蕈样肉芽肿和湿疹中Survivin 和Bcl-xL的表达分析

目的:探讨蕈样肉芽肿、湿疹、正常皮肤中Survivin、Bcl-xL蛋白的表达差异性及其临床意义。方法:运用免疫组织化学法检测30例蕈样肉芽肿、20例湿疹及15例正常人皮肤组织中Survivin、Bcl-xL蛋白的表达情况。结果:蕈样肉芽肿表皮中及真皮中Survivin、Bcl-xL的阳性表达率显著高于湿疹及正常皮肤,差异均有统计学意义(P0.05)。各时期蕈样肉芽肿表皮、真皮中Survivin、Bcl-xL的表达差异有统计学意义(P0.05)。结论:Survivin和Bcl-xL在蕈样肉芽肿中高表达其表达异常在蕈样肉芽肿的发生中起着重要作用,Survivin、Bcl-xL可能作为鉴别诊断蕈样肉芽肿、皮肤炎症性疾病有价值的参考指标。     

蕈样肉芽肿和湿疹中p53, Cox-2 的表达分析

目的:探讨蕈样肉芽肿、湿疹、正常皮肤中p53、Cox-2蛋白的表达差异性及其临床意义。方法:运用免疫组织化学法检测30例蕈样肉芽肿、20例湿疹及15例正常人皮肤组织中p53、Cox-2蛋白的表达情况。结果:蕈样肉芽肿表皮中及真皮中p53、Cox-2的阳性表达率显著高于湿疹及正常皮肤,差异均有统计学意义(P0.05)。各时期蕈样肉芽肿表皮、真皮中p53、Cox-2的表达比较差异均无统计学意义(P0.05)。结论:p53、Cox-2在蕈样肉芽肿和湿疹、正常皮肤的表达有显著差异,提示p53和Cox-2的表达异常在蕈样肉芽肿的发生中起着重要作用,p53、Cox-2可能作为鉴别诊断MF、皮肤炎症性疾病有价值的参考指标。     

巨噬细胞与树突状细胞在正常成人真皮内分布形式的研究

目的观察正常成人真皮内巨噬细胞和树突状细胞的分布、形态学和密度。方法正常人8例,取面部、躯干、四肢近端、四肢远端、手掌和足跖6个部位皮肤,进行纵行与水平切片。CD1a、CD68、OKM5单克隆抗体和FⅩⅢa多克隆抗体染色。结果CD1a和FXⅢa阳性细胞多位于皮肤附属器和血管周围。CD68阳性细胞在真皮浅层呈网状分布,真皮深层密度明显降低。各个部位的OKM5阳性细胞数较少。真皮内各个部位CD68阳性细胞高于相同部位CD1a、FⅩⅢa和OKM5阳性细胞(P<0·0001)。结论在真皮内存在大量的呈网状分布的CD68阳性的单核-巨噬细胞;同时在真皮,特别是浅层,有较多的树突状细胞,如郎格汉斯细胞和真皮树突状细胞,但其数量远低于CD68阳性的单核-巨噬细胞。CD68阳性的单核-巨噬细胞和真皮内的树突状细胞,是真皮内的主要防御细胞。     

蕈样肉芽肿患者皮损及外周血淋巴细胞CD28分子表达的研究

目的探讨CD28分子在蕈样肉芽肿发病机制中的作用。方法15例蕈样肉芽肿病人,分别采用免疫组织化学ABC方法检测皮损组织,流式细胞仪检测外周血淋巴细胞上的CD28分子表达水平。结果免疫组化结果显示蕈样肉芽肿组皮损中CD28表达明显增多,与正常人对照组相比差异均有显著性(t=4.53,P<0.01)。流式细胞仪检测显示MF外周血淋巴细胞上CD28 T淋巴细胞低于正常对照组(t=16.12,P<0.001)。MF外周血CD8 -CD28 T淋巴细胞低于正常对照组(t=4.925,P<0.001)。结论CD28分子在蕈样肉芽肿发病过程中起一定的作用。     

