血管内皮生长因子在寻常型银屑病患者中医辨证分型皮损和血清中的表达

目的探讨血管内皮生长因子(VEGF)在寻常型银屑病患者中医辨证分型(血热型、血燥型和血瘀型)皮损和血清中的表达。方法采用免疫组化法和酶联免疫吸附法(ELISA法)对60例寻常型银屑病患者(中医辨证分型)皮损处及血清中VEGF的水平进行了检测。结果皮损处VEGF水平为血热型组>血燥型组及血瘀型组;血清中VEGF的水平为血热型组>血燥型组>血瘀型组。结论对寻常型银屑病患者皮损处及血清中VEGF水平的检测有可能用于血热型银屑病与非血热型银屑病的中医辨证分型。     

VEGF、PEDF在寻常型银屑病组织中的表达及与微血管密度的关系

目的探讨VEGF、PEDF蛋白在寻常型银屑病组织中的表达及与真皮浅层微血管密度(MVD)的关系,从而阐述寻常型银屑病的发病机制。方法应用免疫组织化学方法(PV-9000)检测皮肤组织中VEGF、PEDF蛋白的表达水平,CD_(31)蛋白标记微血管计算真皮浅层MVD;采用Spearman法进行相关性分析。结果 VEGF、PEDF蛋白表达水平及真皮浅层MVD值在阳性组中明显高于阴性组和对照组,差异显著有统计学意义(P 0.05),而阴性组和对照组相比较差异无统计学意义(P 0.05);相关性分析显示MVD与VEGF的表达水平呈正相关(P 0.001);MVD与PEDF的表达水平呈负相关(P 0.001)。结论 VEGF、PEDF可能通过调节血管增生参与银屑病的发病过程。     

bFGF及其受体FGFR2在银屑病皮损中的检测

目的：探讨碱性成纤维细胞生长因子（bFGF）及其受体FGFR2蛋白在银屑病皮损中的表达状态。方法：采用组织切片免疫组化技术对22例银屑病皮损和19例正常人皮肤的bFGF及其受体FGFR2及血管内皮标记因子CD34的表达状态,并根据CD34染色计数微血管密度。结果：bFGF和FGFR2免疫组化阳性反应在寻常型进行期银屑病皮损的表皮基底层和棘层表达。显著高于正常皮肤（P〈0.01）;寻常型进行期银屑病皮损真皮浅层微血管密度显著高于正常人,该处微血管bFGF的表达也明显高于正常人（P〈0.01）,且与微血管密度（MVD）呈正相关,P〈0.01,而FGFR2在银屑病真皮浅层微血管和正常人则无显著性差异（P〉0.05）。结论：bFGF可能通过FGFR2作用在基底层和基底上层,对角质形成细胞的增殖、分化起一定作用,bFGF亦可能在银屑病真皮浅层微血管异常增殖中起一定的作用。     

银屑病患者血管内皮细胞粘附分子的免疫组化研究

目的 探讨血管内皮细胞在银屑病发病中的作用。方法 采用ＡＢＣ免疫组化方法研究寻常型银屑病皮损处血管内皮细胞ＩＣＡＭ－１、ＣＤ３４、ＨＬＡ－ＤＲ、ＦⅧＲＡｇ和ＣＤ３６的表达情况。结果 进行期寻常型银屑病患者皮损处真皮浅层血管内皮细胞ＩＣＡＭ－１、ＣＤ３４和ＨＬＡ－ＤＲ的表达明显强于静止期,而静止期则强于正常人皮肤。ＦⅧＲＡｇ和ＣＤ３６在进行期和静止期的表达变化不明显。结论 银屑病患者皮损真皮浅层血管     

Ang-1及Tie-2在寻常型银屑病皮损中的表达及其意义

目的:检测血管生成素-1(Ang-1)及其酪氨酸激酶受体-2(Tie-2)在寻常型银屑病进行期皮损和正常皮肤组织中的表达.方法:应用免疫组化方法检测24例寻常型银屑病进行期皮损和12例正常人皮肤组织Ang-1和Tie-2蛋白的表达.结果:寻常型银屑病皮损组织中,Ang-1主要表达于银屑病受累皮肤真皮乳头层的基质细胞,Tie-2主要表达于受累皮肤表皮和高度血管化的真皮乳头层的内皮细胞及真皮深层其它区域的内皮细胞;在正常皮肤组织中,Ang-1表达极弱或呈阴性表达,Tie-2仅在真皮深层内皮细胞表达.寻常型银屑病进行期皮损处的Ang-1和Tie-2受体表达明显高于正常对照组(P＜0.01),Ang-1和Tie-2的表达呈正相关(P＜0.01).结论:Ang-1通过作用于Tie-2受体,参与促进银屑病皮损处的血管生成,与银屑病血管新生密切相关.     

