多烯康治疗Zumbusch型脓疱性银屑病2例

多烯康治疗Ｚｕｍｂｕｓｃｈ型脓疱性银屑病２例吴保昌Ｚｕｍｂｕｓｃｈ型脓疱性银屑病，临床症状较重，偶可死亡［１］。治疗方法甚多，但副作用小、安全而有效的药物少。近我院收治２例，应用多烯康治疗获良效，兹报告如下。１临床资料例１，田×，女，６岁，患者因全身...     

白癜风患者外周血T淋巴细胞亚群和sIL-2R水平变化的研究

采用ＡＰＡＡＰ法和双缺本夹心ＥＬＩＳＡ技术检测１５０例白癜风患者外周血Ｔ淋巴细胞亚群及可溶性白介素－２受体（ｓＩＬ－２Ｒ）水平。结果显示：（１）寻常型白癜风外周血ＣＤ３＾＋、ＣＤ４＾＋细胞数、ＣＤ４＾＋／ＣＤ８＾＋比值明显低于正常对照（Ｐ〈０．０１）,ｓＩＬ－２Ｒ活性显著性高于节段型白癜风和正常人（Ｐ〈０．０１）;节段型白癜风ＣＤ４＾＋、ＣＤ４＾＋／ＣＤ８＾＋与正常对照组比较也显著减少（Ｐ〈０．０     

异位性皮炎皮损中单一核细胞CD4及TH2型细胞特征因子表达

为了探讨Ｔ细胞尤其是ＴＨ细胞在异位性皮炎（ＡＤ）免疫发病机制中的意义，采用免疫组化法检测８例ＡＤ急性期皮损单一核细胞ＣＤ４、ＣＤ８、ＣＤ４５ＲＯ、ＣＤ２０免疫表型和ＩＬ４，ＩＦＮγ表达。结果：ＡＤ急性期皮损单一核细胞大多数呈ＣＤ４或ＣＤ４５ＲＯ表型，少数呈ＣＤ８表型，无ＣＤ２０表型，ＩＬ４蛋白表达阳性，ＩＦＮγ蛋白表达阴性。ＡＤ急性期皮损单一核细胞大多数为ＣＤ４＋Ｔ细胞，且呈ＴＨ２细胞亚型，提示ＡＤ皮肤炎症反应可能是由ＴＨ２细胞介导的皮肤免疫炎症反应，称之为Ⅱ型迟发型超敏反应（ＤＴＨ２）。     

色素障碍性皮肤病

２００１１１３２白癜风患者外周血Ｔ淋巴细胞亚群和ｓＩＬ－２Ｒ水平变化的研究／汪新义（山东省皮防所）…／／临床皮肤科杂志．－２０００，２９（５）．－２５８～２６０ 采用 ＡＰＡＡＰ法和双抗体夹心 ＥＬＩＳＡ法，对１５０例自癜风患者外周血Ｔ淋巴细胞亚群和可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）进行了检测。结果显示寻常型白癜风ＣＤ３＋、ＣＤ４＋细胞数和ＣＤ４＋／ＣＤ８＋比值均显著低于正常对照（Ｐ＜０．０１），ｓＩＬ－２Ｒ活性明显高于节段型白癜风和正常人（Ｐ＜０．００１，Ｐ＜０．０１）；节段型自癜风ＣＤ３…     

周期素依赖性激酶4,视网膜母细胞瘤蛋白在银屑病皮损中的表达

周期素依赖性激酶４、视网膜母细胞瘤蛋白在银屑病皮损中的表达陆前进①卢放根②文海泉①颜兰香①张其亮①张桂英①余桂英①周期素依赖性激酶４（ｃｙｃｌｉｎ－ｄｅｐｅｎｄｅｎｔｋｉｎａｓｅＣＤＫ４）是细胞周期因子依赖性激酶家族（ＣＤＫｓ）中的一员，ＲＢ蛋白是视...     