HHV-8与非Kaposi肉瘤组织相关性的初步研究

目的:检测人类疱疹病毒8型(HHV-8)在四种非Kaposi肉瘤皮损组织中的感染情况,以初步探讨HHV-8与皮肤鳞状细胞癌、蕈样肉芽肿、Castleman病和化脓性肉芽肿相关性研究.方法:使用酚-氯仿-异戊醇方法对新疆维吾尔自治区人民医院皮肤性病科、病理科从2004年到2009年收集的30例鳞状细胞癌、20例Castleman病(其中5例为多中性Castleman病)、13例蕈样肉芽肿、20例化脓性肉芽肿石蜡包埋组织进行HHV-8DNA抽提;然后使用巢式PCR方法对抽提的DNA进行ORF26基因片段的扩增,扩增产物在1.5%的琼脂糖凝胶上电泳,并在凝胶成像系统下观察电泳结果,从而确定ORF26基因阳性标本:然后计算HHV-8在各种标本中的阳性率.结果:30例皮肤鳞状细胞癌皮损组织有5份为阳性(16.7%).13例蕈样肉芽肿石蜡组织有1例为阳性(7.7%),20例化脓性肉芽肿和20例Castleman病石蜡组织中均未检出HHV-8.结论:①HHV-8可能是新疆皮肤鳞状细胞癌发病原因之一.②HHV-8与蕈样肉芽肿的发病可能不具有相关性,HHV-8可能是MF发生后偶发的一种附带感染.(③Castleman 病和化脓性肉芽肿的发病可能均与HHV-8无关.     

肥厚性扁平苔藓皮损中浸润淋巴细胞的研究

目的探讨淋巴细胞浸润在肥厚性扁平苔藓发病机制中的意义。方法采用免疫组织化学SP法对10例肥厚性扁平苔藓患者皮损、20例非肥厚性扁平苔藓患者皮损及10例正常人皮肤中CD3、CD4、CD8、CD20进行检测。结果所有患者皮损均以CD3^＋’T、CD4^＋T、CD8^＋T细胞浸润为主,散在CD20^＋B细胞浸润。肥厚性皮损中浸润T淋巴细胞数少于非肥厚性皮损（P〈0．01）,CD20^＋B细胞占浸润淋巴细胞百分率高于非肥厚性皮损（P〈0．05）。正常人皮肤仅在真皮偶见CD3^＋T细胞。结论肥厚性扁平苔藓皮损T淋巴细胞的减少,B淋巴细胞的增多表达可能与疾病的持续存在及局部过度增殖性改变密切相关。     

胆红素对急性肺损伤大鼠肺血管内皮细胞核因子κB,细胞间粘附分子1表达的影响

目的探讨胆红素对急性肺损伤(ALI)的对抗作用及其对肺血管内皮细胞核因子-κB和细胞间粘附分子1表达的影响.方法用雄性Wistar大鼠(200-250g)30只,随机分为正常对照组、ALI动物模型组(用内毒素制造模型)、胆红素干预组.采用原位杂交技术半定量法和免疫组织化学染色测定肺血管内皮细胞中细胞间粘附分子-1(ICAM-1)mRNA和核因子κB (NF-κB)蛋白的表达.结果 (1)ALI模型组肺血管内皮细胞ICAM-1mRNA表达和NF-κB核染色阳性细胞百分比与正常对照组比较显著升高,(P<0.001);(2)胆红素干预组ICAM-1mRNA表达和NF-κB染色阳性细胞百分比与模型组相比明显减低,(P<0.001、P<0.01),但与正常对照组比较仍较高(P<0.05).结论 ICAM-1和NF-κB在ALI显著增加,胆红素可以抑制ALI动物NF-κB和ICAM-1mRNA的表达,可能是其对抗急性肺损伤的作用机制之一.     

