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 themore traditionalmanual quantification (MQ) and semiquantitative analysis (SQA). The number of CD3+T cells and the expression of E-selectin were evaluated in stained paired skin biopsie s 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 (epiderm is: r=0.88, P ≤0.01, dermis r=0.87, P ≤0.01). Both DIA and MQ were equally eff ective in detecting reductions of T-cell numbers in active-treated patients. M Q took 20 h, compared to 6 h for DIA.We also observed significant correlations b etween SQA and DIA for the expression of E-selectin (r=0.88, P ≤0.01), althoug h DIA was more sensitive than SQA to detect (early) changes. SQA took 10 h, comp ared to 4 h for DIA. In conclusion, the quantification of the inflammatory infil trate in psoriatic lesional skin by DIA generated similar results as MQ and SQA in a reliable, reproducible and higher time efficient fashion.
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