银屑病家系与HLA致病单倍型研究

报告２３个多发银屑病家系及５９例无亲缘关系银屑病患者ＨＬＡ抗原频率分布。其增高的抗原为ＨＬＡ－Ａ１９，Ｂ１３、ＤＲ７（Ｐｃ＜０．００１），降低的抗原为ＨＬＡ－Ｃ７，ＤＱ１，（Ｐｃ＜０．００１），提示具有（Ｃｗ（Ｃ７）者对银屑病的发生具有某种防护作用。２３个家系中，健康同胞５５例，其中２０例与患病同胞有一条或两条单倍型相同，经６～８年观察，４例已发病；另３５例无相同单倍型者，未发病。提示对银屑病家系检测ＨＬＡ单倍型有助于对具有致病单倍型的健康同胞的临床监测。     

药物反应

２００１０９６０发疹型药疹皮损内浸润淋巴细胞类型和亚类的检测／段昕所（承德医学院附院皮肤科）…／／中华皮肤科杂志．－２０００，３３（５）．－３５８ 对３４例皮损进行了淋巴细胞类型及亚类的免疫组化研究。结果浸润的淋巴细胞以Ｔ淋巴细胞为主，ＣＤ４＋淋巴细胞为最多，ＣＤ８＋淋巴细胞少，在皮损组织中ＣＤ４＋／ＣＤ８＋约为（３～４）／１。参３（张孝友）２００１０９６１大疱性表皮松解坏死型药物疹的临床研究／甘才斌（河南新乡市中心医院）…／／新乡医学院学报．－２０００，１７（４）．－２６１～２６３ 对３１例的临…     

梅毒患者外周血T淋巴细胞亚群的检测及临床意义

目的：了解梅毒患者的细胞免疫功能状态及使用免疫调节剂治疗对它的影响。方法：应用流式细胞仪检测了４４例梅毒患者外周血的ＣＤ３＾＋、ＣＤ４＾＋、ＣＤ８＾＋及ＣＤ４＾＋／ＣＤ８＾＋比值。结果：梅毒患者外周血ＣＤ４＾＋及ＣＤ４＾＋／ＣＤ８＾＋比值明显低于正常对照组,而ＣＤ８＾＋则显著高于正常人对照组（Ｐ〈０．０１）,活动期梅毒外周血ＣＤ４＾＋／ＣＤ８＾＋比值低于恢复期（Ｐ〈０．０５）,单纯使用抗梅毒治疗的     

尖锐湿疣患者外周血单个核细胞表型的研究

用碱性磷酸酶抗碱性磷酸酶法对３４例不同病期尖锐湿疣患者、２０例健康人外周血单个核细胞表型的检测表明：２０例反复发作的长病程患者细胞比例增高，活化抗原（ＣＤ２５、ＴＬｉｓＡ１、ｌａ）表达细胞增多，ＣＤ４／ＣＤ８比值下降．在局部治愈后２～３个月，对其中７例的检测发现，增高的及活化细胞较治疗前降低．７例短病程患者各种分化抗原、活化抗原表达细胞与正常人无差异。提示细胞免疫异常是尖锐湿疣反复发作的一个重要因素．     

单双标记技术对T细胞亚群测定的影响

目的 探讨单、双标记技术对Ｔ细胞亚群测定的影响。方法 采用荧光抗体双标记、流式细胞仪对正常４人外周血细胞进行测定。结果 ＣＤ３＾＋ＣＤ４＾＋与ＣＤ４＾＋细胞比较，差异无显著性意义，ＣＤ３＾＋ＣＤ８＾＋与ＣＤ８＾＋比较，有显著性差异（Ｐ〈０．０５），ＣＤ３＾＋ＣＤ４＾＋／ＣＤ３＾＋ＣＤ８＾＋与ＣＤ８＾＋比较，差异有显著性意义（Ｐ〈０．０５）。结论 检测Ｔ细胞亚群应采用双标记技术。     

Immunohistochemical features of cutaneous granulomas in primary immunodeficiency disorders: a comparison with cutaneous sarcoidosis

Background:  Cutaneous granulomas can occur in patients with a primary immunodeficiency disorder. In some cases, an infectious cause cannot be revealed. The pathogenesis of these granulomas still remains to be elucidated. The aim of this study was to study differences or overlap between these rare granulomas and sarcoidosis-related granulomas.
Methods:  Markers for T-cell subsets (CD3, CD4, CD8 and CD45RO), Langerhans' cells (CD1a), macrophages (CD68), B cells (CD20) and NK cells (CD56) were stained immunohistochemically. The amount of CD4+ and CD8+ cells in the granulomas was counted. Results were compared with the CD4+/CD8+ ratio in peripheral blood.
Results:  In the granulomas of two of three patients with a primary immunodeficiency disorder, the cytotoxic T cells (CD8+) outnumbered the T-helper cells (CD4+) with a counted CD4+/CD8+ ratio <<1. In contrast, the granulomas in the cutaneous sarcoidosis patients showed a predominance of CD4+ cells, with CD4+/CD8+ ratios >2.
Conclusions:  A lower CD4+/CD8+ ratio was found in the cutaneous granulomas of patients with a primary immunodeficiency disorder (unclassified combined immunodeficiency, autoimmune lymphoproliferative syndrome and ataxia teleangiectasia) as compared with the patients with cutaneous sarcoidosis. The possible implications of these findings are discussed in this paper.     

