Ann Dermatol.  2016 Aug;28(4):451-456. 10.5021/ad.2016.28.4.451.

Immunohistochemical Comparison of IL-36 and the IL-23/Th17 Axis of Generalized Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis

Affiliations
  • 1Department of Dermatology, Ajou University School of Medicine, Suwon, Korea. esl@ajou.ac.kr
  • 2Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea.
  • 3Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

BACKGROUND
Cutaneous pustular disorders include generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis (AGEP).
OBJECTIVE
To identify differences between GPP and AGEP, here we immunohistochemically evaluated interleukin (IL)-36 and the IL-23/Th17 axis.
METHODS
This retrospective comparative immunohistochemical study was completed using 11 biopsies of 11 cases of GPP and 11 biopsies of 11 cases of AGEP. Through staining with the anti-IL-36-alpha (IL-36α), anti-IL-36 receptor antagonist (IL-36Ra), anti-nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), anti-IL-23, anti-IL-17, and anti-IL-8 antibodies, main expression location and intensity were visualized in the epidermis and dermis.
RESULTS
In both diseases, diffuse IL-36α expression was observed in the epidermis. IL-36Ra expression was observed in the dermal perivascular area as well as in the epidermis. NF-κB expression was observed in the epidermis and perivascular dermal area. Diffuse IL-23 and IL-17 expression was seen in the whole epidermis and the perivascular dermal area. IL-8 was expressed in the subcorneal pustules and parakeratotic area. Contrary to other cytokines, IL-23 expression in the epidermis of patients with GPP was more intense than only that in patients with AGEP.
CONCLUSION
Common pathomechanisms might exist in the development of GPP and AGEP based on these immunohistochemical results, but further studies are needed.

Keyword

Acute generalized exanthematous pustulosis; Immunohistochemistry; Interleukin-17; Interleukin-23; Psoriasis

MeSH Terms

Acute Generalized Exanthematous Pustulosis*
Antibodies
B-Lymphocytes
Biopsy
Cytokines
Dermis
Epidermis
Humans
Immunohistochemistry
Interleukin-17
Interleukin-23
Interleukin-8
Interleukins
Psoriasis*
Retrospective Studies
Antibodies
Cytokines
Interleukin-17
Interleukin-23
Interleukin-8
Interleukins

Figure

  • Fig. 1 The expression of cytokines and its receptor in GPP and AGEP. GPP: generalized pustular psoriasis, AGEP: acute generalized exanthematous pustulosis, IL: interleukin, IL-36Ra: IL-36 receptor antagonist, NF-κB: nuclear factor kappa-light-chain-enhancer of activated B cells.


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