Background and Methods The lesions of cutaneous mastocytosisare characterized by dermal infiltrates of mast cells and mayappear hyperpigmented because of the presence of increased levelsof epidermal melanin. Mast-cell growth factor, the ligand forthe product of the c-kit proto-oncogene, stimulates the proliferationof mast cells and increases the production of melanin by melanocytes.We therefore looked for the expression of the mast-cell growthfactor gene in the skin of patients with cutaneous mastocytosisusing immunohistochemical techniques and the polymerase chainreaction.
Results In the skin of normal subjects and those with unrelateddiseases, immunoreactive mast-cell growth factor was associatedwith keratinocytes and scattered dermal cells, a pattern consistentwith cell-bound mast-cell growth factor. In skin samples containinglesions and in clinically normal skin from patients with mastocytosis,however, mast-cell growth factor was also found free in thedermis and in the extracellular spaces between keratinocytes,suggesting the presence of a soluble form of this protein. MessengerRNA (mRNA) that can encode soluble mast-cell growth factor waspresent in the skin of patients as well as in that of normalcontrol subjects. No sequence abnormalities were detected inmRNA for mast-cell growth factor from one patient.
Conclusions The altered distribution of mast-cell growth factorin the skin of patients with cutaneous mastocytosis is consistentwith abnormal production of the soluble form of this factor.This abnormality is probably due to increased proteolytic processing,since it was not explained by differences in the splicing orsequence of mast-cell growth factor mRNA in the patients. Solublemast-cell growth factor may cause the characteristic accumulationof mast cells and the hyperpigmentation of skin found in cutaneousmastocytosis. These findings suggest that some forms of mastocytosisrepresent reactive hyperplasia rather than mast-cell neoplasia.
Source Information
From the Department of Dermatology (B.J.L., G.S.M., L.T., T.G.D., R.H.) and the Section of Dermatopathology (B.J.L., L.T.), Yale University School of Medicine, New Haven, Conn., and the Departments of Molecular Biology (D.M.A.) and Experimental Hematology (D.E.W.), Immunex Corporation, Seattle.
Address reprint requests to Dr. Longley at Yale University School of Medicine, Department of Dermatology, 333 Cedar St., P.O. Box 3333, LCI 500, New Haven, CT 06510.
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