Primary cutaneous aggressive epidermotropic CD8+ T cell lymphoma with a chronic and indolent course. Is this different from peripheral T cell lymphoma?

Cutaneous T cell lymphomas most commonly have a CD4+ memory T cell phenotype and exhibit a relatively indolent course, but may in rare cases present with a CD8+ cytotoxic phenotype with a strikingly more aggressive clinical behavior. Primary cutaneous aggressive epidermotropic CD8+ T cell lymphoma is an extremely rare entity with distinct clinicopatological features. The clinical features and prognosis of the recently-described CD8+ peripheral lymphoma are very different from cytotoxic CD8+ epidermotropic lymphoma, but the histological and phenotypic characteristics are very similar. We report a new case of CD8+ epidermotropic lymphoma with a chronic course and suggest the possibility of an overlap between these two types of lymphoma.     

Variable CD7 expression on T cells in the leukemic phase of cutaneous T cell lymphoma (Sézary syndrome)

CD7, a molecule normally expressed on 90% of normal CD4+ T cells, is often deficient on the malignant T cells of cutaneous T cell lymphoma. To investigate the clinical and biologic implications of CD7 expression, blood lymphocytes from 42 patients with the leukemic phase of cutaneous T cell lymphoma (CD4/CD8 ratio of 10 or more with evidence of a T cell clone in the blood) were analyzed for level of expression of CD7 by flow cytometry. CD7 expression by cells did not clearly segregate into two distinct subgroups that are either CD7 positive or CD7 negative as generally thought; however, nine of 17 patients with a predominantly CD4+CD7+ tumor population on early studies became CD4+CD7- over time whereas the converse situation was not observed. In addition, of three patients with evidence of large tumor cells in the blood coexisting with smaller cells, discordant CD7 expression was observed in one instance. In lymph node specimens, the percentage of cells expressing CD7 and other T cell markers did not correlate with histologic evidence of involvement. CD7 expression on blood lymphocytes also did not correlate with patients' survival nor to serum IgE levels or blood eosinophil counts, a finding suggesting that this marker does not identify functional cell subsets that produce serum interleukin-4 or -5, respectively. We speculate that the level of CD7 expression on malignant T cells may be the effect of sustained antigen stimulation in vivo analogous to what has been proposed to occur with normal T cells during aging.     

Cutaneous T cell lymphoma: update on treatment

Background Cutaneous T-cell lymphoma (CTCL) is a myeloproliferative disease with pronounced epidermotropism. The major subtypes of CTCL are mycosis fungoides and Sézary syndrome. Survival is dependent on the histological subtype and clinical stage. Early CTCL has a normal life expectancy, therefore early disease recognition and stage adapted treatment might help to ensure a good prognosis. Methods This is a review of recent advances in CTCL treatment based on literature review. Results Skin targeted therapies are useful for patch and limited plaque disease with phototherapy as the cornerstone of such treatments. More advanced disease will benefit from systemic mono- or combined treatments including drug therapy, extracorporeal photopheresis, and radiotherapy. In practice combined treatments may reduce adverse events and improve response rates. For selected younger patients, stem cell transplantation seems a third-line option. Conclusions The therapeutic spectrum for CTCL has been advanced during the last years, providing the opportunity of tailored treatment for patients.     

HIV/AIDS患者CD4~+ T细胞中CD25和CD8~+ T细胞中CD28的表达

目的探讨外周血CD4+ T细胞中CD25表达率和CD8+ T细胞中CD28表达率在HIV/AIDS患者发病中的作用。方法应用流式细胞仪荧光染色技术检测35例HIV/AIDS患者CD4+ T细胞中CD25表达和CD8+ T细胞中CD28的表达,以41名健康体检人员做对照。结果HIV/AIDS患者和健康对照组之间CD4+ T细胞中CD25表达率(27.51±4.23)%,(44.41±9.17)%,CD4+25+ T细胞占淋巴细胞的比例(2.00±1.42)%,(16.62±4.60)%,CD4+25- T细胞占淋巴细胞的比例(5.16±3.37)%,(21.03±6.19)%,CD8+ T细胞中CD28中的表达率(25.12±6.33)%,(44.24±8.61)%,CD8+28- T细胞占淋巴细胞的比例(36.85±8.98)%,(13.33±4.58)%的差异均有显著性(P<0.01),CD8+ 28+ T细胞占淋巴细胞的比例(12.31±4.14)%,(10.51±3.71)%差异无显著性(P>0.05)。结论HIV/AIDS患者CD25在CD4+ T细胞与CD28在CD8+ T细胞的表达率降低可能与HIV感染后引起的免疫缺陷有关,CD8+ CD28- T细胞的增加有助于促进HIV/AIDS患者的炎性反应和免疫激活。     

