融合性网状乳头瘤病皮损中角质形成细胞分化标志分子的异常表达研究

融合性网状乳头瘤病(confluent and reticulate papillomatosis,CRP)是一种临床上相对少见的皮肤病,病因迄今不详.在前期的临床分析中我们发现:本病组织病理上有表皮角化过度及乳头瘤状增生,颗粒层变薄甚至消失,棘层肥厚,基底细胞层黑素增加,真皮浅层及血管周围少许单一核细胞浸润[1].     

神经酰胺诱导培养角质形成细胞分化的实验研究

目的：观察神经酰胺对无血清培养角质形成细胞分化的影响。方法：选择两种神经酰胺（C2和C6）,分别添加于无血清培养的角质形成细胞液中,并在添加后0、3、6、12、24h分别回收总RNA,用逆转录PCR（RT－PCR）方法,检测角质形成细胞分化的特异性标记：TGase1、IVL、KRT、、KRT10等mRNA表达情况。结果：神经酰胺添加后,C2－神经酰胺对TGase1 mRNA、IVL mRNA表达在12小时均明显上升,在24小时分别升高达阴性对照的5.7倍和5.2倍;但C2－神经酰胺对KRT1 mRNA和KRT10 mRNA表达升高不明显。C6－神经酰胺对TGase1 mRNA、IVL mRNA表达大致与C2－神经酰胺相似,只是24小时表达比C2－神经酰胺降低,分别为阴性对照的3.3倍和3.5倍;但C6－神经酰胺对KRT1 mRNA和KRT10 mRNA表达显著高于C2－神经酰胺,24小时分别高达5.4倍和10倍。结论：神经酰胺能明显升高无血清培养的角质形成细胞对分化特异性标记蛋白mRNA的表达,诱导角质形成细胞的分化。     

扁平苔藓皮损中细胞黏附分子CD43的表达

扁平苔藓(LP)是一种病因不明的累及皮肤和黏膜的疾病。细胞黏附分子CD43是一种广泛分布于造血细胞上的跨细胞膜的单链糖蛋白,具有多种生物学功能。为探讨CD43在LP皮损中的表达情况及其意义,采用免疫组化(SP)法及图像分析技术对32例LP皮损及30例对照皮肤进行了CD43、CD3、CD4、CD8的免疫组化染色研究。     

扁平苔藓皮损中caspase-3和Bax蛋白的表达

目的 探讨凋亡相关蛋白半胱氨酸天冬氨酸蛋白酶-3(caspase-3)和Bax在扁平苔藓皮损中的表达及其意义.方法 采用免疫组化SP法对29例扁平苔藓患者皮损组织和10例正常人皮肤组织中caspase-3和Bax的表达进行检测.结果 扁平苔藓皮损组织中caspase-3和Bax蛋白表达水平均明显高于正常皮肤组织,组间比较差异均有统计学意义(均P＜0.01).而且caspase-3蛋白表达与Bax的表达有显著相关性(P＜0.05).结论 Caspase-3和Bax可能通过诱导扁平苔藓皮损处角质形成细胞的凋亡而参与扁平苔藓的发病.     

尖锐湿疣皮损角质形成细胞ICAM-1及HLA-DR表达的研究

目的:研究细胞间黏附分子-1(ICAM-1)及人白细胞分化抗原DR区(HLA-DR抗原)在尖锐湿疣(CA)发病中的作用。方法:采用免疫组织化学技术一链酶亲和素一生物素复合物法(SABC法)对比研究CA初发组、CA复发组及正常人角质形成细胞(KC)表面ICAM-1及HLA-DR抗原的表达。结果:CA初发组与复发组间ICAM-1及HLA-DR抗原表达无显著性差异(P>0.05)。病例组中KC表面ICAM-1及HLA-DR抗原表达有一定相关性(r=0.4316,P<0.05)。结论:CA患者病损处KC表面表达ICAM-1及HLA-DR抗原使局部细胞免疫状态发生变化,诱导T细胞在病损处聚集、活化,是有效地启动并参与局部免疫应答、促进CA病损消退的关键。     

