AJTR Copyright © 2009-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Am J Translational Res 1(2):203-210,2009

Original Article
Lesional skin chemokine ccl27/ctcak expression in mycosis fungoides
and the disease control by therapy

Gaia Goteri, Serena Rupoli, Anna Campanati, Antonello Costagliola, Simona Sabato, Stramazzotti D, Paola
Picardi, Lucia Canafoglia, Stefano Pulini, Anna Maria Offidani, Pietro Leoni

Anatomia Patologica, Clinica Ematologia and Clinica Dermatologica, Azienda Ospedaliera Ospedali Riuniti di
Ancona/Università Politecnica delle Marche, Ancona, Italy; Dipartimento Ematologia, Ospedale Spirito Santo,
Pescara, Italy

Received January, 2009; accepted January, 2009; available online January, 2009

Abstract: Recruitment of neoplastic T-cells in skin is a critical step in the pathogenesis of Mycosis Fungoides
(MF) lesions. The chemokine CCL27 attracts memory T cells to the skin and an increased expression have been
observed in MF patients compared to normal controls. The interactions between neoplastic cells and the skin
immune system needs to be further elucidated. We investigated CCL27 expression and density of dendritic cells,
CD8+ and CD4+ lymphocytes in skin lesions of 52 early stage-MF patients, 34 M/18 F, treated by PUVA plus
interferon alpha. Immunohistochemistry was done on specimens obtained at diagnosis and after treatment. At
diagnosis, CCL27 expression was abnormal/suprabasal in 36. A normal/basal CCL27 expression tended to be
correlated with a high DC density and a low neoplastic infiltrate density. Treatment induced a significant CCL27
expression increase. During follow-up (median, 92.5 mo.s; range, 43-165), 33 patients relapsed (median EFS,
46 mo.s). A normal/basal CCL27 expression at the end of treatment, was correlated with a lower incidence of
disease recurrence and a longer median EFS (111 mo.s vs 39 mo.s with suprabasal expression; log rank test:
P=0.031). We conclude that increased CCL27 expression in early-stage MF lesions might be related to a balance
between neoplastic cells and immunomodulant dendritic cells. A normal CCL27 expression after treatment
designates a subset of patients with a favourable behaviour. The mechanisms involved in the increased CCL27
expression after therapy in the remaining patients, which have a higher probability to recur, need to be further
investigated. (AJTR901010).

Key Words: Chemokine, CCL27/CTACK, mycosis fungoides, lymphocyte, dendritic cells

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Address all correspondence to:
Gaia Goteri, MD, PhD
Anatomia Patologica
Università Politecnica delle Marche
Via Conca 71
I-60020 Torrette di Ancona (Ancona)
Italy
Tel. 0039-071-596-4811; Fax 0039-071-889985
E-mail:
g.goteri@univpm.it