皮肤CD8+T细胞淋巴瘤

皮肤CD8+T细胞淋巴瘤罕见,常见于成人.皮肤损害可表现为蕈样肉芽肿(MF)样、Sezary综合征样、全身性银屑病样、播散性湿疹样网状细胞增生病(PR)、限局性PR和皮肤结节等.约半数病例为侵袭性或惰性.瘤细胞常示向表皮性和主要浸润于皮肤附属器周围,示CD8+、CD7+、CD3+,但常丢失CD2和CD5,不常表达活化抗原(CD25、CD30、Iα).此瘤需与富于CD8+T细胞的疾病如皮肤红斑狼疮、银屑病等鉴别,以及与MF之反应性CD8+细胞区别.     

系统性红斑狼疮患者外周血中T细胞CD4CD25的表达

目的了解CD4,CD25在系统性红斑狼疮患者外周血T细胞中的表达水平及其临床意义。方法用流式细胞术检测30例正常人和30例活动期系统性红斑狼疮(SLE)患者外周血中T细胞CD4,CD25的表达水平,根据CD25表达荧光强度>100者为T细胞CD4+CD25+bright,并与SLE活动指数评分(SLEDAI)进行相关分析。结果SLE患者外周血T细胞CD4+CD25+表达率为(8.82±2.98)%,显著低于对照组(12.24±5.71)%(P<0.05);患者组T细胞CD4+CD25bright表达率为(1.56±0.76)%,低于对照组(2.23±1.22)%(P<0.05),差异有统计学意义;SLE患者外周血T细胞CD4+CD25+、T细胞CD4+CD25bright表达率与SLEDAI评分两者之间无相关性;r分别为-0.156,-0.153,P均>0.05)。结论SLE患者外周血中T细胞CD4+CD25+减少,其可能在发病机制中起一定的作用,低水平T细胞CD4+CD25bright在SLE发病中的确切作用机制有待进一步阐明。     

银屑病患者外周血T淋巴细胞CD40/CD40L表达上调

近年来认为T细胞在银屑病的发病中起重要作用,共刺激信号CD40/CD40L对T细胞的活化是必须的.我们采用流式细胞仪检测进行期寻常性银屑病(以下简称银屑病)患者外周血CD40/CD40L的表达,以探讨其在银屑病发病中的作用.     

CD4+CD25bright调节性T细胞在皮肤病中的作用

CD4~ CD25~(bright)调节性T细胞是一个具有免疫抑制功能的T细胞亚群,丰要通过细胞间直接接触发挥抑制作用,参与机体自身免疫耐受的形成。近年研究发现,CD4~ cD25~(bright)出调节性T细胞在多种皮肤科相关疾病,如感染性疾病、自身免疫病、肿瘤、银屑病以及特应性皮炎的发生发展中起一定的作用。     

散发型白癜风患者外周血CD4~+/CD8~+T细胞比值及CD4~+CD25~+T细胞的检测

目的检测散发型白癜风患者外周血CD4+/CD8+T细胞比值及CD4+CD25+调节性T细胞水平,探讨其与散发型白癜风发病的关系。方法散发型白癜风患者29例,男13例,女16例。通过流式细胞仪对散发型白癜风患者外周血CD4+/CD8+T细胞比值及CD4+CD25+调节性T细胞水平进行检测,并与20例健康人相比较。结果与健康对照组相比,散发型白癜风患者外周血中CD4+/CD8+T细胞比值的差异无统计学意义(P0.05),而CD4+CD25+调节性T细胞水平明显减少,差异有统计学意义(P0.05),但在不同病程的患者中CD4+CD25+调节性T细胞数量的差异无统计学意义(P0.05)。结论散发型白癜风患者外周血中存在CD4+CD25+调节性T细胞水平下降,可能与散发型白癜风的发生发展有一定关系。     

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.     

带状疱疹患者外周血CD+4T细胞表面CD28的表达

目的 研究带状疱疹患者外周血CD3+T、CD4+T及CD4+T细胞表面CD28的表达,探讨CD4+T细胞活化功能状态在带状疱疹发病中的意义.方法 利用流式细胞仪检测35例带状疱疹患者外周血CD3+T、CD4+T及CD4+T细胞表面CD28的表达,以20例正常人作为对照,并分别与患者的临床特征进行比较.结果 状疱疹患者外周血CD3+T细胞、CD4+T细胞及CD4+CD28+T细胞的比率较正常对照组显著降低;不同年龄组和不同病程组患者外周血CD4+T细胞和CD4+CD4+T细胞的比率差异有统计学意义;但不同病情组的表达差异无统计学意义.结论 状疱疹患者外周血CD4+T细胞表面的CD28表达下调,通过影响CD4+T细胞活化,可能参与带状疱疹的发生.     