长期抗病毒治疗的艾滋病患者CD4^+/CD8^+比值影响因素分析

目的探讨艾滋病患者抗病毒治疗后影响CD4^+/CD8^+比值恢复的因素。方法回顾性分析455例患者的基线及随访资料,观察期60个月,对60个月时CD4^+ T细胞数大于350/μL的患者,用Logistic回归分析影响其CD4^+/CD8^+比值恢复的影响因素,同时分析基线CD4^+/CD8^+、CD4^+T细胞数的差异。结果治疗60个月,影响CD4^+ T细胞数大于350/μL的患者CD4^+/CD8^+比值恢复的独立危险因素为年龄、基线CD4^+ T细胞数小于100/μL、基线CD8^+ T细胞数。CD4^+ T细胞数大于350/μL组,与CD4^+ T细胞数小于350/μL组,基线CD4^+/CD8^+比值比较差异有统计学意义(P=0.00),基线CD4^+ T细胞数比较差异有统计学意义(P=0.00)。结论抗病毒治疗可改善CD4^+/CD8^+比值,治疗时间越早,长期治疗后免疫功能恢复情况越好。但高龄、低CD4^+ T细胞数、高CD8^+ T细胞数是长期治疗的HIV/AIDS患者免疫功能重建的影响因素。     

淋巴细胞活化在系统性红斑狼疮发病中的意义

目的 :　探讨系统性红斑狼疮 (SLE)患者外周血淋巴细胞HLA -DR以及植物凝集素 (PHA)刺激下的CD3+ CD4 + 、CD3+ CD8+ 、CD19+ 淋巴细胞的早期活化标志CD6 9的表达。方法 :　应用三色荧光标记流式细胞术检测活动期和非活动期SLE患者外周血CD3+ 、CD3+ CD4 + 、CD3+ CD8+ 淋巴细胞晚期活化标志HLA -DR以及在PHA刺激 4h后CD3+ CD4 + 、CD3+ CD8+ 、CD19+ 淋巴细胞的早期活化标志CD6 9的表达。结果 :　①PHA刺激 4小时后 ,活动期SLECD3+ CD4 + 、CD3+ CD8+ 细胞CD6 9的表达明显低于正常对照组 (P <0 .0 5 ) ;而非活动期SLE与正常对照组之间CD6 9表达无显著性差异 (P >0 .0 5 )。②PHA刺激前SLE活动组CD19+ 细胞表达CD6 9较正常对照组和SLE非活动期明显升高 (P <0 .0 5 ) ,PHA刺激 4小时后 ,活动期SLECD19+ 细胞表达CD6 9低于正常对照组和非活动期SLE ,存在显著性差异 (P <0 .0 5 ) ,而非活动期SLE与正常对照组之间CD19+ CD6 9+ 表达无明显差异 (P >0 .0 5 )。③活动期SLECD3+ HLA -DR+细胞明显高于正常对照组 (P <0 .0 1)和非活动期SLE(P <0 .0 1) ,CD3+ CD4 + HLA -DR+ 细胞、CD3+ CD8+HLA -DR+ 细胞明显高于正常对照组 (P <0 .0 5 ) ,而非活动期SLE与正常对照组之间 ,HLA -DR表达无显著性差异 (P >0 .0 5     

慢性荨麻疹患者外周血中CD8~+CD28~-T细胞检测结果分析

目的:探讨CD8~+CD28~-T细胞在慢性荨麻疹患者致病机制中的作用。方法:收集临床慢性荨麻疹(CU)病例83例,同时设立对照组64例进行比较。应用ELISA法检测研究对象血清中抗Ig E抗体、抗FcεRⅠ抗体浓度,流式细胞仪检测外周血中CD3~+、CD4~+、CD8~+、CD8~+CD28~-、CD4~+CD25~+T细胞比例,分析检测结果。结果:83名CU中,23例抗Ig E抗体为阳性,占27.7%(27/83);31例抗FcεRⅠ抗体为阳性,占37.3%(31/83)。CU患者外周血CD8~+T细胞比例、CD8~+CD28~-T细胞比例低于正常对照组(P0.05),CD4~+/CD8~+比值、CD4~+CD25~+T细胞比例均高于对照组(P0.05)。结论:CU患者机体外周血CD8~+CD28~-T细胞、CD4~+CD25~+T细胞比例与对照组相比存在差异,CD8~+CD28~-T细胞比例降低也可能是CU致病机制之一。     

