Expression of HLA-DR and OKT6 antigens on keratinocytes and dendritic cells in pemphigus

The expression of HLA-DR and OKT6 antigens by epidermal cells in pemphigus was examined by immunohistochemical methods using skin biopsy specimens from human patients with pemphigus vulgaris. Changes in the distribution and subpopulations of Langerhans cells were observed in lesional (involved) skin. HLA-DR-positive, OKT6-negative dendritic cells were numerous and generally confined to the margins of epidermal clefts. OKT6-positive dendritic cells were rare or absent in lesional skin. The HLA-DR-positive, OKT6-negative dendritic cells associated with intraepidermal clefts are most likely functionally active antigen-presenting cells, which may play a role in lesion development. Aberrant expression of HLA-DR molecules by keratinocytes was observed in both involved and uninvolved skin, and may function to facilitate the recognition of surface-bound pemphigus antigen(s) by immunocompetent cells.