银屑病皮损区肥大细胞分布和血管内皮细胞CD34表达的研究

目的探讨肥大细胞(MC)和血管内皮细胞在银屑病发病中的作用.方法采用组织化学和免疫组化的方法,观察寻常性银屑病皮损处MC和CD34标记血管内皮细胞的分布情况.结果经甲苯胺蓝特殊染色发现,银屑病患者真皮区的MC密度在进行期(33.07±14.63)个/mm2,高于静止期(21.80±4.86)个/mm2,静止期又高于正常对照组(15.85±6.93)个/mm2,它们之间的差异均有显著性;免疫组化观察发现,银屑病真皮区CD34标记的微血管密度在进行期(2931±4.04)个/mm2,明显高于静止期(2231±2.07)个/mm2,而静止期又明显高于正常对照组(18.81±2.59)个/mm2.结论寻常性银屑病皮损处真皮内肥大细胞和血管内皮细胞密度明显增加,且与病情变化有关.     

银屑病皮损中VEGF、bFGF的表达及与微血管密度的相关性研究

目的探讨血管内皮生长因子(VEGF)及碱性成纤维细胞生长因子(bFGF)在银屑病患者皮损血管生成机制中的作用。方法采用免疫组化法检测寻常型银屑病患者皮损处VEGF、bFGF及微血管密度(MVD)的表达情况,并与正常皮肤进行比较分析。结果寻常型银屑病患者皮损处VEGF、bFGF的表达及MVD值明显高于正常对照组(P0.05),VEGF与bFGF在银屑病患者皮损中的表达差异有显著相关性(P0.05)。结论 VEGF及bFGF可能引起银屑病患者皮损处血管增生,VEGF与bFGF在银屑病微血管增生过程中发挥正性调节作用且具有协同促进性。     

Fractalkine和其受体Cx3CR1在寻常性银屑病中的表达及意义

目的探讨Fractalkine/Cx3CR1在寻常性银屑病发病中的作用。方法应用免疫组化SABC法分别检测寻常性银屑病(进展期)皮损26例、皮损周边0.5 cm皮肤8例和正常皮肤15例中Fractalkine/Cx3CR1的表达情况。分析其与PASI(疾病严重度评分)之间的关系。结果寻常性银屑病患者角质形成细胞和真皮浅层血管内皮细胞中Fractalkine/Cx3CR1阳性率较皮损周围0.5 cm范围皮肤明显增强(P<0.05),正常皮肤中未见Fractalkine/Cx3CR1表达。寻常性银屑病皮损中Fractalkine的表达与PASI呈正相关(γ=0.6097,P<0.01),Cx3CR1的表达与PASI无相关性(γ=0.2965,P>0.05)。结论Fractalkine/Cx3CR1的异常表达可能在寻常性银屑病发病中发挥重要作用。     

同型半胱氨酸和尿酸与寻常型银屑病中医辨证分型的研究

目的探讨同型半胱氨酸(HCY)和尿酸(UA)在寻常型银屑病及其不同中医证型中的作用机制以及与中医辨证分型的关系。方法采用循环酶法和酶动力学比色法分别检测67例寻常型银屑病患者(血热型27例、血毒型18例、血瘀型22例)血中的HCY和UA,并与对照组(61例)行对比分析。结果寻常型银屑病组血HCY、UA水平分别为(14.13±8.18)μmol/L和(305.14±79.71)μmol/L,高于对照组(9.31±2.38)μmol/L和(258.63±73.10)μmol/L(P0.01),及各证型组亦高于对照组(P0.05或0.01);血毒型和血瘀型血HCY、UA水平高于血热型。结论 HCY与UA在寻常型银屑病的过程中可能起一定的作用,可作为寻常型银屑病的中医辨证分型参考依据。     

红斑丘疹及鳞屑性皮肤病

20 0 4 35 38　银屑病皮损区肥大细胞分布和血管内皮细胞 CD34表达的研究 /任德连 (泸州医学院微生物与免疫学教研室 )… / /临床皮肤科杂志 .- 2 0 0 4 ,33(8) .- 46 8～ 4 70采用组织化学和免疫组化的方法观察 30例银屑病皮损处真皮内肥大细胞 (MC)和 CD34标记的血管内皮细胞的分布情况。结果表明 ,银屑病患者真皮区的MC密度在进行期高于静止期 (P<0 .0 5 ) ,静止期又高于正常对照 (P<0 .0 5 ) ,提示 MC在发病中起重要作用 ;银屑病真皮区 CD3 4 标记的微血管密度和以上结果相同 ,提示病情变化与内皮细胞和微血管变化相关。图2表 1参…     

