CD4+CD25+调节性T细胞与斑秃的关系

CD4+CD25调节性T细胞是T细胞中具有免疫调节功能的主要细胞群,在调节免疫应答和维持外周免疫耐受中起重要作用.CD4+CD25调节性T细胞的数量减少或功能缺失可能导致自身免疫病的发生.斑秃是一种T细胞介导的累及毛囊的器官特异性自身免疫性疾病.斑秃的动物实验和临床研究均发现,斑秃时存在CD4+CD25+调节性T细胞异常,提示CD4+CD25+调节性T细胞可能参与了斑秃的自身免疫发病机制.     

T细胞因子在斑秃发病中的作用

目的研究T细胞因子与斑秃发病的关系,比较活动期和稳定期斑秃患者血清T细胞因子的变化情况,并探讨斑秃患者的Th1和Th2免疫功能状况。方法107例斑秃患者,根据临床表现分为活动期和稳定期,采用夹心抗体酶联免疫吸附试验法(Sandwich,ELISA)检测活动期和稳定期组斑秃患者血清的IFN-γ、IL-2、IL-4、IL-10和IL-16水平,并分析脱发严重程度与血清细胞因子的关系,采用单因素方差分析和LSD检验。结果稳定期组血清IFN-γ水平显著高于健康对照组(P<0.05),活动期组血清IFN-γ水平与健康对照组间的差异无统计学意义(P>0.05);IL-2、IL-16水平比较,活动期组、稳定期组、健康对照组间的差异无统计学意义(P>0.05);IL-4、IL-10水平比较,稳定期组显著低于对照组,活动期组显著低于稳定期组,组间差异均有统计学意义(P<0.05);随着脱发面积占头皮面积百分比增加,患者血清IFN-γ升高(P均<0.05),IL-2、4、10、16水平的改变无明显统计学意义(P>0.05)。结论IFN-γ参与斑秃稳定期免疫反应,可能与诱导斑秃发病无关;IL-4和IL-10与病情活动有关;IL-2和IL-16可能与斑秃发病无关;IFN-γ可能与斑秃的严重程度有关。     

斑秃患者外周血T细胞亚群的测定

斑秃是皮肤科的常见疾病，但病因不明，发病机理不确切。目前多认为它是一种与免疫有关的疾病犤１，２犦。为了进一步探讨斑秃的病因和发病机理，我们运用免疫荧光流式细胞术测定３０例斑秃患者外周血的T细胞亚群，并对其在斑秃发病中的意义进行了探讨。１临床资料：选择我科斑秃患者３０例，均未使用过皮质类固醇或免疫抑制剂，并具备斑秃的典型临床表现。其中，男性１６例，女性１４例；年龄１７～５４岁，平均３４．６岁；其中稳定期１３例，活动期１７例；病程２天到１年，平均３．４个月。均为局限型病例，皮损数目２到７个不等，平均…     

斑秃皮损凋亡因子Annexin V表达及与T细胞浸润的相关性

目的:检测斑秃皮损凋亡因子Annexin V的表达并确定其与T细胞浸润的相关性。方法:对22例斑秃患者皮损(11例早期斑秃和11例中晚期斑秃)和10例正常头皮进行CD3/CD4/CD8和Annexin V的免疫组化双染。结果:早期斑秃Annexin V在浅层血管和毛囊周围的阳性细胞数显著高于中晚期斑秃,而在深层毛囊周围显著低于中晚期斑秃(P0.05)。早期斑秃深层毛囊周围T细胞浸润与Annexin V阳性细胞数量呈显著正相关,而浅层毛囊周围两者无明显相关性。结论:早期斑秃浅层永久性毛囊细胞凋亡与T细胞浸润无相关性,而深层周期性毛囊周围T细胞浸润是毛囊细胞凋亡的主要原因。     

斑秃患者外周血Th17细胞的检测北大核心CSCD

目的 分析Th17细胞与斑秃病程、病情等的关系.方法 分别抽取斑秃组和健康对照组的外周血,流式细胞仪检测Th17细胞的比例,用SPSS16.0进行统计分析.结果 斑秃组60例外周血中Th17细胞占CD4＋T细胞的比例（1.33％±0.74％）显著高于30例健康对照组（0.91％±0.54％,P＜ 0.01）.初发斑秃患者Th17细胞比例显著高于复发患者（P＜0.05）,活动期高于非活动期（P＜0.05）,病程≤6个月者高于病程＞6个月者（P＜0.01）,而头皮脱发面积≤50％者与脱发面积＞50％及全秃和普秃者比较差异无统计学意义.结论 外周血Th17细胞的水平与斑秃活动性、疾病复发及病程有关.     