CD1a、CD209 及MHCII在新生儿指皮组织中的表达及意义

目的:探讨新生儿指尖皮肤及皮下组织中树突状细胞的形态、数量和分布情况。方法:5例尸检新生儿无名指指皮组织样本,行免疫组织化学染色(CD1a、CD209和MHCⅡ标记),光镜观察。结果:新生儿指皮组织中,阳性细胞呈棕褐色,大小不等、形态多样,有数量不等的突起,呈散在或灶带状分布。CD1a标记的细胞阳性率为(23±11.9)%,多位于表皮乳头周围,血管外膜以及真皮疏松结缔组织中;CD209标记的细胞阳性率为(30±7.7)%,多位于真皮层内,血管神经分叉处,血管外膜,环层小体被囊结缔组织中;MHCⅡ的标记的细胞阳性率(8±1.9)%,多位于血管外膜及周围疏松结缔组织中。结论:稳态下,新生儿皮肤组织中存在多种分化发育程度不同的DCs(且以不成熟DCs为主),是皮肤免疫微环境的重要组成部分。     

表达CD19~+CD56~-的多发性骨髓瘤浆细胞免疫表型的鉴别

目的:研究多发性骨髓瘤患者浆细胞和对照组正常浆细胞免疫表型,有效地识别表达CD19+CD56-的多发性骨髓瘤恶性浆细胞。方法:采用四色流式细胞仪(BD,FACSCalibur)检测44例MM患者浆细胞以及25例健康骨髓捐献者正常浆细胞膜上的抗原表达。采用CellQuest软件分析结果。细胞膜表面抗原表达率大于20%定义为表达阳性。阳性率为表达阳性的患者及健康对照者所占百分比。结果:44例MM患者浆细胞免疫表型表达频率为:CD138+:97.72%(43/44)、CD38+:100%(44/44)、CD56+:63.64%(28/44)、CD19-:84.09%(37/44)、CD200+:77.27%(34/44)、CD28+:38.64%(17/44);25例对照组正常浆细胞免疫表型表达频率为:CD138+:100%(25/25)、CD38+:100%(25/25)、CD56-:100%(25/25)、CD19+:96%(24/25)、CD200+:0%(0/25)、CD28+:0%(0/25)。在44例MM患者中,9%(4/44)患者表达CD19+CD56-,利用CD200检测4例表达CD19+CD56-的患者,有3例患者伴有CD200阳性表达,可与正常浆细胞鉴别。结论:CD200有利于鉴别表达CD19+CD56-MM恶性浆细胞与正常浆细胞。     

DNCB诱导昆明小鼠特应性皮炎模型的建立

目的探索外用1-氯-2,4-二硝基苯(DNCB)经皮肤致敏并激发昆明小鼠特应性皮炎(Atopic Dermititis)模型的方法。方法 10只昆明小鼠随机分成两组(n=5)。用1%DNCB致敏及4%SDS+0.5%DNCB激发模型组小鼠,以丙酮、橄榄油混合溶液致敏并激发对照组小鼠,药物作用部位均为双侧耳朵及背部皮肤。观察小鼠耳朵厚度、组织病理学、免疫学指标,评价皮炎损伤程度。结果外用DNCB可以引起昆明小鼠明显的特应性皮炎样皮损。模型组小鼠出现皮肤干燥、红斑、水肿、糜烂,利用HE染色进行组织病理分析,显示表皮和真皮增厚、过度角质化和炎症细胞浸润。结论先后外用1%DNCB和4%SDS+0.5%DNCB重复刺激昆明小鼠可引起皮肤生理和病理的改变,与AD患者临床表现基本一致,成功建立特应性皮炎模型。可以作为研究AD病因及治疗AD的有效动物模型。     

Image cytometric evaluation of nuclear texture features and DNA content of the reticular form of oral lichen planus