尖锐湿疣患者HPV感染与细胞免疫功能的相关性

目的研究尖锐湿疣初发、复发患者之间,以及不同病程患者之间T淋巴细胞亚群的表达情况。方法选择56例尖锐湿疣患者,经冷冻治疗后至疣体消失后随访3个月,未复发者计入A组(20例),再次复发者计入B组(36例),应用三色荧光抗体染色法检测各组患者外周血CD4+,CD8+T淋巴细胞的表达,比较A,B两组CD4+,CD8+T细胞百分率及CD4+/CD8+比值的差异,并与正常对照组进行比较。同时根据病程长短,病程<3个月者计入C组(37例),病程≥3个月者计入D组(19例),比较C,D两组CD4+,CD8+T细胞百分率及CD4+/CD8+比值的差异,并与正常对照组进行比较。结果①初发及复发患者组T淋巴细胞亚群的变化:A组CD4+,CD8+T细胞百分率及CD4+/CD8+比值分别为(34.61±4.98)%,(29.46±4.56)%和(1.20±0.22),B组分别为(30.33±4.84)%,(33.10±5.90)%和(0.94±0.21),正常对照组分别为(39.58±4.31)%,(25.44±3.54)%和(1.57±0.17),与正常对照组相比,A,B两组CD4+细胞百分率及CD4+/CD8+比值明显降低,CD8+T细胞百分率明显升高,差异有统计学意义(P<0.05),且B组变化更为明显,与A组差异有统计学意义(P<0.05);②不同病程患者组T淋巴细胞亚群的变化:C组CD4+,CD8+T细胞百分率及CD4+/CD8+比值分别为(33.03±4.51)%,(30.60±5.36)%和(1.11±0.23),D组分别为(29.57±5.98)%,(34.12±5.73)%和(0.89±0.22),C,D两组与正常对照组相比,CD4+细胞百分率及CD4+/CD8+比值明显降低,CD8+T细胞百分率明显升高,差异有统计学意义(P<0.01),且D组变化更为明显,与C组差异有统计学意义(P<0.05)。结论与正常对照组比较,尖锐湿疣患者存在细胞免疫功能降低,且随着病程延长、病情反复,全身细胞免疫功能降低更为明显,导致CA迁延不愈。     

Increased circulating skin-homing cutaneous lymphocyte-associated antigen (CLA)+ type 2 cytokine-producing cells, and decreased CLA+ type 1 cytokine-producing cells in atopic dermatitis

BACKGROUND: Skin-homing T cells are characterized by expression of cutaneous lymphocyte-associated antigen (CLA). Few data are available on the frequency of circulating CLA+ cytokine-producing T cells in atopic dermatitis (AD) patients. OBJECTIVES: We aimed to investigate cytokine synthesis capability vs. CLA expression in phorbol myristate acetate and ionomycin-stimulated, secretion-inhibited peripheral blood T cells of AD patients compared with healthy subjects and psoriatic patients. METHODS: Multiparameter flow cytometry was used. RESULTS: The expression of CLA among CD4+ T cells was significantly elevated in AD patients compared with healthy subjects and psoriatic patients, whereas there was no significant difference between each group in CLA expression among CD8+ T cells. The frequency of interleukin (IL)-4- and IL-13-producing cells in AD patients was significantly higher than in healthy subjects (in both CD4+ and CD8+ T-cell subsets) and psoriatic patients (in CD4+ T cells). In contrast, the frequency of interferon (IFN)-gamma-producing cells was significantly reduced in AD patients, among both CD4+ and CD8+ T cells, compared with healthy subjects and psoriatic patients. Moreover, in AD patients, the frequency of IL-4- and IL-13-producing cells was remarkably increased among the CLA+ subset (in both CD4+ and CD8+ T cells), whereas the frequency of IFN-gamma-producing cells was decreased in the CLA+ subset (in CD4+, but not in CD8+ T cells). CONCLUSIONS: These results provide evidence for the expansion of skin-homing type 2 cytokine-secreting T cells, associated with a reduction in skin-homing type 1 cytokine-producing T cells, in peripheral blood of AD patients.     

