Oral lupus erythematosus: Immunohistochemical evaluation of CD1a, CD21, CD123, and langerin expression in dendritic cells

• Published in: Journal of cutaneous pathology Vol. 51; no. 5; pp. 368 - 378
• Main Authors: Marques, Elisa Raquel Martins da Costa, Hsieh, Ricardo, Lourenço, Silvia Vanessa, Nico, Marcello Menta Simonsen
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2024; Wiley Subscription Services, Inc
• Subjects: CD123 antigen; Dendritic cells; Dendritic Cells - pathology; Epithelium; Humans; Immunohistochemistry; Inflammation; Interleukin-3 Receptor alpha Subunit - metabolism; Lamina propria; Lesions; Lupus; lupus erythematosus; Lupus Erythematosus, Systemic - pathology; oral mucosa; Skin - pathology; Systemic lupus erythematosus; dendritic cells; immunohistochemistry; lupus erythematosus; oral mucosa
• ISSN: 0303-6987; 1600-0560
• DOI: 10.1111/cup.14568

Background Dendritic cells participate in the pathophysiology of lupus erythematosus (LE), which are studied in systemic and cutaneous forms; however, little is known about their oral manifestations. Methods The expressions of dendritic cell markers (including CD1a, CD21, CD123, and langerin) were investigated by immunohistochemistry technique. Sixty intraoral and lower lip LE lesions, and additional 10 control samples were collected from 2003 to 2019. They were topographically analyzed in the epithelium (EP), lamina propria (LP), epithelial junction (JUN), and deep perivascular (PV) areas. Results The expression of CD1a was decreased in the EP (p = 0.003) and increased in the deep PV area (p = 0.002). Langerin immunostaining showed no significant decrease in EP (p = 0.944); however, it increased in LP (p = 0.012) and JUN (p = 0.006). CD21 was expressed in only two specimens (EP, p = 0.012; LP, p < 0.001; deep PV area, p = 0.018). CD123 expression increased in all topographies (EP, p < 0.005; LP, p < 0.001, JUN, p < 0.001; deep PV, p < 0.001). The comparison between vermilion and intraoral mucosa LE lesions suggested that sun‐exposed sites showed higher expression of CD123 (EP, p = 0.024; LP, p = 0.047; JUN, p = 0.001). Conclusions CD1a, langerin, and CD123 expressions were detected coincidently surrounding the inflammatory infiltrate in oral LE, suggesting that these cells may play an important role in immune response. Interestingly, plasmacytoid dendritic cells showed increased CD123 expression in sun‐exposed site lesions, which point out a possible function in their pathogenesis. Further studies are needed to confirm this hypothesis.