扁平苔藓皮损MMP-2、MMP-9的表达及外周血MMP-9的检测

目的: 探讨基质金属蛋白酶(MMP-2、MMP-9)在扁平苔藓皮损及外周血中的表达及意义.方法: 应用免疫组化SP法对33例扁平苔藓及20例正常皮肤组织MMP-2、MMP-9的表达进行观察,进一步采用双抗体夹心酶联免疫吸附法检测22例扁平苔藓和16例正常人血清中MMP-9水平.结果: MMP-2在扁平苔藓及正常皮肤组织几乎均无免疫组化着色.MMP-9在扁平苔藓强烈表达于表皮角质形成细胞及真皮淋巴细胞胞浆,其表达显著高于正常皮肤(P<0.01).扁平苔藓患者血清MMP-9水平明显高于对照组(P<0.01).结论: MMP-9在扁平苔藓基底膜带降解中发挥了作用.     

吲哚胺2,3-双加氧酶在尖锐湿疣皮损中表达的研究

目的 分析尖锐湿疣组织中吲哚胺2,3-双加氧酶(IDO)水平,研究其局部代谢色氨酸的能力.方法 免疫组化法观察尖锐湿疣患者皮肤IDO蛋白表达情况,计数IDO阳性细胞的比例.免疫荧光观察IDO(+)细胞与树突细胞的关系.分离对照皮肤角质形成细胞和疣体上皮细胞,色氨酸体外孵育后检测上清液中色氨酸代谢产物犬尿氨酸的浓度以反映细胞代谢色氨酸的能力.结果IDO(+)细胞在正常皮肤中非常少,但在疣体表皮中却大量聚集.疣体内IDO(+)细胞/总体细胞48.3%±15.4%显著高于正常皮肤5.2%±2.4%,差异有统计学意义(P<0.05).IDO(+)细胞的荧光信号和皮肤朗格汉斯细胞并不重合,提示来源于疣体表皮细胞.从疣体组织分离的上皮细胞在体外代谢色氨酸的能力强于健康对照皮肤中分离的表皮细胞.结论 尖锐湿疣疣体中存在大量的IDO(+)细胞,这些细胞可能参与尖锐湿疣的发病.     

半胱天冬酶-3、Bcl-2在扁平苔藓皮损中的表达

目的：探讨半胱天冬酶（caspase）-3和Bcl-2在扁平苔藓（LP）中的表达及意义。方法：应用免疫组化SP法对30例LP患者皮损和10名正常对照者皮肤中半胱天冬酶-3和Bcl-2的表达进行检测。结果：半胱天冬酶-3在LP皮损表皮中表达明显增强．Bcl-2在LP皮损表皮、真皮淋巴细胞浸润带的表达均明显增强;正常对照者皮肤基底细胞中半胱天冬酶-3表达仅为20％,Bcl-2偶见表达。结论：半胱天冬酶-3和Bcl-2在皮肤LP发生和发展中起一定作用。     

经典和色素性扁平苔藓常见皮肤镜特征的比较

目的：比较经典扁平苔藓与色素性扁平苔藓常见皮肤镜的特征。方法：选取13例经典扁平苔藓和6例色素性扁平苔藓患者共99处皮损进行皮肤镜检查并对其特征进行比较。结果：经典扁平苔藓常见的皮肤镜特征有Wickham纹,以片状模式为主的黄棕色色素结构和点状、线状及球状等血管;色素性扁平苔藓常见的皮肤镜特征有以点状、球状模式为主的蓝灰色、黄棕色色素结构和毛囊角栓。结论：皮肤镜可用于经典扁平苔癣和色素性扁平苔藓的辅助诊断。     

Keratin and involucrin expression in discoid lupus erythematosus and lichen planus

Received: 23 April 1996     

Prevalence of vulval lichen planus in a cohort of women with oral lichen planus: an interdisciplinary study