Soluble CD4 and CD8 in serum from patients with localized scleroderma

Localized scleroderma has been shown to be accompanied by various immunologic abnormalities. To obtain functional information on activated CD4+ or CD8+ T cells, we studied the levels of soluble CD4 (sCD4) and soluble CD8 (sCD8) in serum from patients with localized scleroderma. Serum samples were examined by enzyme-linked immunosorbent assay. The samples were obtained from 49 patients in the following three subgroups: 15 patients with generalized morphea, 22 with linear scleroderma, and 12 with morphea. The levels of sCD4 and sCD8 were significantly elevated in patients with generalized morphea. Furthermore, these patients showed significantly higher levels of sCD4 than those with systemic sclerosis (SSc). The frequency of positivity for IgG anti-single-stranded DNA (ssDNA) antibody was significantly higher in localized scleroderma patients with elevated sCD4 levels than in patients with normal sCD4 levels. The frequency of positivity for antinuclear antibodies, IgM antihistone antibodies, IgG anti-ssDNA antibody and rheumatoid factor, and elevated sCD23 levels were significantly higher in localized scleroderma patients with elevated sCD8 levels than in patients with normal sCD8 levels. Our findings suggest that both CD4+ and CD8+ T cells are activated in vivo in generalized morphea and that the immunologic events in generalized morphea are different from those in SSc.     

T淋巴细胞亚群失衡与SLE中医辨证分型的关系

目的观察不同中医证型SLE患者外周血CD4~+T,CD8~+T,CD8~+CD28~+T,CD8~+CD28~-T,CD3~+CD4~+IFN-r~+T和CD3~+CD4~+IL-4~+T细胞百分率。方法 SLE患者中医辨证分为气血两燔型、肝热血瘀型、气阴两虚血瘀型和脾肾阳虚型4型,流式细胞技术检测外周静脉血中CD4~+T,CD8~+T,CD8~+CD28~+T,CD8~+CD28~-T,CD3~+CD4~+IFN-r~+T和CD3~+CD4~+IL-4~+T细胞百分率,并与正常组比较。结果不同证型SLE患者外周血CD4~+T表达均下降(P均<0.01),气阴两虚血瘀型CD8~+CD28~+T表达降低、CD8~+CD28~+T/CD8~+CD28~-T比值降低、CD8~+CD28~-T表达升高,脾肾阳虚型CD3~+CD4~+IFN-r~+T表达显著高于其他各组,其CD3~+CD4~+IL-4~+T表达也显著高于正常组及气血两燔型(P均<0.05)。结论 SLE患者存在T淋巴细胞数量及功能失衡,中医辨证分型与微观指标有一定的关系。     

Characterization of the dermal infiltrates in Jessner''s lymphocytic infiltrate of the skin, polymorphous light eruption and cutaneous lupus erythematosus: differential diagnostic and pathogenetic aspects

In the present study a comparative immunohistochemical study was performed on skin biopsies from of patients with Jessner's lymphocytic infiltration of the skin (LIS), polymorphous light eruption (PLE), discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE) using a large panel of monoclonal antibodies against T cell differentiation antigens (CD3, CD4, CD8), immunoregulatory T cell subsets (CD7, 4B4, 2H4, Leu 8), B cells (CD22), activated cells CD25, OKT9, HLA-DR), Langerhans cells (CD1) and macrophages (Leu-M5). The results showed many similarities between LIS and PLE. The most important differences between these conditions and CDLE/SCLE were the high proportions of cells reactive with monoclonal antibody Leu-8 and the absence of T cells expressing HLA-DR antigens in LIS and PLE, suggesting absence of local T cell activation in these conditions. The differential diagnostic and pathogenetic aspects of these findings will be discussed.     

带状疱疹患者CD_4~+T淋巴细胞亚群的检测

目的通过观察带状疱疹患者T细胞亚群的变化,分析机体免疫功能与患带状疱疹的相关性,揭示带状疱疹发病的规律和机理。方法采用流式细胞仪技术检测73例不同年龄和性别的带状疱疹患者T细胞亚群的分布情况,并选择88例健康体检者做为健康对照。结果带状疱疹患者血清CD4+T细胞显著降低,CD3+T细胞降低,CD8+T细胞升高,CD4/CD8比值有所下降;不同年龄和不同病程的患者间也存在T细胞亚群的明显差异。结论带状疱疹患者存在CD4+T细胞的降低和T细胞亚群免疫功能下降,其在带状疱疹的发生和发展中可能起重要作用;老年人是带状疱疹发病的危险人群。