Tissue Eosinophilia in Pemphigoid Gestationis: Association with Eotaxin and Upregulated Activation Markers on Transmigrated Eosinophils

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Abstract
We studied chemotactic cytokines and activation of skin-homed eosinophils in pemphigoid gestationis, a rare autoimmune bullous disease of late pregnancy. Eotaxin and interleukin (IL)-5 were analysed in patients' blister fluid and serum by enzyme-linked immunosorbent assay. Lesional tissue was investigated for eotaxin deposition by immunohistochemistry. Adhesion molecules and activation markers on tissue eosinophils were analysed by immunofluorescence staining. Eotaxin was elevated in serum of two pemphigoid gestationis patients compared with nine healthy pregnant women. Blister fluid contained even higher amounts of eotaxin and in addition IL-5. Eotaxin was mainly expressed in subepidermal tissue in close proximity to eosinophils that expressed high levels of adhesion molecules (CD11b, CD11c, CD18 and CD49d) and the activation marker HLA-DR. High local levels of eotaxin and IL-5 as present in the blister fluid correspond to the high state of activation of the infiltrated eosinophils.

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