免疫功能正常及受损的寻常疣患者中具有相同的人类乳头瘤病毒类型

至今,从皮肤及粘膜损害中已分离到67种以上不同的人类乳头瘤病毒(HPV),但寻常疣(包括跖疣)中最常见的为HPV1、2、4、7型。新近发表的HPV感染的流行病学资料主要着眼于免疫缺陷患者,因为后者更易患寻常疣、扁平疣及疣状表皮发育不良样损害。该研究旨在分析免疫功能正常患者中寻常疣的HPV类型,并与免疫缺陷患者进行比较。     

不同病程尖锐湿疣患者HPV感染与T细胞亚群表达情况的关系

目的探讨不同病程尖锐湿疣(CA)患者人乳头状瘤病毒(HPV)感染与T细胞亚群表达情况的关系。方法选择2012年1月—2015年2月我院收治的151例CA患者,根据病程长短分为A、B组,A组病程≤3个月,B组病程3个月,A组97例,B组54例,另选同期体检健康的51例作为对照组。采集3组患者外周血,并使用流式细胞术检测T淋巴细胞亚群的表达情况。取脱落疣体细胞,并使用核酸快速杂交分型法检测HPV-DNA。结果 B组患者CD4~+、CD4~+/CD8~+水平显著低于A组和对照组,CD8~+水平显著高于对照组及A组患者,差异均有统计学意义(P0.05)。HPV阳性患者151例,其中包括单纯HPV6/11~+、HPV16/18~+型感染各45例、49例,HPV6/11、16/18~+混合型感染57例。HPV6/11~+、HPV16/18~+、(HPV6/11~+、16/18~+)各组患者CD3~+、CD4~+、CD4~+/CD8~+水平均低于健康组,差异有统计学意义(P0.05);而3组间CD3~+、CD4~+、CD8~+、CD4~+/CD8~+水平比较,差异均无统计学意义(P0.05)。结论病程3个月以上CA患者细胞免疫功能明显降低,且各型HPV感染患者细胞免疫功能差异无统计学意义。     

应用单克隆抗体评估异位性皮炎患者的T淋巴细胞亚群

有关文献报导异位性皮炎是一种T-抑制细胞(Ts)活性降低的细胞介导免疫功能障碍性疾病,许多作者把Ts缺陷和血清IgE增高联系起来。外周血单克隆抗体研究结果表明OKT_3~+和所有成熟的T细胞,OKT_4~+和T辅助细胞(T_H)和OKT_8~+和Ts抗原有关。本文报导了异位性皮炎患者外周血中OKT_3~+、OKT_4~+、OKT_8~+研究的结果和B细胞数、淋巴细胞转化试验及IgE的量,共查21例,男10、女11,年龄16～73岁,大多数患者年幼时曾有渗出性素质和本人或家族变态反应的病史,其中10例伴变     

132例皮肤疣组织人乳头瘤病毒分型检测

目的 探讨皮肤疣组织中人乳头瘤病毒（HPV）的感染率和病毒型别。方法 门诊皮肤疣患者132例中寻常疣46例,跖疣38例,扁平疣48例。以特异性DNA序列为模板设计引物,进行PCR扩增,电泳,对结果进行分析。 结果 132例皮肤疣中,HPV阳性128例,感染率为97.0%,其中HPV2型阳性111例,感染率为84.1%。寻常疣、跖疣感染主要为HPV2、HPV1型,扁平疣感染主要为HPV2、HPV10、HPV3、HPV1型。89例为多重感染,感染率为67.4%,其中二重感染率为41.7%（55例）,三重感染率为21.2%（28例）,四重感染率为4.6%（6例）;寻常疣多重感染率为50.0%（23/46）,跖疣为76.3%（29/38）,扁平疣77.1%（37/48）。多重感染中,以HPV1 + 2型最多,有35例（39.3%）,其次为HPV1 + 2 + 10型,有12例（13.5%）。 结论 遵义皮肤疣感染以HPV2型为主,其次为1型;2型与多种皮肤疣感染有关;皮肤疣中多重感染率较高,其中扁平疣多重感染率最高;新发现HPV3、10型感染寻常疣,HPV10型感染跖疣,HPV1、7型感染扁平疣。     

