Identity of Immune Cells in Graft-versus-host Disease of the Skin. Analysis Using Monoclonal Antibodies by Indirect Immunofluorescence

The cellular infiltrate in skin biopsies of 9 patients with graft-versus-host disease (GVHD) has been characterized with the use of monoclonal antibodies by indirect immunofluorescence. Most infiltrating cells in dermis reacted with monoclonal antibodies which recognize T-cell antigens. A mean of 45% of all dermal cells were T11-reactive, while a smaller proportion of cells were identified by another "pan" antibody, OKT3. In all but two instances the proportion of dermal cells reactive with OKT8 exceeded the proportion reactive with OKT4. Anti-Tac, which identifies activated T cells, reacted with a variable proportion of cells. Monocytes and null cells (OKM1+) were frequently observed but were less numerous than T-lymphocytes. Infiltrates were sparsely populated with OKT6-reactive cells, and there was no difference between the number of intraepidermal cells reactive with this antibody in study subjects and normal controls. Few cells reactive with Leu 7 (large granular lymphocytes) or with anti-B-cell reagents were seen. These findings may have clinical implications for use of monoclonal antibodies for prophylaxis and treatment of GVHD.