Skip to main content

Advertisement

SpringerLink
Log in

Digital image analysis for the evaluation of the inflammatory infiltrate in psoriasis

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Traditionally the evaluation of the cellular infiltrate and protein expression in skin tissue sections is done by manual quantification. However, for reliable evaluation of histology in the development of new anti-psoriatic treatments there is a need for a more time-efficient and reproducible method. To test the use of digital image analysis (DIA) in this situation we compared the assessment of immunohistochemically stained skin sections with the more traditional manual quantification (MQ) and semi-quantitative analysis (SQA). The number of CD3+ T cells and the expression of E-selectin were evaluated in stained paired skin biopsies from 11 patients with chronic plaque psoriasis before and after initiation of anti-psoriasis therapy. We observed significant correlations between MQ and DIA for the number of T cells (epidermis: r=0.88, P≤0.01, dermis r=0.87, P≤0.01). Both DIA and MQ were equally effective in detecting reductions of T-cell numbers in active-treated patients. MQ took 20 h, compared to 6 h for DIA. We also observed significant correlations between SQA and DIA for the expression of E-selectin (r=0.88, P≤0.01), although DIA was more sensitive than SQA to detect (early) changes. SQA took 10 h, compared to 4 h for DIA. In conclusion, the quantification of the inflammatory infiltrate in psoriatic lesional skin by DIA generated similar results as MQ and SQA in a reliable, reproducible and higher time efficient fashion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. De Rie MA, Bos JD (2004) New biological therapies for the treatment of psoriasis. G Ital Dermatol Venereol 139:3–13

    Google Scholar 

  2. Ellis CN, Krueger GG (2001) Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. New Engl J Med 345:248–255

    Article  PubMed  CAS  Google Scholar 

  3. Chaudhari U, Romano P, Mulcahy LD, Dooley LT, Baker DG, Gottlieb AB (2001) Efficacy and safety of infliximab monotherapy for plaque-type psoriasis: a randomised trial. Lancet 357:1842–1847

    Article  PubMed  CAS  Google Scholar 

  4. Mease PJ, Goffe BS, Metz J, VanderStoep A, Finck B, Burge DJ (2000) Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 356:385–390

    Article  PubMed  CAS  Google Scholar 

  5. Gordon KB, Papp KA, Hamilton TK, Walicke PA, Dummer W, Li N, Bresnahan BW, Menter A, Efalizumab Study Group (2003) Efalizumab for patients with moderate to severe plaque psoriasis: a randomized controlled trial. JAMA 290:3073–3080

    Google Scholar 

  6. Fredricksson T, Petterson U (1978) Severe psoriasis: oral therapy with a new retinoid. Dermatologica 157:238–244

    Article  PubMed  Google Scholar 

  7. Ramsay B, Lawrence CM (1991) Measurement of involved surface area in patients with psoriasis. Br J Dermatol 124:565–570

    Article  PubMed  CAS  Google Scholar 

  8. Bos JD, Hulsebosch HJ, Krieg SR, Bakker PM, Cormane RH (1983) Immunocompetent cells in psoriasis. In situ phenotyping by monoclonal antibodies. Arch Dermatol Res 275:181–189

    Article  PubMed  CAS  Google Scholar 

  9. Piskin G, Heydendael VMR, De Rie MA, Bos JD, Teunissen MBM (2003) Cyclosporin A and methotrexate are equally effective in reducing T cell numbers in psoriatic skin lesions but have no consistent effect on IFN-γ and IL-4 expression in psoriatic skin in situ. Arch Dermatol Res 294:559–562

    PubMed  Google Scholar 

  10. Goedkoop AY, Kraan MC, Picavet DI, de Rie MA, Teunissen MBM, Bos JD, Tak PP (2004) Deactivation of endothelium and reduction in angiogenesis in psoriatic skin and synovium by low dose infliximab therapy in combination with stable methotrexate therapy, a prospective single-center study. Arthritis Res Ther 6:R326–R334

    Article  PubMed  CAS  Google Scholar 

  11. Goedkoop AY, Kraan MC, Teunissen MBM, Picavet DI, de Rie MA, Bos JD, Tak PP (2004) Early effects of TNF-alpha blockade on skin and synovial tissue in patients with active psoriasis and psoriatic arthritis. Ann Rheum Dis 63:769–773

    Article  PubMed  CAS  Google Scholar 

  12. Tak PP, Taylor PC, Breedveld FC, Smeets TJM, Daha MR, Kluin PM, Meinders AE, Maini RN (1996) Decrease in cellularity and expression of adhesion molecules by anti-tumor necrosis factor α monoclonal antibody treatment in patients with rheumatoid arthritis. Arthritis Rheum 39:1077–1081

    Article  PubMed  CAS  Google Scholar 

  13. Kraan MC, Haringman JJ, Ahern MJ, Breedveld FC, Smith MD, Tak PP (2000) Quantification of the cell infiltrate in synovial tissue by digital image analysis. Rheumatology (Oxford) 39:43–49

    Article  PubMed  CAS  Google Scholar 

  14. Kraan MC, Smith MD, Weedon H, Ahern MJ, Breedveld FC, Tak PP (2001) Measurement of cytokine and adhesion molecule expression in synovial tissue by digital image analysis. Ann Rheum Dis 60:296–298

    Article  PubMed  CAS  Google Scholar 

  15. Youssef PP, Triantafillou S, Parker A, Coleman M, Roberts-Thomson PJ, Ahern MJ, Smith MD (1997) Variability in cytokine and cell adhesion molecule staining in arthroscopic synovial biopsies: quantification using color video image analysis. J Rheumatol 24:2291–2298