尖锐湿疣局部细胞免疫功能状态与人乳头瘤病毒型的相关性研究

我们采用 (1)聚合酶链反应检测皮损中HPV6 11、16 18。 (2 )应用免疫组化技术对 6 1例CA患者疣体组织、疣旁“正常”组织及 2 0例对照包皮组织表皮中CD1a+ 朗格汉斯细胞 (LC)及表真皮中CD4 +T、CD8+ T细胞数目及CD4 + CD8+ 比值进行检测。探讨CA患者局部细胞免疫功能状态与HPV型的关系。结果CA疣体组织表皮CD1a+ LC细胞数量较正常对照明显降低 (P <0 .0 1) ,不同HPV亚型感染所致CA其CD1a+ LC数目差异无显著性 (P >0 .0 5 ) ;真皮中CD4 + T、CD8+ T细胞数目较正常对照升高 ,但CD4 + CD8+ 比值下降 (P <0 .0 1) ;CD4 + T、CD8+ T细胞数目及CD4 + CD8+ 比值相应的改变与不同HPV亚型无关。表皮CD1a+ LC与表皮、真皮中CD4 + T细胞及CD4 + CD8+ 比值成正相关 ,与CD8+ T细胞数目成负相关。因此 (1)CA患者皮损局部细胞免疫功能低下 ;疣体组织中CD1a+ LC细胞数目及CD4 + CD8+比值均降低。 (2 )CA患者局部免疫缺陷程度与HPV型无相关性。     

自拟平疣方剂对扁平疣患者疗效及外周血T淋巴细胞亚群的影响

目的初步探讨"平疣方剂"对扁平疣患者的疗效和对外周血T淋巴细胞亚群的影响。方法运用碱性磷酸酶-抗碱性磷酸酶(APAAP)法,检测扁平疣患者服用"平疣方剂"前后及健康人外周血T淋巴细胞亚群,并进行比较。结果治疗组(平疣方剂组)有效率81.7%,优于对照组(胸腺肽胶囊组)65.0%;且"平疣方剂"能提高扁平疣患者外周血CD4+T淋巴细胞百分比及CD4+/CD8+比值。结论"平疣方剂"能增强细胞免疫功能,导致疣体脱落,提高疗效。     

荧光定量PCR检测人类乳头瘤病毒在尖锐湿疣中的应用

目的　对尖锐湿疣 (CA)患者进行乳头瘤病毒 (HPV )DNA定量测定。方法　用聚合酶链反应 (PCR )测定HPVDNA的载量及HPV分型。结果　 2 0 0例尖锐湿疣患者中 198例疣体组织HPV测定阳性 ,2例阴性。在 84例疣体组织HPV6、11阳性者中有 12例合并HPV16、18阳性。 5例疣体组织及宫颈分泌物同时阳性。定量测定结果显示 :HPV6、11患者最高 2 .0× 10 8copy/ml ,最低 3 .0× 10 4copy/ml,HPV16、18患者最高 1.75× 10 7copy/ml,最低 3 .0× 10 5copy/ml。 结论　尖锐湿疣患者应用荧光定量PCR检测HPV阳性率高 ,并可快速区分致癌型及致疣型HPV感染 ,对尖锐湿疣复发及癌变作出可能性预测     

病毒性皮肤病患者外周血淋巴细胞亚群的检测分析

目的探讨病毒性皮肤病患者的免疫功能状态。方法应用流式细胞仪分析检测486例病毒性皮肤病患者外周血中的淋巴细胞亚群,并与正常人进行比较。结果病毒性皮肤病患者之间外周血淋巴细胞亚群比较,CD4~+T细胞,CD8~+T细胞,CD3~-CD19~+细胞,CD3~-CD16~+56~+NK细胞,CD4~+/CD8~+差异有统计学意义(P0.05)。单纯疱疹患者组与带状疱疹患者组比较,CD8~+T细胞,CD3~-CD16~+56~+NK细胞,CD4~+/CD8~+差异有统计学意义(P0.05)。寻常疣患者组、扁平疣患者组与尖锐湿疣患者组三组相比较,CD4~+T细胞、CD8~+T细胞、CD3~-CD19~+细胞、CD3~-CD16~+56~+NK细胞差异也有统计学意义(P0.05)。与正常组相比较,五种病毒性皮肤病患者组CD3~+T细胞、CD4~+T细胞、CD8~+T、CD4~+/CD8~+细胞除带状疱疹患者组,CD3~-CD19~+细胞仅尖锐湿疣患者组,CD3~-CD16~+56~+NK细胞除尖锐湿疣患者组外差异均有统计学意义(P0.05)。结论各类病毒性皮肤病患者均存在不同程度的免疫异常。免疫功能的紊乱是病毒性皮肤病患者发病的一个重要机制,在各类病毒性皮肤病患者的发生、发展过程中可能起到重要的作用。     

