[Impending Coumarin-necrosis in a patient with heterozygous protein C deficiency type I].

Painful pink or magenta colored skin lesions characterized by a clear line of demarcation between the affected area and surrounding tissue appearing under therapy with coumarins may be a sign for evolving coumarin-necrosis. Immediate treatment with a protein C preparation in patients with protein C deficiency can prevent necrosis.

Inability to culture the dominant T-cell clone from the skin of primary cutaneous T-cell lymphoma as proven by TCR gamma-chain gene sequencing.

Molecular analysis of T-cell receptor (TCR) chain rearrangement has recently become an attractive tool for demonstrating the clonal origin of cutaneous T-cell lymphoma (CTCL) and for identifying the malignant clone at the molecular level. Over the past decade a number of attempts have been made to culture malignant CTCL cells using standard procedures and these attempts have resulted in several cell lines from the peripheral blood of Sézary syndrome, mycosis fungoides and CD30+ lymphoma patients. However, so far it has not been proven by sequence analysis that the cultured T cells truly represent the malignant cells.

T-cell clones from early-stage cutaneous T-cell lymphoma show no polarized Th-1 or Th-2 cytokine profile.

Recent studies of the cytokine pattern in skin lesions of patients with cutaneous T-cell lymphoma (CTCL) have shown that interleukin-4 (IL-4) and Il-10, both cytokines produced by T-helper type 2 cells, dominate in these lesions. Also, in single studies, interferon-gamma (IFN-gamma), a major cytokine of Th-1-cells, has been found to be absent. Consequently, it has been hypothesized that immune-suppressive Th-2 cytokines may promote local growth of the malignant lymphocyte clone.

Expression of the CD4+ cell-specific chemoattractant interleukin-16 in mycosis fungoides.

Interleukin-16 is a soluble ligand to the CD4 molecule with chemotactic properties for CD4+ cells and a competence growth factor for CD4+ T cells, upregulating HLA-DR and the interleukin-2 receptor CD25. There is also evidence for a synergistic effect of interleukin-16 and interleukin-2 on the activation of CD4+ T cells. The infiltrate in mycosis fungoides, the most common cutaneous T cell lymphoma, is typically CD4+.

Human macrophages secrete a tumoricidal activity distinct from tumour necrosis factor-alpha and reactive nitrogen intermediates.

Human macrophages, differentiated in vitro from blood monocytes, can be induced to secrete tumouricidal activity when activated by combined treatment with recombinant interferon gamma and bacterial lipopolysaccharide. We have analysed conditioned culture supernatants of activated human monocytes and in vitro differentiated macrophages cultivated under serum-free conditions for cytolytic activity against a TNF alpha-insensitive human tumour cell line and characterized this activity with respect to its relationship to TNF alpha and reactive nitrogen intermediates. Cytolytic activity was recovered in the high molecular weight fraction of culture supernatants conditioned by terminally differentiated macrophages, whereas conditioned culture supernatants of freshly isolated blood monocytes, processed under identical conditions, were devoid of significant cytolytic activity.