An immunofluorescence complement-fixation test for detection of human papilloma viruses in various warts and wartlike lesions of epidermodysplasia verruciformis.

Comparative studies of indirect immunofluorescence (IF) and IF complement fixation tests were performed in 11 warts induced by various human papilloma viruses (HPV) or wartlike lesions of epidermodysplasia verruciformis. For the detection of HPVs, specific immune sera against HPV1, HPV2, HPV3, HPV5, HPV9 and/or HPV8 were used. The complement-fixation test proved to be as specific as the indirect IF method for the detection of HPVs in the tissues and was superior in clarity of IF readings (no nonspecific IF staining).

Stripping of the stratum corneum in patients with psoriasis: production of prepinpoint papules and psoriatic lesions.

In patients with psoriasis, partial stripping of the stratum corneum induced minute erythematous and edematous, nonscaling papules six hours to seven days later. These "prepinpoint papules" PPPs) comparable to spontaneous PPPs, which we described earlier, appeared in 75 of 159 patients with active psoriasis but in none of 27 controls; 73% to 91% of these PPPs, depending on the activity of the disease, transformed into pinpoint papules. Histological and histochemical examinations of the PPPs showed infiltrates containing numerous polymorphonuclear leukocytes around the vessels and penetrating into the epidermis, partly destroying it.

Earliest clinical and histological changes in psoriasis.

Studies were performed in 89 patients with active psoriasis and in 10 normal volunteers. Areas of uninvolved skin of 10 x 10 cm in size were demarcated and closely observed for 14 days. In 54 patients with psoriasis, there developed very fine, erythematous papules almost skin level (with no scaling of the surface), which changed in the course of observation into typical pinpoint papules.

[Is psoriasis an autoimmunologic disease?].

DThe defective function of T-lymphocytes, which is a finding in active psoriasis, is transitional and reversible, whereas the immunological mechanism is mainly related to the formation of immune complexes consisting of stratum corneum antibodies and stratum corneum antigen, which through binding of complement and activation of chemotactic complement components is responsible for the phenomenon of "squirting papillae". The earliest lesions preceding pin point papules, called pre-pin-point papules, were induced by stripping or developed spontaneously in a marked field closely observed for several days. In the changes preceding earliest psoriatic lesions.

[New developments relating to papillomaviruses].

Molecular hybridization technique and immunofluorescence studies with use of specific immune sera against the purified virions isolated from various types of warts and wart-like lesions of epidermodysplasia verruciformis (EV) made it possible to detect four different types of human papilloma viruses (HPV). The recognition of the viruses is important because of the different morphology of the lesions induced and their various oncogenic potentials. HPV1 is mainly responsible for plantar warts, HPV2 for common (hand) warts, HPV3 has been found both in flat warts and in the variety of EV in which skin lesions are of flat wart type, the course is relatively more benign, and usually malignant transformation is not to be expected.

Epidermodysplasia verruciformis versus disseminated verrucae planae: is epidermodysplasia verruciformis a generalized infection with wart virus?

Recently it has been shown that epidermodysplasia verruciformis is induced by human papilloma/virus different from the papilloma/virus of warts, and that 2 distinct viruses-designated HPV-3 and HP-4--are responsible for it. Ten cases of epidermodysplasia verruciformis were found to have been caused by HPV-3. Clinically and histologically, as well as in the often depressed cell-mediated immunity they closely resembled long-standing verrucae planae, also caused by HPV-3.

Immunopathology of psoriasis.

Immunofluorescence (IF) studies by the direct and indirect methods demonstrate immunoglobulins and complement bound in vivo in psoriatic scales. The IF pattern is comparable to that of stratum corneum antibodies (SCAb) bound in vitro on specific substrate, as visualized by the indirect IF method. Formation of immune complexes can be responsible for the "squirting papilla" phenomenon, and conversion of the stratum corneum - which is normally an inaccessible antigen - into its reactive form seems to be brought about by proteases of polymorphonuclear leukocytes.

Twenty-one years of follow-up studies of familial epidermodysplasia verruciformis.

21 years of follow-up study of a family with epidermodysplasia verruciformis (e.v.) have shown that members of one family can be infected with different human papillomaviruses (HPVs), either HPV 3 or HPV 4, and sometimes with both.

Autoimmunity in psoriasis. Relation of disease activity and forms of psoriasis to immunofluorescence findings.

