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Evaluation of hematopoietic stem cells in chronic discoid lupus erythematosus

Objective The aim of the present study was to investigate the role of hematopoietic stem cell (HSC) and nonhematopoietic stem cells in lupus erythematosus through exploring the immunohistochemical expression of CD34 and c-kit. Backgrounds Chronic discoid lupus erythematosus (CDLE) is the most common type of cutaneous lupus erythematosus whose pathogenesis is still debated. The presence of autoantibodies in CDLE and the association between stem cell defects and autoimmunity encouraged us to investigate the possibility of HSC abnormality in CDLE through their immunohistochemical localization in skin samples of this disease using CD34 and c-kit antibodies. Materials and methods In total, 25 CDLE cases were selected, with 15 age-matched and sex-matched healthy individuals as a control group. Results CD34 showed positive expression in spindle-shaped dermal cells in 96% of CDLE cases with mild to strong intensity. CD34 was downregulated in CDLE cases compared with normal skin. Strong dermal intensity and higher Histo score (P < 0.001 for both) were significantly associated with normal skin. Regarding c-kit, spindle-shaped dermal cells showed positive immunoreactivity in 84% of cases, with mild to moderate intensity. Strong dermal intensity and higher dermal Histo score (P < 0.001 for both) were significantly associated with normal skin compared with CDLE cases. Conclusion We can conclude that HSCs are defective in CDLE cases as proved by CD34 and c-kit immunostaining. Further research is needed to investigate bone marrow HSCs and the underlying molecular mechanisms for such defect. Experimental studies using HSC transplantation for resistant or disseminated CDLE cases may be evaluated.