银屑病与T细胞和自身免疫

银屑病的发病机制涉及到４种重要的细胞类型,大量证据表明Ｔ细胞可能起着重要作用,该文列举了Ｔ细胞功能原发缺陷的证据,皮损内Ｔ淋巴细胞活化是银屑病表皮过度增殖的介体,皮损中存在着特定类型的Ｔ细胞亚群,细菌超抗原与体内角蛋白之间叉交表的位存在是银屑病中自身免疫反应的主要机制。     

T淋巴细胞亚群与斑秃发病关系的研究

目的:探讨T细胞亚群(CD3 、CD4 、CD8 T)在斑秃发病中所起的作用。方法:用流式细胞仪分别检测斑秃患者PBMC中CD3 、CD4 、CD8 T淋巴细胞的表达水平。结果:重型斑秃、轻型斑秃的CD4 T淋巴细胞表达高于正常对照组,且差异有统计学意义;重型斑秃、轻型斑秃的CD8 T淋巴细胞表达亦高于正常对照组,且差异有统计学意义;CD3 T淋巴细胞表达、CD4 /CD8 比值较正常对照升高,差异无统计学意义。结论:提示了由T淋巴细胞介导的斑秃的发病机理,CD8 和CD4 T淋巴细胞在其发病过程中起到重要作用,两者协同作用导致毛囊受损。     

银屑病与T细胞和自身免疫

银屑病的发病机制涉及到4种重要的细胞类型,大量证据表明T细胞可能起着重要作用,该文列举了T细胞功能原发缺陷的证据,皮损内T淋巴细胞活化是银屑病表皮过度增殖的介体,皮损中存在着特定类型的T细胞亚群,细菌超抗原与体内角蛋白之间交叉表位的存在是银屑病中自身免疫反应的主要机制。     

斑秃家族患病调查及其研讨

报道原发性斑秃1210例,发现有家族史者75例(6.2%),其家族中共有患者163例,患病率为14.91%.家族患者之间亲缘关系分属于:Ⅰ级亲属142例(87.12%),Ⅱ级17例,Ⅲ级4例,患者发病在同一个世代者33户,70例;发于两世代40户,87例;三世代2户,6例.有4例单合子双胎,今尚未见其孪生者同发斑秃.对遗传因素与斑秃发病之关系进行了分析研讨.     

Nivolumab-Induced Alopecia Areata: A Case Report and Literature Review

Nivolumab (anti-PD-1) currently used in many cancers. With the usage of nivolumab increased, many cutaneous side effects were reported including maculopapular rash, lichenoid reactions, vitiligo, bullous disorders, psoriasis exacerbation, and alopecia areata (AA). Here, we report AA after nivolumab for treatment of hepatocellular carcinomas (HCC). A 55-year-old male presented with multiple hairless patch from 1 month ago. He suffered HCC and treated with nivolumab for 6 months after hepatectomy. He treated for hair loss with triamcinolone intra-lesional injection without improvement. We performed skin biopsy on the scalp. Histopathologic findings revealed decreased of hair follicles on the horizontal section with lymphocyte infiltration on the perifollicular area on the vertical section. Clinicopathologic findings were agreed with AA. Considering lack of previous history of AA and hairless patches with 6 months after nivolumab injection, we diagnosed him as nivolumab induced AA. Treatment included topical steroid, and minoxidil. No regrowth of hair was noted after 4 months of follow-up. Nivolimumab induced AA is rare side effect. Pathogenesis of nivolumab induced AA remain unclear. But our case is likely related to nivolumab, known to induce immune related adverse events, and given in the delay of a few months between introduction and the occurrence of the hair loss. Here, we reports nivolmumab induced AA; rare side effect.     