    PubMed  CAS  Google Scholar 

  16. Bland JM, Altman DG (1995) Comparing methods of measurements: why plotting difference against standard method is misleading. Lancet 346:1085–1087

    Article  PubMed  CAS  Google Scholar 

  17. Jarvis LR (1988) Microcomputer video image analysis. J Microsc 150:83–97

    Google Scholar 

  18. Ong SH, Jin XC, Jayasooriah, Sinniah R (1996) Image analysis of tissue section. Comput Biol Med 26:269–279

    Article  PubMed  CAS  Google Scholar 

  19. Youssef PP, Smeets TJM, Bresnihan B, Cunnane G, Fitzgerald O, Breedveld, Tak PP (1998) Microscopic measurement of cellular infiltration in the rheumatoid arthritis synovial membrane: a comparison of semiquantitative and quantitative analysis. Br J Rheumatol 37:1003–1007

    Article  PubMed  CAS  Google Scholar 

  20. Masseroli M, Bollea A, Bendotti C, Forloni G (1993) In situ hybridisation histochemistry quantification: automatic count on single cell in digital image. J Neurosci Methods 47:93–103

    Article  PubMed  CAS  Google Scholar 

  21. Johansson AC, Visse E, Widegren B, Sjogren HO, Siesjo P (2001) Computerized image analysis as a tool to quantify infiltrating leukocytes: a comparison between high- and low-magnification images. J Histochem Cytochem 49:1073–1079

    PubMed  CAS  Google Scholar 

  22. Matkowskyj KA, Schonfeld D, Benya RV (2000) Quantitative immunohistochemistry by measuring cumulative signal strength using commercially available photoshop and matlab. J Histochem Cytochem 48:303–311

    PubMed  CAS  Google Scholar 

  23. Norazmi MN, Hohman AW, Jarvis LR, Skinner JM, Stoll P, Bradley J (1990) The use of computer-assisted video image analysis in the enumeration of immuno-stained cells in tissue sections. J Immunol Methods 131:223–227

    Article  PubMed  CAS  Google Scholar 

  24. Wild R, Ramakrishnan S, Sedgewick J, Griffioen AW (2000) Quantitative assessment of angiogenesis and tumor vessel architecture by computer-assisted digital image analysis: effects of VEGF-toxin conjugate on tumor microvessel density. Microvasc Res 59:368–376

    Article  PubMed  CAS  Google Scholar 

  25. Wong AJ, Koh GJ, Schwartz HJ, Ruebner BH, Lawson MJ (1995) Colorectal cancer and non-cancer patients have similar labeling indices by microscopy and computed image analysis. Hum Pathol 26:1329–1323

    Article  PubMed  CAS  Google Scholar 

  26. Danning CL, Illei GG, Hitchon C, Greer MR, Boumpas DT, McInnes IB (2000) Macrophage-derived cytokine and nuclear factor κb p65 expression in synovial membrane and skin of patients with psoriatic arthritis. Arthritis Rheum 43:1244–1256

    Article  PubMed  CAS  Google Scholar 

  27. Kivinen PK, Hyttinen M, Harvima RJ, Naukkarinen A, Horsmanheimo M, Harvima I (1999) Quantitative digital image analysis applied to demonstrate the stratified distribution of involucrin in organ cultured human skin. Arch Dermatol Res 291:217–223

    Article  PubMed  CAS  Google Scholar 

  28. Smolle J, Hofmann-Wellenhof R(1998) Quantitative assessment of epidermal Langerhans cells using automated image analysis. Skin Res Technol 4:37–40

    Article  Google Scholar 

  29. Lee ES, Kim JH, Im S, Lee KB, Sohn S, Kang WH (2001) Application of computerized image analysis in pigmentary skin diseases. Int J Dermatol 40:45–49

    Article  PubMed  CAS  Google Scholar 

  30. Williams RA, Rode J, Dhillon AP, Jarvis LR, Skinner JM, Jamal O (1986) Measuring S100 protein and neurone specific enolase in melanocytic tumours using video image analysis. J Clin Pathol 39:1096–1098

    Article  PubMed  CAS  Google Scholar 

  31. Cunnane G, Bjork L, Ulfgren AK, Lindblad S, FitzGerald O, Bresnihan, Andersson U (1999) Quantitative analysis of synovial membrane inflammation: a comparison between automated and conventional microscopic measurements. Ann Rheum Dis 58:493–499

    Article  PubMed  CAS  Google Scholar 

  32. Jagoe R, Steel JH, Vucicevic V, Alexander N, van Noorden S, Wootton R, Polak JM (1991) Observer variation in quantification of immunocytochemistry by image analysis. Histochem J 23:541–547

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Marjan de Groot for repeating the digital image analysis.

Author information

Authors and Affiliations

  1. Department of Dermatology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100, DD Amsterdam, The Netherlands

    Amber Y. Goedkoop, Menno A. de Rie, Marcel B. M. Teunissen, Daisy I. Picavet & Jan D. Bos

  2. Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100, DD Amsterdam, The Netherlands

    Amber Y. Goedkoop, Pascal O. van der Hall, Paul P. Tak & Maarten C. Kraan

Authors
  1. Amber Y. Goedkoop
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Menno A. de Rie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcel B. M. Teunissen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daisy I. Picavet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pascal O. van der Hall
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jan D. Bos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paul P. Tak
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Maarten C. Kraan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amber Y. Goedkoop.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goedkoop, A.Y., Rie, M.A.d., Teunissen, M.B.M. et al. Digital image analysis for the evaluation of the inflammatory infiltrate in psoriasis. Arch Dermatol Res 297, 51–59 (2005). https://doi.org/10.1007/s00403-005-0578-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-005-0578-4

Keywords

Search

Navigation