In vivo quantification of microvessels in clinically uninvolved psoriatic skin and in normal skin

BACKGROUND: Microvascular abnormalities (capillary elongation, widening and tortuosity) are a characteristic feature of psoriasis and form one of the pathological diagnostic criteria. However, it is still not entirely clear when these microcirculatory changes appear in the skin of psoriatic subjects. Some studies suggest that capillary dilatation and elongation are present in the clinically uninvolved skin of psoriatic patients even at sites at which psoriatic plaques rarely occur. OBJECTIVES: To determine, using noninvasive techniques in vivo, the nature of any microvascular changes in the clinically uninvolved skin of psoriatic subjects and to quantify the dermal microvasculature in the clinically uninvolved skin of psoriatic subjects, in vivo. METHODS: Dermal microvessels in both the clinically uninvolved skin of psoriatic subjects and in the skin of normal volunteers (i.e. individuals without any clinical evidence of psoriasis or other inflammatory dermatoses) were directly visualized by native video-capillaroscopy, in vivo. Images were analysed using a combination of nonstereological and stereological measurements. The findings in each group were then compared to determine if there were any differences in microvascular parameters. RESULTS: Quantitative analysis of capillaroscopic images showed that there were no significant differences in microvessel density (P = 0.9), image area fraction (P = 0.6), microvessel length density (P = 0.7) and vessel image width (P = 1.0) in the clinically uninvolved skin of psoriatic subjects and the normal skin of healthy volunteers, when extensor forearm skin was examined. CONCLUSIONS: These findings indicate that prior to the development of clinical lesions there are no significant morphological differences between the dermal microvessels in the clinically uninvolved skin of psoriatic subjects and the dermal microvessels in the normal skin of healthy volunteers. However, during plaque formation, the superficial papillary microvessels in plaque skin undergo a striking, characteristic change, i.e. elongation, widening and tortuosity. These blood vessels must therefore, at least in part, play an important, necessary, but probably secondary role in the pathogenesis of clinical lesions in psoriasis.     

Dermal vasculature in psoriasis and psoriasiform dermatitis: a morphometric study

Background:

Vascular proliferation in the papillary dermis is considered to be an important and probably an early feature of psoriasis. Few morphometric studies have attempted to analyze the vascular changes. However, no study was found in the available literature comparing vascular changes between psoriasis and psoriasiform dermatitis.

Materials and Methods:

Skin biopsies from 25 cases each of psoriasis and psoriasiform lesions were immunohistochemically stained for CD34 (endothelial marker). Microvessel density (MVD), microvessel length density and ratio of microvessel area to papillary dermal area were calculated using image analysis software.

Results:

Skin biopsies from psoriasis showed higher staining for CD34 on light microscopy. Using morphometric techniques, microvessel length density was significantly higher in psoriasis compared to psoriasiform lesions (P value <0.05). MVD was also higher in psoriasis, though the difference was not significant. The ratio of microvessel area to dermal area was almost similar in both the groups.

Conclusion:

Our results indicate that vascular tortuousity and dilatation is significant only in psoriatic lesions. These results may assist in automated diagnosis of skin biopsies.     

Evaluation of the clinical and immunohistological efficacy of the 585-nm pulsed dye laser in the treatment of psoriasis

Background  The 585-nm pulsed dye laser (PDL) therapy is useful for the patients with psoriasis. PDL treatment is based on selective photothermolysis of the dermal vasculature.
Objective  The objectives of this study were to evaluate the clinical and immunohistological effects of PDL on psoriasis and to examine the association between psoriatic dermal vasculature and the clinical effects.
Methods  Eleven patients with recalcitrant psoriasis were treated with 585-nm PDL. Biopsy specimens obtained before and after treatment were stained with CD31. All microvessels to the depth of 400 µm from the rete ridge were counted and the internal diameters were measured.
Results  The mean percent reduction of plaque severity score was 42. The mean microvessel count decreased significantly from 63 to 35.6 ( P  < 0.001). There was a strong positive correlation between the plaque severity score and microvessel number ( P  < 0.001) and a strong negative correlation between the microvessel count of an untreated area and degree of the change in the microvessel count after treatment ( P  = 0.005).
Conclusions  The findings of this study suggest that PDL treatment improves psoriasis. Moreover, PDL treatment decreased the number of dermal papillary microvessels. Dermal papillary microvessels are important pathogenetic targets of psoriasis, and PDL therapy, which selectively targets superficial vessels, is therefore a valid therapeutic approach.