二苯环丙烯酮治疗斑秃16例疗效观察

目的观察斑秃患者局部外用二苯环丙烯酮(DPCP)治疗的临床疗效。方法应用DPCP治疗16例斑秃患者,2%DPCP外搽秃发区致敏,1周后用0.001%DPCP外搽患者头皮,每周1次,并据患者反应增加浓度观察其治疗反应及副作用,并与局部外用米诺地尔酊2次/d进行对照。结果治疗组坚持治疗的11例患者中,8例出现终毛生长,有效率为72.73%,达到良好反应的中位时间为(9.07±3.96)月,停止治疗后复发率为25.00%,12.50%患者出现较严重副作用。对照组13例坚持治疗,4例患者出现终毛生长,有效率30.77%,复发率为25.00%。治疗组疗效明显优于对照组(P<0.05)。结论 DPCP治疗斑秃有效率高,安全性相对较好,是值得推荐的一种有效治疗方法。     

Increased Circulating CXCL10 in Non-Segmental Vitiligo Concomitant with Autoimmune Thyroid Disease and Alopecia Areata

BackgroundVitiligo is a common acquired pigmentary disease caused by destruction of epidermal melanocytes in underlying autoimmune response. Few studies have been focused on the role of chemokines in non-segmental vitiligo (NSV) concomitant with autoimmune thyroid disease (AITD) and alopecia areata (AA).ObjectiveThe aim of this study was to determine the best serum biomarker for predictive role in the progression of vitiligo and to evaluate the influence of AA and/or AITD on vitiligo by using the biomarker.MethodsThis prospective cohort study recruited 45 NSV patients: 14 without either AITD or AA, 12 with AITD, 11 with AA, and 8 with both AITD and AA. Serum levels of CXCL1, CXCL8, CXCL9, CXCL10, CXCL12, CXCL13, and CXCL16 were analyzed by ELISA. CXCR3 mRNA expression was detected on PBMCs by RT-PCR. Improvement was evaluated using repigmentation scales.ResultsSerum CXCL10 levels, along with the expression of CXCR3 mRNA were higher in NSV patients with AITD or AA alone than in those without AITD or AA. Moreover, serum CXCL10 levels, along with the expression of CXCR3 mRNA were higher in NSV patients with both AITD and AA than in those with AITD or AA alone. Poorer repigmentation was observed in NSV patients with both AA and AITD than in those with AA or AITD alone.ConclusionCXCL10 could be a biomarker to predict the progression of NSV. Dermatologists should pay much attention to those NSV patients concomitant with AITD and/or AA, for comorbidity might lead to more active autoimmune reaction.     

皖籍汉人斑秃的遗传流行病学研究

目的描述斑秃患者的遗传流行病学特征和探索可能的遗传模型。方法应用病例对照研究的方法对1032例斑秃先证者进行遗传流行病学研究。采用Falconer方法和SAGE-REGTL软件进行遗传度和复合分离分析。结果患者平均发病年龄为28.98±13.43岁,男女之间无差异,82.6%的患者第一次脱发发生在40岁以前。有阳性家族史的有87人(8.43%)。早发组患者比晚发组病情更重、病程更长。先证者一、二、三级亲属的患病率分别为1.58%,0.19%和0.03%,显著高于对照组(P<0.001)。斑秃一、二、三级亲属的遗传度分别为47.16%±2.79%,42.53%±7.36%和22.29%±21.63%,三者加权平均遗传度为46.23%±0.07%。根据SAGE-REGTL结果,斑秃的最佳模型是多基因累加模式。结论斑秃具有多基因遗传病的特点,在其发病过程中,遗传起了重要的作用。     

308 nm准分子激光治疗斑秃进展

斑秃是皮肤科的一种常见疾病,其治疗包括局部治疗和系统用药,紫外线光疗法是其中的重复方法之一。新近用于临床治疗斑秃的308 nm准分子激光是中波紫外线光疗法的最新进展,其作用机制与诱导皮损处T细胞凋亡、抑制细胞因子产生和影响抗原提呈细胞功能等有关。临床实验研究表明,该疗法方便、高效、安全及患者依从性好。为此,综述了308 nm准分子激光治疗斑秃的作用机制、临床应用及不良反应。     

方正酸二丁酯外用治疗斑秃疗效观察

目的　观察方正酸二丁酯 (squaricaciddibutylester,SADBE)外用治疗斑秃的临床疗效。 方法　 2 %SADBE丙酮溶液作斑贴试验 ,阳性者给予 0 .0 0 0 0 1%～ 1.0 %的SADBE溶液外用 ,每周 1次。结果　治疗组 16例中 13例 (81.2 5% )长出新发 ,其中 11例 (68.75% )毛发完全再生 ,3例 (18.75% )无新发出现。结论　SADBE局部外用是治疗斑秃的有效方法之一。     

Trichostasis spinulosa of the scalp mimicking Alopecia Areata black dots

Alopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.