皮肤疣中人类乳头瘤病毒的特征及分析

目前,人类乳头瘤病毒(HPV)至少已发现有60型。HPV的型别,在一定程度上决定了其感染部位,病理特征,临床表现及相应的病程。该作者对台湾人皮肤疣患者中的HPV感染进行了分析。 61份临床标本取自跖疣、寻常疣、扁平疣患者手术切除的疣体。用Southern印迹杂交     

人乳头瘤病毒及其致病性的研究进展

人乳头瘤病毒(human papillomavirus HPV)是寻常疣、扁平疣、踱疣、尖锐湿疣以及疣状表皮发育不良(EV)、口腔乳头瘤和喉乳头瘤的致病因子。现在,特别是1977年以来,由于新的研究技术的进展,对HPV和它在临床中的作用已有进一步的认识和新的发现。以下就HPV和它在皮肤病学中作用的有关问题综述如下:     

A comparative study on peripheral blood lymphocyte subpopulations in different kinds of warts

Peripheral blood T-cell subpopulations were evaluated in 36 patients with clinically different types of warts, subdivided in 4 groups (common, genital, flat and plantar warts). A significant decrease was found in OKT3 and OKT4 subsets total count and in OKT4/OKT8 ratio in patients with common and genital warts as compared with controls. Only in common and genital warts did we also observe a significant decrease of percentage of OKT4 subset. No significant difference of considered parameters was observed in flat and plantar warts as compared to controls, apart from a significant increase in number of OKT8 subset in flat warts. We then discuss this different status of C.M.I. in patients with different clinical warts, stressing the importance of various types of HPV.     

Subclinical human papilloma virus infection in condylomata acuminata patients attending a VD clinic.

In 37 (77%) of 48 patients with external genital warts, application of 5% acetic acid revealed areas of acetowhite epithelium. The lesions were not clinically apparent before acetic acid was applied but were easily detected without the use of a colposcope. In a control group of 20 patients with chlamydial urethritis and no history of genital warts, none had acetowhite genital lesions. Histological examination of biopsy specimens from the flat acetowhite lesions showed HPV infection with koilocytosis in 29 (78%) and in 3 (8%) intra-epithelial neoplasia grade II-III. Using in situ hybridization with commercially available biotinylated DNA probes, HPV types 16/18 could be detected in 7 (24%) patients with koilocytosis and in 3 (100%) patients with dysplasia. Simultaneous infection with HPV types 6/11, 16/18, and 31/33/35 was found in 8 of the 13 HPV DNA-positive patients. It is concluded that subclinical HPV-induced acetowhite lesions are common among patients with genital warts and that these flat lesions may be associated with a high grade of dysplasia. Consequently, routine use of the acetic acid test on the genital epithelium is recommended in patients with condylomata acuminata in order to diagnose and treat all HPV-infected areas.     

Correlation between human papillomavirus (HPV) type and histology of warts

Forty warts from different patients and of different clinical type were examined histologically and virologically. Eight lesions were found to be associated with human papillomavirus type 1 (HPV 1), 15 tumors were induced by HPV 2, HPV 3 was detected 4 times, HPV 4 twice, and HPV 6 eleven times. HPV 3, HPV 4, and HPV 6 induced warts revealed a correlation between histology and virus type. They are characterized by the so called "edematous type clear cells". In HPV 3 associated flat warts pycnotic nuclei were mainly localized in the center of large vacuoles. In genital warts sickle shaped nuclei were pushed to the margin of the vacuolized cells. The histology of HPV 1 and HPV 2 induced warts was more heterogenous. With one exception HPV 1-induced lesions represented typical myrmecia warts, varying in the number and shape of inclusion bodies. HPV 2 associated common warts, however, revealed 3 very distinct histologic features: (1) Inclusion wart typical for HPV 1, (2) Classical common wart with marked condensation of keratohyalin granules, (3) Warts with extreme vacuolization of squamous and granular cells leading to a honeycomb-like picture.     

Peripheral blood lymphocyte subpopulations in patients with viral warts

Peripheral blood T-cell subpopulations were evaluated in 32 patients affected by viral warts and in 32 unaffected individuals belonging to a control group. A significant decrease was found in total lymphocytes as well as OKT3 and OKT4 subsets among affected patients. A significant negative correlation was also found between OKT3 and OKT4 numbers as well as OKT4/OKT8 ratio and duration and extent of lesions. A significant positive correlation was found between the duration and the extent of lesions and the percentage of OKT8 subsets, but not the total number of OKT8. These data confirm that a cell-mediated immune deficiency is present in patients with viral warts. We then discuss whether the decrease of cellular immunity in these patients is a primary event or, rather, the result of persistent verrucosis.     