Immunofluorescence (IF) studies using the test providing information on the reactivity of stratum corneum (SC) antibodies and their in vivo binding have been performed in 193 cases of psoriasis and 89 cases with other dermatoses. It has been shown that: 1. Essentially all fully developed, active psoriatic lesions had IgG deposits in the stratum corneum at the sites of the SC antigen, presumably due to in vivo binding of SC antibodies.

Autoimmunity in psoriasis. A complement immunofluorescence study.

The stratum corneum (SC) antibodies are present in all human sera as seen by indirect immunofluorescent (IF) staining. They appear to bind in vivo to the stratum corneum of psoriatic lesions. They fix complement in vitro in a two step complement IF test system using either anti C4 or anti C3 conjugates as indicators.

Characterization of two types of human papillomaviruses in lesions of epidermodysplasia verruciformis.

Human papillomaviruses (HPVs) found in lesions of 11 patients suffering from epidermodysplasia verruciformis were compared to HPV type 1 (HPV-1) and HPV type 2 (HPV-2) previously characterized in plantar and common warts, respectively. Complementary RNAs (cRNAs) to HPV-1, HPV-2, and viruses obtained from two patients with epidermodysplasia verruciformis (J.D.

Studies on the Koebner phenomenon.

The examination of induced Koebner reactions in 71 patients by the IF methods and by histology at selected times after scratching, show, that immunologically specific but non-disease specific reactions of stratum corneum (SC) antibodies occur adjacent to the crusts in both control subjects and psoriasis patients. In lesions induced by scratching in patients with psoriasis there develop progressively additional foci of apparent in viveo binding of SC antibodies. IF deposits may appear before histologic or clinical changes.

Autoimmune phenomena in psoriasis.

The striatum corneum (SC) antibodies are present in all human sera as seen by indirect immunofluorescent (IF) staining. They appear to bind in vivo to the stratum corneum of psoriatic lesions. They fix complement in vitro in a two step complement IF test system using either anti C4 or anti C3 conjugates as indicators.

Crithidium luciliae immunofluorescence test (CL test) a simple and reliable method for detecting anti-native DNA antibodies.

Antibodies directed against native DNA using Crithidium lucillae as an antigen substrate were demonstrated in 39 of 72 cases of systemic lupus erythematosus (SLE) with active lesions whereas results were negative in 42 cases of SLE during remission and in 69 cases of other collagenoses, and in 20 healthy subjects. A clearcut correlation with the peripheral type of fluorescence of anti-nuclear antibodies (ANA) was found in the routine method of immunofluorescence on the monkey esophagus. Renal lesions were present in almost all cases of SLE with positive results of the test for Crithidium luciliae.

Mixed connective tissue disease (MCTD)--its immunological characteristics.

The concept of the MCDT is controversial; it is still not settled whether it is nosological entity, or a variety of SLE, or a special variety of scleroderma. From the practical point of view the authors consider it important to perform tests for RNA antibodies whenever the characteristics of different collagenoses coexist. Detection of the antibodies is relevant both to the prognosis and the choice of treatment.

Antibodies against extractable nuclear antigens (ENA) in systemic scleroderma.

Antibodies against nuclear ribonucleoprotein (RNP) were found in 5 of 63 cases of systemic scleroderma, whereas they were present in all but one case of mixed connective tissue disease and in 15 of 67 cases of systemic lupus erythematosus. In all RNP positive cases of systemic scleroderma there were some features of other collagen diseases, and their course was relatively more benign. Studies of RNP antibodies in systemic scleroderma may be of importance for treatment and prognosis.

Immunological studies in epidermodysplasia verruciformis.

Immunofluorescence and cell mediated immunity studies have been performed in 14 cases of epidermodysplasia verruciformis (EV), 3 of those abortive or regressing in members of the families of the patients with EV. Two different types of human papillomavirus (HPV)--HPV3 and HPV4--have been found in cases of EV. HPV3 was detected also in flat warts without features of EV.

Tissue specificity of antinuclear antibodies in scleroderma.

Studies of antinuclear antibodies (ANA) were carried out in 39 cases of systemic scleroderma and for comparison in 19 cases of systemic lupus erythematosus (SLE) using indirect immunofluorescence (IF) methods under standard conditions. The results on three different substrates--monkey esophagus, guinea pig lip and rat liver--are reported. In 48.