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January 1994

Fibrogenic Growth Factors in the Eosinophilia-Myalgia Syndrome and the Toxic Oil Syndrome

Author Affiliations

From the Departments of Medicine, Division of Allergy, Rheumatology, and Clinical Immunology (Drs Kaufman and Gruber), Dermatology (Dr Gruber), and Pathology (Dr Miller), State University of New York at Stony Brook; the Northport Veterans Affairs Medical Center (Dr Gruber); and the Department of Medicine, Section of Rheumatology, Hospital 12° de Octubre, Madrid, Spain (Dr Gomez-Reino).

Arch Dermatol. 1994;130(1):41-47. doi:10.1001/archderm.1994.01690010045005

Background and Design:  We sought to determine if growth factors of potential pathogenetic significance are deposited in the skin, muscle, and peripheral nerve lesions of eosinophilia-myalgia (EMS) and toxic oil syndrome. Immunohistochemical studies using affinity-purified peroxidase-conjugated antibodies to detect transforming growth factor-β, platelet-derived growth factorAA and growth factorBB, fibroblast growth factor, epidermal growth factor, and interleukin 4 were performed on formalin-fixed, paraffin-embedded specimens. Seven skin biopsy specimens from EMS, six skin biopsy specimens from toxic oil syndrome, nine muscle biopsy specimens from EMS, and one sural nerve biopsy specimen from EMS were studied.

Results:  Growth factor staining was noted primarily in the epidermis and periappendageal locations of the dermis. The presence of TGF-β and platelet-derived growth factorAA in the periappendageal dermis was significantly more prevalent in EMS than toxic oil syndrome (57% vs 0%). Prominent staining of transforming growth factor-β was also present in the perimysial connective tissue of five (63%) of eight EMS muscle biopsy specimens and one sural nerve biopsy specimen.

Conclusions:  These studies implicate transforming growth factor-β and platelet-derived growth factorAA as potentially important cytokines in EMS and suggest that the pathogenesis of tissue fibrosis in EMS and toxic oil syndrome may be dependent on different growth factors.(Arch Dermatol. 1994;130:41-47)