血清中抗酪氨酸酶抗体的检测与白癜风活动性的关系

目的：探讨白癜风患者血清中抗酪氦酸酶IgG、IgM抗体滴度与疾病活动程度的关系和意义。方法：抗酪氯酸酶IgG、IgM抗体检测采用酶联免疫吸附试验（ELISA）方法。结果：①白癜风患者血清抗酪氨酸酶IgG抗体、平均滴度为0．316，显著高于正常对照组0．082（P〈0．001）；抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常对照组0．065（P〈0．001），②活动期白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期白癫风患者（均P〈0.001）；泛发型白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于局限型白癜风患者（均P〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IGg抗体性呈正相关（均P〈0．001）；抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgM抗体阳性呈正相关（均P〈0．001）。①糖皮质激素治疗后患者抗酪氨酸酶IgG、IgM抗体滴度均低于治疗前（均P〈0．001）。结论：白癜风患并血清抗酪氨酸酶IgG、IgM抗体与疾病活动性和严重程度相关。     

甲氧沙林脂质体对小鼠黑素瘤细胞黑素生成影响的研究

目的:探讨甲氧沙林脂质体(8-MOPL)对小鼠B16F黑素瘤细胞增殖、黑素含量、酪氨酸酶活性的影响。方法:采用体外培养的小鼠B16F黑素瘤细胞株,以等浓度的甲氧沙林(8-MOP)为对照,用四甲基偶氮唑蓝(MTT)法测定细胞增殖情况;NaOH裂解法测定黑素合成;多巴氧化法测定酪氨酸酶活性。结果:与等浓度8-MOP相比,低浓度8-MOPL(10-25μmol/L)能显著提高酪氨酸酶活性和黑素含量(P<0.05)。高浓度8-MOPL(100-200μmol/L)对细胞的抑制作用更显著(P<0.05)。结论:用脂质体作为8-MOP的载体可以显著提高8-MOP对靶细胞的作用,为8-MOPL制剂治疗白癜风的临床应用提供了实验依据。     

中国北方汉族泛发型白癜风与HLA-DRB1等位基因的相关

目的:探讨HLA-DRB1等位基因与中国北方汉族泛发型白癜风的相关性。方法:采用聚合酶链反应-序列特异引物(PCR-SSP)技术检测34例北方汉族泛发型白癜风患者的HLA-DRB1等位基因。结果:与262例正常对照组相比较,泛发型白癜风患者HLA-DRB1*0701/02、DRB1*1201/02基因频率显著增高(Pc<0.0001),HLA-DRB1*0901、DRB1*11基因频率降低(但经校正后Pc>0.05);有明确家族史的患者HLA-DRB1*1201/02基因频率显著增高(Pc<0.0001);无家族史者HLA-DRB1*0701/02基因频率显著升高(Pc<0.0001),DRB1*1201/02基因频率显著增高(经校正后Pc>0.05),DRB1*0901基因频率降低(经校正后Pc>0.05)。结论:中国北方汉族人群,HLA-DRB1*0701/02、DRB1*1201/02等位基因可能与泛发型白癜风的发病有关,而DRB1*0901、DRB1*11等位基因可能是防止其发病的“保护因子”,为进一步揭示泛发型白癜风的易感基因及免疫遗传发病机制提供线索。     

白癜风患者血浆和皮肤组织液内皮素1的测定

目的了解白癜风患者血浆和皮肤组织液内皮素1(ET-1)水平,并讨论其临床意义。方法采用放射免疫方法对30例白癜风患者和12例健康体检者血浆中ET-1水平进行测定,以及对20例稳定期白癜风白斑部位和对侧部位非白斑的皮肤组织液中ET-1水平进行测定。结果患者白斑部位皮肤组织液ET-1值明显低于非白斑部位(P<0.01);白癜风患者血浆ET-1水平与正常人群差异无显著性(P>0.05)。结论在白癜风色素恢复过程中不仅受黑素细胞存在与否的影响,还与邻近角质形成细胞ET-1分泌功能异常有关。     

先天性巨大色素痣并发白癜风1例

患者女，17岁。出生时即发现躯干有大片黑褐色素片，6年前开始全身出现散在色素脱失斑，苏木糖－伊红（HE）染色可见黑斑区真皮内散在和呈巢状分布的痣细胞，S－100和HMB45染色阳性。超微结构观察痣细胞内存在单个或复合黑素小体。白斑区皮扶表皮明显缺少黑素细胞。黑斑和白斑交界处未见朗格汉斯细胞。     

