PERTURBATION OF EPIDERMAL LANGERHANS CELLS IN IMMUNOSUPPRESSED HUMAN RENAL ALLOGRAFT RECIPIENTS

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Abstract
As an initial attempt to gain a better understanding of the basis for the increased incidence of UV-light-related skin cancer in chronically immunosuppressed human renal allograft recipients, both morphological and functional characteristics of epidermal Langerhans cell (LC) populations present in the forearm skin of 9 such patients with those of age, sex and race-matched controls were compared. The LC surface densities in vacuum-induced blister-derived epidermal sheets taken simultaneously from extensor and flexor forearm skin of the patients were significantly lower than those observed in the controls. The most abnormal LC densities seen were in the patients'' extensor forearm skin. There were disturbances in LC distribution and morphology that were most marked in the extensor forearm skin of patients. Differences in the alloantigen presenting capacity of LC present in epidermal cell suspensions prepared from patient and control forearm skin were also noted. These differences were not as great as were the LC density differences. The alloantigen-presenting capacity of patients'' LC was depressed proportionately more than was the alloantigen presenting capacity of their peripheral blood mononuclear cells. The LC population is clearly perturbed in human renal allograft recipients. This perturbation is greatest in a sun-exposed region of skin.