BACKGROUND: Lichen planus (LP) is a mucocutaneous inflammatory dermatosis that frequently involves the oral and genital mucosae. Patients with LP affecting these sites are often seen by oral medicine specialists or gynaecologists who work in isolation and depend heavily on histopathologists to help them in confirming the diagnosis. There are few studies in the literature combining the experiences of these specialists who share the care of patients with both oral and genital LP. OBJECTIVES: To estimate the prevalence of vulval LP (VLP) in a cohort of patients with histologically confirmed oral LP (OLP). METHODS: The study group consisted of 42 women histologically diagnosed with OLP. The mean age was 60.5 years (range 27-81). They underwent genital examination, colposcopy and vulvoscopy. For the histological confirmation of clinical VLP biopsies were performed whenever a clinical lesion was found. Oral and genital biopsy specimens were processed through histological and immunohistochemical staining. Histological diagnoses of LP were made according to the modified World Health Organization histopathological criteria proposed by van der Meij and van der Waal for the diagnosis of OLP, and extended to VLP. Patients with clinical evidence, but without the histological confirmation of OLP and VLP, were excluded from the study group. RESULTS: Thirty-two vulval and one vaginal biopsy specimens were obtained. Histological diagnoses were confirmed in 24 of 32 (75%) patients who underwent a vulval biopsy: these represent 57% (24 of 42) of the study group. Of the 12 patients free of symptoms such as itching, burning and dyspareunia, but with clinical vulval lesions, 11 (92%) had histological confirmation of VLP. Vulval lichen sclerosus was ascertained in five of 32 (16%) cases. CONCLUSIONS: This study showed a 57% prevalence of VLP in selected patients with OLP. The high prevalence of VLP of 92% in the women who were free of vulval symptoms confirmed the usefulness of this careful integrated approach.     

Camptothecin induces differentiation, tissue transglutaminase and apoptosis in cultured keratinocytes

Abstract: Cultured normal human adult keratinocytes were exposed to (S)-(+)- camptothecin over the concentration range 10^-5 to 10^-10 M. The dose-dependent inhibition of growth was recorded using cell counting. The induction of terminal differentiation was demonstrated by the relative increase in squamous and cornified cells, and the concomitant decrease in small, proliferative cells, with an overall decrease in total cell numbers on going from 10^-10 to 10^-6 M concentration of the drug. The induction of apoptosis was studied by assay of two types of transglutaminase, "tissue" and "keratinocyte", and by assay of histonelinked mono- and oligonucleosomes. Induction of apoptosis was accompanied with increase in "tissue" transglutaminase and in the amount of nucleosomes, the latter being indicative of endonuclease activity. This activity was sharply increased at a camptothecin concentration of 10^-5 M, and may have been faciliated by "tissue" transglutaminase at lower concentrations. The data suggest that camptothecin restricts keratinocyte growth by several mechanisms including apoptosis and emphasize its possible use in topical therapy for psoriasis.     

Bcl-2、p53在扁平苔藓病变组织中的表达

为了探讨扁平苔藓的发病机理，采用标记抗链菌卵蛋白生物素（ＬＳＡＢ）的方法，检测了３５例扁平苔藓Ｂｃｌ２和ｐ５３蛋白的表达。结果发现，在扁平苔藓组织中Ｂｃｌ２和ｐ５３蛋白有广泛的表达（分别为８５７１％和６０％），Ｂｃｌ２阳性表达率和强度均高于ｐ５３（两者Ｐ＜００５），并呈平行关系（Ｐ＜００５）。提示Ｂｃｌ２和ｐ５３可能是协同参与扁平苔藓病变的重要因素。     

Functional studies of skin mast cells in lichen planus

In order to identify possible functional differences between mast cells obtained from the skin of lichen planus (LP) patients and healthy donors, biopsies from lesional skin of 11 lichen planus patients and from normal skin of 7 healthy donors were sampled. Mast cells were obtained from the skin using an enzymatic dispersion technique. The cells were challenged in vitro with substance P (SP), tumor necrosis factor α (TNF-α) and anti-IgE. Their reactivity was estimated on the basis of histamine release. LP skin mast cells and healthy skin mast cells showed similar sensitivity to stimulation with TNF-α at a concentration of 10 ^–7 M (15.2% histamine release, as a proportion of total cellular content vs 15.9%) and to stimulation with anti-IgE at a dilution of 1:100) (38.8% vs 37.0%). Spontaneous histamine release was also very similar in both the populations of mast cells (10.2% vs 12.7%, respectively). However, LP skin mast cells showed significantly higher ( P < 0.01) sensitivity towards stimulation with SP at a concentration of 10 ^–4 M than healthy skin mast cells (15.9% histamine release vs 7.0%). This finding could suggest that neurogenic inflammatory mechanisms contribute to the pathogenesis of LP. Received: 3 July 1996