Conflicts of interest

None declared     

CD34+ dermal dendritic cells and mucin deposition in dermatomyositis

Dermal mucinosis is often associated with collagen diseases such as rheumatoid arthritis, lupus erythematosus, and dermatomyositis, in addition to autoimmune thyroiditis. We report eight cases of dermal mucin deposition secondary to typical dermatomyositis with cutaneous lesions known as heliotrope rash and Gottron’s papules. Striking mucin deposition was observed in both the papillary dermis and reticular dermis of all biopsy specimens. Immunohistochemical analysis showed that CD34+ dermal dendritic cells (DDCs) in the perilesional area in combination with vimentin+ cells within the mucinous lesion might be important in giving rise to abnormal deposition of dermal mucin. On the other hand, numbers of factor XIIIa+ DDCs and tryptase+ mast cells were reduced within and surrounding the mucin deposition, as compared with those in the dermis of normal controls. A pathogenic mechanism of dermal mucin deposition is proposed.     

寻常性银屑病皮损处神经纤维的数量及其与朗格汉斯细胞关系的观察

目的 观察寻常性银屑病患者皮损处神经纤维的数量变化及其与朗格汉斯细胞的关系.方法采用免疫组化过氧化物酶法观察28例寻常性银屑病患者皮损处神经纤维的数量变化;采用免疫荧光双标记及共聚焦激光扫描显微镜技术观察寻常性银屑病患者皮损处神经纤维与朗格汉斯细胞的关系.结果寻常性银屑病患者皮损处神经纤维长度显著增加,与正常人对照比较有统计学差异(t=4.09,P＜0.001).皮损表皮内神经纤维与朗格汉斯细胞的接触明显增多,与正常人对照比较有统计学差异(t=3.55,P＜0.01).结论寻常性银屑病皮损处神经纤维长度显著增加,表明此部位神经纤维增生明显,并且表皮内神经纤维与朗格汉斯细胞的直接接触明显增加,提示银屑病患者神经系统的免疫调控作用可能是通过改变朗格汉斯细胞的功能实现的。     

Hyaluronan and CD44 in psoriatic skin. Intense staining for hyaluronan on dermal capillary loops and reduced expression of CD44 and hyaluronan in keratinocyte-leukocyte interfaces

The distributions of hyaluronan (HA) and its presumptive receptor, CD44, were studied in skin samples from 13 psoriasis vulgaris patients, using an HA-specific probe (HABC), and monoclonal antibodies, respectively. The general distribution of HA and CD44 in psoriatic lesional epidermis resembled that in normal epidermis. However, areas of epidermis invaded by leukocytes showed a local depletion of HA and CD44, particularly at the contact areas of keratinocytes to lymphocytes and neutrophils. Removal by cellular uptake or extracellular degradation of CD44 and HA may be required for tight adherence between a keratinocyte and a leukocyte. On the dermal side, the tips of the prolonged dermal papillae in psoriatic lesions were intensively stained with HABC. The dilated capillaries and the space below the tip basal lamina, in particular, were heavily covered with HA. Occasionally, a similar intense staining was seen around an enlarged capillary in uninvolved psoriatic skin. CD44-positive leukocytes were found around the affected capillaries. The accumulation of HA in the dermal papillae may support the growth of psoriatic lesions, since HA stimulates the growth of capillaries as well as attracting inflammatory cells.     

不同辨证分型寻常性银屑病表皮各层P物质表达特征

目的探讨不同辨证分型的银屑病表皮各层P物质表达特征。方法应用免疫组化方法检测不同证型寻常性银屑病皮损中P物质的表达,利用计算机成像分析系统检测银屑病皮损表皮各层P物质的平均光密度。结果与对照组相比,三种证型银屑病P物质表达均高于正常,其中血燥型表达最强,其次是血热型,最弱是血瘀型。三型均在角质层表达最强,其次是基底层,最弱是颗粒层和棘层。血热型在基底层、角质层表达最强,棘层次之,颗粒层最弱。血燥型以颗粒层和角质层强,基底层和棘层弱。血瘀型在基底、颗粒和角质层表达强。结论不同证型的银屑病表皮各层P物质表达存在差异。     

降钙素基因相关肽在银屑病斑块型皮损的分泌与表达

为了解精神心理刺激诱发加重银屑病的原因,探讨神经肽在银屑病发病机理中的作用,研究了降钙素基因相关肽（ＣＧＲＰ）在银悄病皮损中的分泌与表达,并确定ＣＧＲＰ作用的靶细胞,应用特异性放射免疫反相法分析,测定３２例建党型银屑病慢性斑块型皮损组织提取液中ＣＧＲＰ的含量,用抗生物素蛋白－生物素－过氧化物酶复合法和兔抗人ＣＧＲＰ抗体进行免疫组化染色,观察ＣＧＲＰ分泌表达的部位和作用的靶细胞。结果建党型银屑病慢性