Endothelial-cell injury in cutaneous acute graft-versus-host disease

J. S. Dumler, W. E. Beschorner, E. R. Farmer, K. A. Di Gennaro, R. Saral, G. W. Santos

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Abstract

The presence of an erythematous skin rash and hemorrhagic complications in acute graft-versus-host disease (GVHD) suggest that the vasculature may be involved in the immunopathologic process. We reviewed endothelial and vascular histopathologic changes on light microscopy and on immunoperoxidase stained sections of skin biopsies obtained from 41 HLA-identical allogeneic marrow transplant recipients with at least grade 2 GVHD. Biopsies taken from 14 allogeneic HLA-identical bone marrow transplant recipients who never developed GVHD were used as controls. Sections were evaluated for evidence of immunologic vascular injury using the rank file analysis of histologic features, expression of HLA-DR antigen, and the distribution of fibrin and factor VIII-related antigen (F VIII RAg). Patients with acute GVHD had significantly greater intimal lymphocytic infiltrates, perivascular nuclear dust deposition, perivascular F VIII Rag extravasation and deposition and vascular proliferation than controls. We find significantly greater endothelial injury in GVHD patients, which may represent primary immunologic injury to the vasculature. The clinical findings in acute GVHD probably result from cumulative endothelial as well as epithelial injury.

Original languageEnglish (US)
Pages (from-to)1097-1103
Number of pages7
JournalAmerican Journal of Pathology
Volume135
Issue number6
Publication statusPublished - 1989

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ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Dumler, J. S., Beschorner, W. E., Farmer, E. R., Di Gennaro, K. A., Saral, R., & Santos, G. W. (1989). Endothelial-cell injury in cutaneous acute graft-versus-host disease. American Journal of Pathology, 135(6), 1097-1103.