Early mycosis fungoides (MF)

MMP-9 staining in the epidermis changed significantly
from basal cell pattern in 70% of the controls to a suprabasal
single cell or patchy epidermal cell–staining patterns in
patients with MF (P , 0.001). MMP-9 plays an important role
in the regulation of formation of the basement membrane
Early mycosis fungoides (MF) poses a great diagnostic challenge among dermatologists and dermatopathologists. There is a great similarity between the clinical and the histopathological features of early MF and that of other inflammatory dermatoses (Zackheim and McCalmont). Several immunohistochemical markers have been used to differentiate between early MF and other inflammatory dermatoses. However, the diagnosis -in most of these markers- depends on the loss of the antigen expression (Pimpinelli et al., 2005). This means that there is a general lack of positive identification marker that can differentiate between early MF and inflammatory dermatoses.
Matrix metalloproteinase-2 (MMP-2) belongs to a group of proteases that can cause matrix degradation and tumor progression in the late stage. The expression and activation of MMPs is increased in almost all human cancers compared with normal tissue (Egeblab and Werb, 2002). In patients with MF, the expression of MMP-2 and MMP-9 mRNAs was observed to be significantly upregulated in advanced stages (Nabeshima et al, 2004). In addition to its role in the late stage, it can also promote early oncogenesis through influencing all the hallmarks of carcinogenesis in many human malignancies (Hua et al., 2011). To the best of our knowledge, no study described the expression of MMP-2 at the early stage.
The regulation of MMP-2 depends on several factors. At the transcription level, Specificity protein-1 (Sp-1) transcription factor can affect the expression of MMP-2. Sp1 mediates the oncogenetic effect of MMP-2 in many cancers. Up-regulation of Sp1 could increase activity and expression of MMP-2 in human glioma (Guan et al., 2011). Also, PTEN underexpression in human hepatocellular carcinoma is associated with activation of Akt/Sp1/MMP-2 pathway (Sze et al., 2011). Sp1 was also involved in the induction of MMP-2 and MMP-9 in lung cancers by Skp2 which in turn promotes cell invasion (Hung et al., 2010). In follicular lymphoma, MMP-2 induces angiogenesis through activation of hypoxia induced factor (HIF) and VEGF. This effect is mediated by Sp1 transcription factor (Fruchon et al., 2012). However, Sp1 has not been studied in MF so far. This study was carried out to detect the expression of Sp-1 and MMP-2 in early MF and to compare this expression with that in chronic dermatitis.

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