Profile of anti-stratum corneum autoantibodies in patients with aural cholesteatoma.

The stratum corneum (SC) antibodies are present in high titers in the sera of patients who have diseases in which cells containing keratin intermediate filaments have been damaged. Aural cholesteatoma is a skin-related disease of the temporal bone with an extensive production and accumulation of keratinizing epithelium in the middle ear. The aim of the present investigation was to study the humoral immune response to SC in these patients. Sera were obtained from patients with aural cholesteatoma (n = 10) and from normal donors (n = 8) of about the same sex and age distribution. All sera were analyzed for the existence of autoantibodies (IgG and IgM) against SC by both direct and indirect immunofluorescence, using skin and cholesteatoma frozen tissue sections as antigen substrate. The direct immunofluorescence showed a low level of staining intensity for nearly all of the cholesteatoma patients, indicating the in vivo absence of deposits of anti-SC autoantibodies. The indirect immunofluorescence demonstrated positive staining of the SC in both cholesteatoma and skin tissue sections. Furthermore, some patients showed for IgG anti-SC-autoantibodies a positive staining of the highest suprabasal layers of the epithelium of cholesteatoma. IgM anti-SC autoantibodies were always weaker in titer than IgG autoantibodies. Results show that cholesteatoma patients do not have particularly high levels of anti-SC autoantibodies. A humoral response against SC seems not to be a significant event in the pathogenesis of cholesteatoma disease.