Summary
Background
Inducible co-stimulator (ICOS) is a co-stimulatory receptor on activated T cells that
provides the signals needed for Th1 and Th2 responses via its interaction with B7h.
Chronic focal infections are closely related to pustulosis palmaris et plantaris (PPP),
but the involvement of ICOS in PPP has not been clarified.
Objective
To investigate the effectiveness of treatments for focal infections on PPP skin lesions
and the involvement of ICOS-positive T cells at focal infection sites in the tonsils
and in PPP lesional skin.
Methods
In patients that had undergone a tonsillectomy or dental treatment, the clinical activities
of PPP, both the skin lesions and pustulotic arthro-osteitis were followed for over
2 years. The expressions of ICOS and various other activation markers on T cells were
examined in tonsil tissue from both PPP patients and non-PPP patients, and the expression
levels in peripheral blood were also evaluated in PPP patients and healthy donors.
ICOS-positive T cells and B7h expression in PPP and normal skin were examined immunohistochemically.
Results
The above treatments for focal infections led to a dramatic and persistent improvement
in the PPP skin lesions and pustulotic arthro-osteitis. The expression of ICOS, but
not of other activation markers, was higher in tonsil tissues from PPP patients than
in tonsil tissues from non-PPP patients. B7h was upregulated without numerous ICOS-positive
T cell infiltrates in the skin lesions.
Conclusion
The activation of T cells via ICOS co-stimulation in focal infections likely triggers
the skin and skeletal inflammation associated with PPP, resulting in tissue damage.
Abbreviations:
ICOS (inducible co-stimulator), PPP (pustulosis palmaris et plantaris), APC (antigen presenting cell), CLA (cutaneous lymphocyte-associated antigen), TGF (transforming growth factor), IFN (interferon), TNF (tumor necrosis factor), PBMC (peripheral blood mononuclear cell), hICOSmIg (human ICOS-mouse IgG Fc fusion protein), hCTLA-4hIg (human cytotoxic T lymphocyte-associated antigen 4-human IgG Fc fusion protein)Keywords
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Article info
Publication history
Published online: July 12, 2010
Accepted:
December 27,
2007
Received in revised form:
December 25,
2007
Received:
August 30,
2007
Identification
Copyright
© 2008 Japanese Society for Investigative Dermatology. Published by Elsevier Inc. All rights reserved.
