliximab ».Résultats Linfliximab a été utilisé dans le traitement des affections suivantes: psoriasis, maladie de Behçet, maladie du greffon contre lhôte, hidrosadénite, panniculite, pyoderma gangrenosum, syndrome de SAPHO (synovite, acné pustulose palmo-plantaire, hyperostose et ostéite), sarcoïdose, dermatose pustuleuse sous-cornée, syndrome de Sweet, nécrolyse épidermique toxique et granumatulose de Wegener. Le profil dinnocuité de 1inflimixab est généralement bon, similaire au profil dinnocuité dans le traitement de la maladie de Crohn et de la polyarthrite rhumatoïde.Conclusion Bien que linfliximab ne soit pas approuvé pour le traitement des maladies de la peau, plusieurs rapports en prouvent 1efficacité contre les maladies inflammatoires cutanées. Le traitement à linfliximab semble le plus prometteur dans les maladies avec une forte présence de TNF- dans les lésions cutanées, telles que le psoriasis.

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Funding for the publication of this article was provided by Centocor, Inc., Malvern, PA, USA.     

Morphology and glycoconjugate histochemistry of the eccrine glands in the snout skin of the North American raccoon (<Emphasis Type="Italic">Procyon lotor</Emphasis>)

The eccrine nasolabial glands were found in the hypodermis of the nasal plane in the North American raccoon (Procyon lotor). In addition to light and electron microscopic observations, the distribution and selectivity of complex glycoconjugates in the eccrine tubular glands of the raccoon snout skin were studied using various histochemical methods, particularly lectin staining. The secretory epithelium and the luminal secretions exhibited high amounts of glycoconjugates with various saccharide residues (-D-mannose, -L-fucose, -D-galactose, -N-acetyl-D-glucosamine, sialic acid). The excretory duct cells also showed positive reactions with most of the histochemical methods applied. The results are discussed with regard to possible functions of the glandular secretions. The complex glycoconjugates that are produced by the eccrine nasolabial glands may be related to moistening of the skin surface as well as protecting the epidermis against physical damage or microbial contamination. This is the first report on the glands in the snout skin of carnivores.     

Der Einfluß von Δ 1-Dehydro-Hydrocortison auf das Verhalten proteingebundener Kohlenhydrate im Blutserum bei Neurodermitis diffusa

Zusammenfassung Bei 14 Patienten mit Neurodermitis diffusa wurde das Verhalten der Serumeiweißzucker nach Applikation von ₁-Dehydro-Hydrocortison untersucht. Deutlich war den Befunden eine Verminderung von Glucosamin an Albumin, -und -Globulin. Die proteingebundenen Hexosen stiegen unter der Therapie an und zeigten sich zumeist an Albumin, -und -Globulin vermehrt.     

A comparison of the stimulatory effects of cytokines on normal and psoriatic keratinocytes in vitro

Keratinocytes from normal and psoriatic skin were tested for their in vitro proliferative response to a range of concentrations of rIL-6, rTGF, rIL-8 and rGM-CSF using a serum-free culture system. With one exception, all normal cultures (11/12) were stimulated by 1000 ng/ml IL-6 (P<0.001). Six out of ten psoriatic keratinocyte cultures were also stimulated at this concetration, but this just failed to reach significance (P=0.05). As a group, the response by psoriatic keratinocytes to IL-6 was significantly less than that of normal keratinocytes (P=0.02). TGF at 1 ng/ml induced proliferation in approximately 60% of both normal (8/12,P<0.05) and psoriatic (6/10,P<0.1) keratinocyte cultures; there was no significant difference between the responses of the two groups to this cytokine. In addition, small numbers of both normal and psoriatic cultures responded to TGF over a concentration range of 0.1 to 100 ng/ml. Approximately half of the normal and psoriatic cultures were stimulated by 10–1000 ng/ml IL-8. However, the effect was not significant for the group at any of the concentrations tested. GM-CSF had minimal to no effect on most of the normal and psoriatic cultures tested. This study showed that psoriatic keratinocytes are equally responsive to the stimulatory effects of TGF and IL-8, but are less susceptible to IL-6 compared to keratinocytes from normal skin. These findings are consistent with a role for these cytokines in the maintenance of a hyperproliferative epidermis in psoriasis.     

A study on prostaglandin F2α in photodermatoses

Summary Prostaglandin F₂ (PGF₂) as a possible mediator was studied. Its plasma content was determined by radioimmunoassay. Changes in the DNA synthesis were followed by autoradiography. In active polymorphous light eruption (PLE) and porphyria cutanea tarda (PCT) a remarkable increase (over 300 pg/ml) in plasma content occurred, especially in cases involving large skin areas. Values returned to normal in remission. PGF₂ administered i.d., significantly increased the DNA synthesis of the epidermal cells 48 h after injection similar to the effect of three minimal erythema dosis UV-irradiation. This was more pronounced in PLE patients than in controls. These findings suggest some role of PGF₂ in producing the inflammatory and perhaps proliferative components of the skin symptoms in PLE. PGF₂ — in parallel to literary data concerning PGE — seems to be a mediator of UV-induced changes in DNA synthesis of the epidermal cells. Offprint requests to: Irene Horkay, MD (address see above)     

Immunoelektrophoretische Untersuchungen an Hautkranken

Zusammenfassung Immunoelektrophoretische Serumanalysen bei 113 Patienten mit verschiedenen Hauterkrankungen ergaben bei Purpura hyperglobulinaemica Waldenström, Antikörpermangel-Syndrom und Xanthomatosen der Haut krankheitsspezifische Serumeiweißbilder.Die Waldenströmsche Purpura zeigt ein charakteristisches Makroglobulin im ₂-Bereich. Beim Antikörpermangel-Syndrom fehlt das -Globulinsystem ganz oder teilweise. Bei den Xanthomatosen der Haut findet sich eine massive Vermehrung von -und ₂-Lipoproteinen und eine Verstärkung des ₂-Makroglobulins. Das ₁-Lipoprotein erscheint unverändert. Es finden sich keine Unterschiede zwischen hyperlipidämischen und hypercholesterinämischen Formen.Entzündliche Erkrankungen der Haut und der HautgefÄße zeigen häufig eine Vermehrung von Proteinen aus der Gruppe der -Glykoproteine und des -Globulinsystems, und zwar vorwiegend des ₂-Makroglobulins und des ₂-Makroglobulins.