OBJECTIVE: To analyze image cytometric chromatin changes reflected in nuclear texture features and DNA ploidy of oral lichen planus in relation to the normal buccal mucosa and buccal mucosa expressing malignancy-associated changes in cancer patients. STUDY DESIGN: Twenty-eight patients with the reticular form of oral lichen planus, with a follow-up period of 25 years, 50 healthy controls and 50 lung cancer patients were included in the study. Scrapings of buccal mucosa were suspended in transport medium. Monolayer filter preparations were Feulgen-thionin stained. Image cytometric analysis was performed by Cyto-Savant. RESULTS: All oral lichen planus specimens in our study were diploid. In univariate analysis, differences between the normal buccal mucosa and oral lichen planus were found in several nuclear texture features, which gave an 80% correct classification rate in multivariate analysis. In the second part of the study, the classifier that recognizes malignancy-associated changes on the buccal mucosa of patients with lung cancer correctly recognized > 80% of oral lichen planus samples as normal buccal mucosa. CONCLUSION: Our results indicate that chromatin changes in oral lichen planus exist compared to normal cells; however, the chromatin structure of the reticular form of oral lichen planus does not express malignancy-associated changes and is more similar to normal squamous cells.     

Immune Derangements in Patients with Myelofibrosis: The Role of Treg,Th17, and sIL2Rα

Myelofibrosis (MF), including primary myelofibrosis, post-essential thrombocythemia MF, and post-polycythemia vera MF, has been reported to be associated with autoimmune phenomena. IMiDs have been reported to be effective in some patients with MF, presumably for their immune-modulator effects. We therefore sought to elucidate the immune derangements in patients with MF. We found no differences in T regulatory cells (Treg) and T helper 17 (Th17) cells in MF patients and normal healthy controls. However, we found significantly elevated soluble interleukin 2 alpha (sIL2Rα) in MF patients compared to those with other myeloproliferative neoplasm diseases and normal healthy controls. Our studies with MF patients further revealed that Treg cells were the predominant cells producing sIL2Rα. sIL2Rα and IL2 complex induced the formation of Treg cells but not the formation of Th1 or Th17 cells. sIL2Rα induced CD8⁺ T cell proliferation in the presence of Treg cells. Monocytes or neutrophils had no effect on the production of sIL2Rα by Treg cells. Furthermore, we found plasma sIL2Rα levels were correlated to the auto-immune serology in MPN patients and ruxolitinib significantly inhibits the sIL2Rα production by the Treg cells in MF patients which may explain the effects of ruxolitinib on the relief of constitutional symptoms. All these findings suggest that sIL2Rα likely plays a significant role in autoimmune phenomena seen in patients with MF. Further studies of immune derangement may elucidate the mechanism of IMiD, and exploration of immune modulators may prove to be important for treating myelofibrosis.     

Biochemical Changes Observed After PUVA Versus PUVA Plus Methotrexate Therapy in Mycosis Fungoides Using Synchrotron Infrared Microspectroscopy

Mycosis fungoides (MF) is the most common type of cutaneous T cell lymphoma in which the distinction between early stage MF and other inflammatory dermatosis remains difficult. Twenty patients of early stage MF and nine patients with psoriasis and lichen planus were included in this study. Ten MF patients were treated with psoralen plus UVA (PUVA) and the other 10 MF patients were treated with PUVA plus methotrexate (MTX) until complete clinical remission. Synchrotron infrared microspectroscopy (SIRM) found that MF lesions were biochemically different compared to inflammatory diseases. After treating MF with either therapeutic modality, the lymphocytic count decreased significantly in both the epidermis and dermis (P < 0.001) but no biochemical changes were observed in the remaining lymphocytes after treatment, indicating the disease process was slowed by treatment but not eradicated. In conclusion SIRM is a promising method for distinguishing MF from other inflammatory diseases such as psoriasis and lichen planus. A significant reduction in lymphocyte count indicated that PUVA therapy is an effective treatment for early stage MF, and MTX could be reserved for more advanced cases that are not PUVA responsive. However, SIRM evidence of persistent disease suggests that maintenance therapy is recommended after clinical remission.     

