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Severe dermatitis with loss of epidermal Langerhans cells in human and mouse zinc deficiency
Tatsuyoshi Kawamura, … , Atsuhito Nakao, Shinji Shimada
Tatsuyoshi Kawamura, … , Atsuhito Nakao, Shinji Shimada
Published January 3, 2012
Citation Information: J Clin Invest. 2012;122(2):722-732. https://doi.org/10.1172/JCI58618.
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Research Article Dermatology

Severe dermatitis with loss of epidermal Langerhans cells in human and mouse zinc deficiency

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Abstract

Zinc deficiency can be an inherited disorder, in which case it is known as acrodermatitis enteropathica (AE), or an acquired disorder caused by low dietary intake of zinc. Even though zinc deficiency diminishes cellular and humoral immunity, patients develop immunostimulating skin inflammation. Here, we have demonstrated that despite diminished allergic contact dermatitis in mice fed a zinc-deficient (ZD) diet, irritant contact dermatitis (ICD) in these mice was more severe and prolonged than that in controls. Further, histological examination of ICD lesions in ZD mice revealed subcorneal vacuolization and epidermal pallor, histological features of AE. Consistent with the fact that ATP release from chemically injured keratinocytes serves as a causative mediator of ICD, we found that the severe ICD response in ZD mice was attenuated by local injection of soluble nucleoside triphosphate diphosphohydrolase. In addition, skin tissue from ZD mice with ICD showed increased levels of ATP, as did cultured wild-type keratinocytes treated with chemical irritants and the zinc-chelating reagent TPEN. Interestingly, numbers of epidermal Langerhans cells (LCs), which play a protective role against ATP-mediated inflammatory signals, were decreased in ZD mice as well as samples from ZD patients. These findings suggest that upon exposure to irritants, aberrant ATP release from keratinocytes and impaired LC-dependent hydrolysis of nucleotides may be important in the pathogenesis of AE.

Authors

Tatsuyoshi Kawamura, Youichi Ogawa, Yuumi Nakamura, Satoshi Nakamizo, Yoshihiro Ohta, Hajime Nakano, Kenji Kabashima, Ichiro Katayama, Schuichi Koizumi, Tatsuhiko Kodama, Atsuhito Nakao, Shinji Shimada

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Figure 5

Loss of epidermal LCs in patients with AE.

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Loss of epidermal LCs in patients with AE.
(A and B) Immunohistochemical...
(A and B) Immunohistochemical staining for HLA-DR (green) and langerin (red) in the erythematous lesions of patients with psoriasis vulgaris (psoriasis), atopic dermatitis (A.D.), hereditary AE (hAE), and acquired AE (aAE) or normal skin. Original magnification, ×200. (C) Clinical appearance and immunohistochemical staining of a patient with hereditary AE before and after treatment by oral Zn supplement. White dotted lines denote the epidermis/dermis interface. Original magnification, ×200.
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