Human papillomavirus DNA detection in primary anogenital warts and cervical low-grade intraepithelial neoplasias in adults by in situ hybridization.

In this study, 58 consecutive patients with primary anogenital warts were selected from patients attending a genitourinary clinic. Patients were grouped on the basis of clinical lesion site, i.e. patients with genital warts only, patients with perianal or anal canal warts only, and patients with concurrent perianal and genital warts. Of these patients, 38% of the men (12/31) and 33.3% of the women (9/27) had other anogenital infections, such as nonspecific urethritis (NSU) or nonspecific genital infection, which were the most common. Of the patients who had perianal warts, 37% of the men (7/19) and 25% of the women (4/16) also had warts in the anal canal. Of the women who had anogenital warts, 63% (17/27) had concurrent subclinical low-grade cervical intraepithelial neoplasia (CIN) lesions. Human papilloma virus (HPV) DNA (either 6 or 11, 16 or 18, or 31 or 33 or 35) was detected in 53.3% (40/75) of the anogenital wart biopsy samples, and in 35.2% (6/17) of the low-grade CIN lesions. HPV types 6 or 11 were the most common types in anogenital warts (45.3%); and in CIN lesions HPV types 6 or 11 and 16 or 18 were found with equal frequency (17.6% each). There were no significant differences in HPV types between patients with genital warts and patients with perianal and anal canal warts. Anogenital infection with HPV is multicentric; external anogenital warts and subclinical CIN lesions often exist concurrently. The low prevalence of HPV DNA detected in anogenital warts and CIN biopsy samples may be due to insensitivity of the in situ hybridization technique used in this study.     

Genital warts among 18- to 59-year-olds in the United States, national health and nutrition examination survey, 1999--2004

BACKGROUND: Genital warts are caused by human papillomavirus (HPV); over 90% are due to HPV types 6 and 11. We determined the percentage of persons who reported having been diagnosed with genital warts in the United States from 1999--2004. METHODS: We collected genital wart diagnosis history and sociodemographic and sexual behavior data from 8849 sexually active men and women aged 18 to 59 years as part of the National Health and Nutrition Examination Survey, 1999--2004. RESULTS: Overall, 5.6% of 18-to 59-year olds reported having ever been diagnosed with genital warts. The percentage was higher in women (7.2%, 95% CI, 6.2%-8.4%) than in men (4%, 95% CI, 3.2%-5.0%). History of genital wart diagnosis peaked among 25- to 34-year-old women (10.4%) and 35- to 44-year-old men (6.0%). Sex, age, race/ethnicity, number of lifetime sex partners, and cocaine/street drug use were associated with genital warts in multivariate analysis. CONCLUSIONS: These are the first national data on the burden of genital warts in the United States. The substantial burden of genital warts could be reduced by a prophylactic HPV vaccine to types 6 and 11.     

Childhood warts: an update

Warts are benign intraepidermal neoplasms that are caused by infection with human papillomavirus and commonly affect children and adolescents. The 4 most common types of cutaneous warts are common warts, plantar warts, flat warts, and genital warts. Although they rarely pose a serious health problem, warts can result in physical impairment and psychosocial discomfort. A variety of treatment modalities are employed to treat these growths in children.     

泛发性进行期银屑病患者外周血单个核细胞的研究

用单克隆抗体对25例泛发性进行期银屑病患者外周血单个核细胞各亚群进行分析,发现患者T_11~+细胞、T_4~+细胞、DR~+细胞和T_4/T_8比值显著减低(p<0.01),T_5~+细胞、B_1~+细胞和LeuM_5~+细胞数在正常范围(P>0.05),说明泛发性进行期银屑病患者外周血T淋巴细胞亚群失衡。     

Nonavalent human papillomavirus vaccination as alternative treatment for genital warts

Genital warts caused by the human papillomavirus (HPV) are the most common sexually transmitted disease and have a negative impact on quality of life. Of the more than 200 different types of HPV, low‐risk types 6 and 11 are mainly responsible for the development of condyloma acuminata. Despite a large arsenal of local therapies such as numerous topical agents, CO₂ laser ablation, and surgical removal, genital warts tend to be recalcitrant. HPV vaccination is mainly used as a preventive strategy to prevent genital warts, cervical cancer, and other anogenital cancers. However, in a few cases, HPV vaccination has been shown to be a good treatment alternative for patients with recalcitrant skin warts. Here we report five cases of recalcitrant genital warts that responded well to treatment with the nonavalent HPV vaccine. HPV vaccines could be beneficial as a noninvasive treatment alternative for recalcitrant genital warts.