Lichen planus and liver diseases: a multicentre case-control study. Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).

OBJECTIVE--To assess the association of lichen planus with liver complaints and with known aetiological factors of liver diseases. DESIGN--Multicentre case-control study. Interviews were conducted by trained medical investigators on the basis of a structured questionnaire. At the interview patients and controls were asked for consent to blood samples being taken to determine transaminase activities and the presence of hepatitis B virus surface antigen. SETTING--Outpatient departments of 27 Italian general and teaching hospitals that were collaborating in the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED). SUBJECTS--Incident cases and controls were eligible. A total of 577 patients with lichen planus and 1031 controls with dermatological diseases other than lichen planus were interviewed. Less than 1% of the people contacted refused to participate. Patients and controls were matched for sex and age in five year intervals. RESULTS--The risk of lichen planus was higher in patients with a history of liver diseases requiring hospital admission or specialist consultation (relative risk = 1.6; 95% confidence interval = 1.2 to 2.2), those who had had liver biopsy (5.5; 1.9 to 15.6), and those with a history of viral hepatitis (1.9; 1.1 to 3.1). High activities of liver enzymes and positive results of tests for hepatitis B virus surface antigen were also associated with lichen planus. The association with alcohol consumption was not clearly confirmed by a dose-risk relation. CONCLUSION--This study adds quantitative epidemiological evidence to the clinical observation that liver disease is a risk factor for lichen planus although not a specific marker of it.     

Immunohistological characterization of leukocytes in the lungs of healthy mice and after bacterial intratracheal infection

Leukocytes in the peripheral lung parenchyma of mice have not been characterized histologically during bacterial infection. The aim of this study was to investigate (a) the immunohistological characteristics of healthy murine lungs and (b) the cell kinetics during acute inflammation. BALB/c and MF1 mice were examined; as well as transgenic mice with the gene defect of cystic fibrosis (CF) in the airways as an animal model for this disease. MF1 mice served as controls for the transgenic animals. Lavaged and perfused lungs were snap frozen. B and T lymphocytes, CD4+ and CD8+ cells, dendritic cells, neutrophils and a subset of macrophages were enumerated on cryostat lung sections. The lung tissue and bronchoalveolar lavage (BAL) of BALB/c mice, infected intratracheally with Haemophilus influenzae type b (Hib), were studied at different time points after infection. In the lungs of healthy mice, including CF mice, the largest population was that of T cells, CD4+ cells being always more frequent than CD8+ cells. During acute inflammation the number of neutrophils in the lung parenchyma and BAL increased strongly within the first hours after bacterial instillation and reached baseline levels within one week. This study provides a semi-quantitative analysis of immunocompetent cells in normal and infected murine lung tissue. Differences in cell numbers are found between different strains. Moreover, the cellular reaction during Hib infection in mouse lungs is dominated by neutrophils, as expected in a primary immune response. In uninfected CF mice the numbers and distribution of immune cells in the lung tissue are normal, indicating that the cellular defense is adequate.     

Analysis of oral microbial community and Th17‐associated cytokines in saliva of patients with oral lichen planus