白癜风相关黑素细胞膜抗原VIT150、VIT90、VIT75纯化及分析

目的：纯化和分析白癜风相关的黑素细胞膜抗原，为蛋白质微量测序及筛选、克隆黑素细胞膜抗原打下基础。方法：培养高纯度的正常人黑素细胞，活细胞ELISA法和蛋白免疫印迹法(Western blot)检测并筛选抗黑素细胞的高滴度IgG抗体血清，生物素标记可溶性黑素细胞膜抗原，加入筛选血清与蛋白A-琼脂糖凝胶(protein A-sepharose)进行免疫共沉淀．沉淀后的抗原抗体复合物行平极电泳及电转印，碱性磷酸酶标记的亲合素进行化学发光法检测及鉴定。结果：活细胞ELISA法和Western blot检测结果中共筛选了10例白癜风患者高滴度IgG血清，免疫沉淀、免疫印迹、化学发光法检测后发现10例患者均有阳性条带，其抗原相对分子质量为150000、90000、75000、60000。结论：白癜风患者血清中存在抗黑素细胞膜抗原的自身抗体，抗原相对分子质量主要为150000、90000、75000，通过免疫共沉淀初步纯化了150000、90000和75000抗原。     

Transplant of cultured autologous pure melanocytes after laser-abrasion for the treatment of segmental vitiligo

Segmental vitiligo is a special type of vitiligo with unilateral distribution of lesions and has a stable course. Clinically, many patients with segmental vitiligo have unsatisfactory responses to topical corticosteroid or UV phototherapy. We have developed a technique for the isolation of melanocytes from a small specimen of normally pigmented skin obtained via a suction blister. The melanocytes can be proliferated in culture and then replanted onto laser-abrased vitiliginous areas. We used this procedure to treat 25 patients with segmental vitiligo that were refractory to medical therapy. The repigmented portion of the total treated area amounted to 95-100% in 21 patients and 65 to 94% in 4 patients. The response rate to treatment was 100% in this study. No scarring or other side-effects developed. The results of this study demonstrate that this method is a valuable tool for the treatment of patients with segmental vitiligo.     

Role of macrophage infiltration in successful repigmentation in a new periphery‐spreading vitiligo lesion in a male Japanese patient

Vitiligo is an acquired disorder in which depigmented macules result from mostly autoimmune loss of melanocytes. The initiating process in vitiligo has still been uncertain. Here, we report the case of a 19‐year‐old man with undetermined/unclassified vitiligo with a new periphery‐spreading vitiligo lesion on the right dorsal hand after rigorous sun exposure. Histopathological evaluation showed noticeable infiltration of CD68⁺ macrophages, moderate infiltration of CD3⁺ T cells, little infiltration of CD8⁺ T cells and CD11c⁺ myeloid dendritic cells, HMB45/CD11c double‐positive cells, and Melan‐A/MART1⁺ deposits in the dermis. We surmised that melanocyte‐derived deposits were mostly phagocytosed by CD68⁺ macrophages and were faintly phagocytosed by CD11c⁺ myeloid dendritic cells, referring distribution of CD68⁺ mononuclear cells and melanocyte biomarkers. Complete repigmentation was achieved following topical application of hydrocortisone butyrate propionate 0.1% ointment. We summarize that prompt clearance of debris by macrophages would be essential to an excellent prognosis of complete repigmentation.     

Linkage and association of HLA class II genes with vitiligo in a Dutch population

BACKGROUND: Serological typing of HLA has shown discrepancies in HLA associations with vitiligo in different ethnic populations. OBJECTIVES: To perform genotyping of HLA class II genes on a Dutch vitiligo population in order clearly to identify susceptible and protective HLA alleles in vitiligo. METHODS: HLA typing was carried out by amplifying genomic DNA by polymerase chain reaction (PCR) followed by dot-blot hybridization with sequence-specific oligonucleotides (SSO). Fifty Dutch vitiligo probands, and their parents (150 individuals) and 204 healthy controls were studied. RESULTS: Family-based case-control association studies and linkage disequilibrium analysis showed the linkage and association of DRB4*0101 allele with vitiligo (P(c) = 0.0016, relative risk = 2.21). The family-based association study also provided evidence for linkage and association of DQB1*0303 allele with vitiligo (chi(2) = 7.36, P = 0.006). We measured the clinical relevance of the test by calculating the prevalence corrected positive predictive values (PcPPV). The PcPPV of disease for the DRB4*0101 allele was 0.017 and for the DRB4*0101/0101 genotype was 0.0358. In other words, a DRB4*0101/0101 genotype carries a 3.58% risk of developing vitiligo. CONCLUSIONS: Both DRB4*0101 and DQB1*0303 alleles provide significant susceptibility for vitiligo.