{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:50:49Z","timestamp":1792029049789,"version":"4.4.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2011,10,10]],"date-time":"2011-10-10T00:00:00Z","timestamp":1318204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,10,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Thymoma-associated multi-organ autoimmunity is a rare, autoimmune disease that causes colitis, liver dysfunction and cutaneous graft-versus-host (GVH)-like skin damage. This paraneoplastic autoimmune disorder may be due to inadequate T cell selection in the tumour environment of the thymus. Although sporadic case reports have revealed its clinical features, little is known about its pathological mechanism. By comparing the skin-infiltrating T cell subsets with those of GVH disease (GVHD) and other inflammatory skin diseases, we sought to elucidate the pathological mechanism of thymoma-associated multi-organ autoimmunity. Histopathological and immunohistochemical analysis of skin biopsies was performed for three patients with thymoma-associated multi-organ autoimmunity. Histopathological findings of thymoma-associated multi-organ autoimmunity were indistinguishable from those of patients with acute GVHD, although the aetiologies of these diseases are completely different. The frequency of regulatory T cells (Tregs) is reduced in cutaneous lesions and CD8+ cytotoxic T lymphocytes that massively infiltrate into the epidermis of patients with thymoma-associated multi-organ autoimmunity. Additionally, the ratio of T helper type 17 (Th17) cells to CD4+ cells in patients with thymoma-associated multi-organ autoimmunity and acute GVHD was higher than that in healthy controls, but similar to that in psoriasis vulgaris patients. Similarity of the skin-infiltrating T cell subsets with those of acute GVHD suggested that skin damage in patients with thymoma-associated multi-organ autoimmunity might be induced by self-reactive cytotoxic T lymphocytes under the diminished suppressive capacity of Tregs.<\/jats:p>","DOI":"10.1111\/j.1365-2249.2011.04472.x","type":"journal-article","created":{"date-parts":[[2011,8,16]],"date-time":"2011-08-16T15:07:31Z","timestamp":1313507251000},"page":"164-170","source":"Crossref","is-referenced-by-count":34,"title":["Diminished regulatory T cells in cutaneous lesions of thymoma-associated multi-organ autoimmunity: a newly described paraneoplastic autoimmune disorder with fatal clinical course"],"prefix":"10.1093","volume":"166","author":[{"given":"T","family":"Hanafusa","sequence":"first","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Azukizawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Kitaba","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Murota","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Umegaki","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Terao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Kochi Medical School, Kochi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Nakagiri","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Osaka University Graduate School of Medicine, Osaka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2011,10,10]]},"reference":[{"key":"2021122708465112900_b1","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/00000478-199502000-00011","article-title":"Graft-versus-host-like colitis associated with malignant thymoma","volume":"19","author":"Kornacki","year":"1995","journal-title":"Am J Surg Pathol"},{"key":"2021122708465112900_b2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1365-2230.1997.tb01098.x","article-title":"Thymoma-associated cutaneous graft-versus-host-like reaction","volume":"22","author":"Holder","year":"1997","journal-title":"Clin Exp 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