Oral lichen planus (OLP) is a chronic inflammatory disorder of oral mucosa of unknown cause. Microbial infection and dysimmunity appear to play important roles in its pathogenesis. In this study, differences in genetic profiling of salivary microbial communities in two subtypes of OLP and healthy controls were evaluated by means of PCR‐denaturing gradient gel electrophoresis (DGGE). Additionally, ELISA was used to investigate the possible role of Th17 in lesion formation by detecting two related cytokines IL‐17 and IL‐23 in the saliva of OLP patients. When the DGGE profiles were analyzed, the bacterial populations were found to be significantly less rich in subjects with reticular and erosive OLP than in healthy controls. There was significantly less microbial diversity, as denoted by the Shannon index, in saliva samples from subjects with erosive OLP than in those from healthy controls. Cluster analysis and principal component analysis showed that the DGGE profiles formed distinctly group‐specific clusters. Salivary concentrations of IL‐17 in subjects with erosive OLP group were significantly higher than in those with reticular OLP and healthy controls. What's more, significantly positive correlations were observed between salivary IL‐17 concentrations and disease clinical scores. Microbial richness and diversity was negatively correlated with salivary IL‐17 concentrations. These results suggest there is significantly less salivary bacterial diversity and complexity in subjects with OLP han in healthy controls and that the shifted community composition is closely related to an immune cytokine, IL‐17.     

IL-15 and the initiation of cell contact-dependent synovial fibroblast-T lymphocyte cross-talk in rheumatoid arthritis: effect of methotrexate

To characterize the molecules responsible for synovial fibroblast-T lymphocyte (TL) cross-talk in rheumatoid arthritis (RA), synovial fibroblasts from patients with established RA (RASFibs) were cocultured with TLs from peripheral blood of early RA patients (RAPBTL). TLs from peripheral blood of healthy controls and from synovial fluid of RA served as controls. Adhesion molecules and cytokines were determined by flow cytometry, ELISA, and real-time PCR. RAPBTL (n = 20) induced an up-regulation of ICAM-1, intracellular IL-8, IL-6, IL-15, and surface IL-15 in cocultured RASFibs. In turn, RAPBTL showed an up-regulation of TNF-alpha, IFN-gamma, IL-17, CD25, and CD69 expression. Responses seen with TLs from peripheral blood of healthy controls (n = 20) were significantly lower, whereas responses with TLs from synovial fluid of RA (n = 20) were maximal. Blocking Abs to IL-15 and CD54, but not an isotype-control Ab, down-regulated the increased TL cytokine and activation marker expression. Abs to CD69, CD11a, IL-17, TNF-alpha, and IFN-gamma significantly decreased the up-regulation of RASFib cytokine and CD54 expression. Cocultures using 0.4- micro m inserts did not result in up-regulation of surface molecules or cytokines. Methotrexate significantly inhibited RASFib/TL cross-talk signals and decreased adhesion of TL to RASFibs. In summary, RASFib production of IL-15 induces the proinflammatory cytokines TNF-alpha, IFN-gamma, and IL-17 in cocultured TLs through a cell contact-dependent mechanism. In turn, these cytokines stimulate the expression of IL-15, IL-8, and IL-6 in RASFibs, thereby creating a feedback loop that favors persistent synovial inflammation. Methotrexate seems to disrupt this loop by decreasing cell adhesion.     

Candida biotypes in patients with oral leukoplakia and lichen planus

Prevalence of yeasts in 35 leukoplakia and 34 oral lichen planus patients was compared with that observed in persons without oral diseases. Serotype and morphotype were determined on Candida albicans isolates. Yeasts were isolated from the oral cavity specimens of 43.7% of the patients. C. albicans (serotype A) was the predominant species (76% in leukoplakia, 88.2% in lichen planus and 60.8% in healthy persons). Sixteen morphotypes were encountered on malt extract agar, being 732, 733, 734, 753 and 754 the most frequently found. Morphotypes SP1N and SP1Y were the most common on Sabouraud-trypheniltetrazolium agar (68.4% of the isolates from leukoplakia and 73.3% from lichen planus, but only 46.6% of the isolates from healthy oral mucosa showed SP1N morphotype). Presence of oral lesions was associated with a marked reduction in the yeast species and C. albicans biotypes, suggesting that C. albicans and particularly some of its biotypes, show a high potential of adaptation to the changes associated with the development of oral leukoplakia and lichen planus.