Use of monoclonal antibodies specific for T cell subsets in cutaneous disorders: I. Quantitative analysis of peripheral blood lymphocytes.

Peripheral blood mononuclear cells obtained from patients with various skin disorders were studied by indirect immunofluorescence using the monoclonal antibodies OKT3, OKT4, and OKT8 which react with human T cells (OKT3+ cells), helper-inducer (OKT4+) and suppressor-cytotoxic (OKT8+) T cell subsets, respectively. In parallel, the balance between peripheral blood helper and suppressor subsets was established by the determination of OKT4+/OKT8+ ratios (helper/suppressor ratios). In patients with the Sézary syndrome, but not in patients with mycosis fungoides or parapsoriasis "en plaques," highly significant increases in the helper/suppressor ratios accompanied by decreased levels of suppressor cells were found compared to controls. T cell imbalance with high helper/suppressor ratios and low percentages of circulating OKT8+ suppressor cells were also observed in patients with atopic dermatitis, lichen planus, or acute sarcoidosis (i.e. patients with erythema nodosum sarcoidosis and bilateral hilar adenopathy). In patients with cutaneous manifestations of chronic graft vs. host diseases, low helper/suppressor ratios and elevated OKT8+ cell levels were observed. T cells and T cell subset enumerations and related helper/suppressor ratios were found to be within normal range in patients with psoriasis, systemic lupus, erythematosus, discoid lupus erythematosus, bullous disorders (bullous pemphigoid, dermatitis herpetiformis, pemphigus vulgaris), and miscellaneous diseases.