Increased immunoglobulin E Fc receptor bearing cells in germinal centers of hyperimmunoglobulinemia E patients.

Lymph nodes from 6 patients with hyperimmunoglobulinemia E (hyper-IgE; 4 with Kimura's disease, 1 with atopic dermatitis, and 1 with immunoblastic lymphadenopathy-like T cell lymphoma) and from 7 patients with normal IgE levels were studied to determine the localization of dendritic reticulum cells and of cells bearing Fc epsilon and C3d receptors and immunoglobulin E. The avidin-biotin-glucose oxidase method was used for unfixed biopsy specimens. To identify the above-mentioned cells, H107, a murine monoclonal antibody specific to the Fc epsilon receptor molecule, and corresponding antibodies specific to the other cell types were used. In 5 hyper-IgE patients (4 with Kimura's disease and 1 with atopic dermatitis) all germinal centers of the lymph nodes showed heavy reticular staining with H107, the dendritic reticulum cells being most intensely stained. In contrast, the germinal centers of the lymph nodes in the 7 patients with a normal IgE level only lightly or partially stained with H107. The staining pattern of anti-IgE was similar to that of H107 in the hyper-IgE cases. Likewise, C3d receptor and dendritic reticulum cell-related antigens were demonstrated very intensely in all germinal centers in lymph nodes of patients with hyper-IgE and normal IgE levels. These findings suggest that in a hyper-IgE state increased numbers of dendritic reticulum cells in a germinal center express the Fc epsilon receptor and that such cells may play a role in the differentiation of IgE-producing memory B cells.