系统性红斑狼疮患者CCR7+CD8+CD45RO+T细胞诱导CD4＋T细胞向Th2分化

目的探讨系统性红斑狼疮(SLE)患者外周血CCR7 CD8 CD45RO 记忆性T细胞对CD4 T细胞的诱导分化作用及其与SLE发病的关系。方法流式细胞仪、实时定量RT-PCR和RNA印迹检测同系CCR7 CD8 CD45RO T细胞和树突细胞协同刺激CD4 T细胞分泌细胞因子。结果活动期SLE患者CCR7 CD8 CD45RO 记忆性T细胞诱导CD4 T细胞表达Th2类细胞因子:白介素4的表达效率显著高于正常人对照组和非活动期SLE患者组(P<0.01),1型调节性T细胞(Tr1)源性细胞因子:白介素10和转化生长因子β的表达效率均低于正常对照组和非活动期SLE患者组(P<0.01);而活动期和非活动期SLE患者干扰素γ的表达效率显著低于正常人对照组(P<0.01)。结论活动期SLE患者外周血CCR7 中央型记忆性T细胞可与树突细胞相互作用,诱导同系CD4 T细胞向Th2分化,发挥CCR7-CD45RO 效应性记忆性T细胞的功能。     

活动性皮肌炎CD4+CD25+CD127lo/-调节性T细胞的检测

皮肌炎(DM)是一种自身免疫性结缔组织病.CD4+CD25+调节性T细胞(Treg)是存在于人胸腺和外周血中的一类具有免疫抑制作用的T细胞亚群,该细胞数量减少或者功能异常均可导致自身免疫性疾病的发生.转录因子Foxp3是Treg细胞的特征性检测分子.研究发现,表面标志CD127(IL-7αR)的表达与Foxp3呈负相关,可以代替Foxp3作为Treg细胞的检测标志[1].为研究Treg细胞在活动性DM患者发病机制中的作用,我们分别对17例活动性DM患者和正常人对照外周血中的CD4+CD25+、CD4+CD25+CD127lo/-T细胞的百分比进行检测,同时与患者血清肌酸激酶(CK)含量进行相关性分析.并对其中7例住院患者给予糖皮质激素联合免疫抑制剂治疗,观察治疗后10 d,20 d CD4+CD25+和CD4+CD25+CD127lo/-T细胞百分比的变化.     

白癜风患者外周血CD4+CD25+调节性T细胞的检测

Objective To determine the level of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo at different stages and to study its relationship with the development of vitiligo. Methods Blood samples were collected from 34 outpatients with vitiligo, including 19 cases of progressive vitiligo and 15 cases of stable vitiligo, as well as from 20 normal human controls. Flow cytometry was used to detect the levels of peripheral CD4+ and CD4+CD25+ T lymphocytes in these samples. Results Compared with the controls, the percentage of CD4+CD25+ regulatory T lymphoeytes in peripheral lymphocytes was significantly lower in patients with progressive vitiligo than those in patients with stable vitiligo and normal human con-trois [(2.43±0.30)% vs (3.49±0.39)% and (3.34±0.24)%, both P <0.05], but no significant difference was found between patients with stable vitiligo and normal human controls (P＞0.05). A significantly nega-tive correlation was observed between the percentage of CD4+CD25+ regulatory T lymphocytes and lesion area in patients with progressive vitiligo (r = -0.48, P <0.05), but not in patients with stable vitiligo (P ＞0.05). There was no significant correlation between the course of disease and the percentage of peripheral CD4+CD25+ regulatory T lymphocytes in patients with progressive vitiligo or stable vitiligo (both P ＞ 0.05). Conclusion There is an abnormal proportion of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo, which may be related to the development of vitiligo.     

CD4+ CD25+调节性T细胞及其在性传播疾病中的作用

CD4 CD25 调节性T细胞(CD4 CD25 Treg)是近年来确定的一类具有免疫抑制功能的T细胞亚群,可通过与细胞直接接触和分泌细胞因子如IL-10、TGF-β发挥调节作用,在维持机体免疫自稳、防止自身免疫以及抗感染免疫、肿瘤免疫、移植免疫、变态反应等方面起着重要作用.本文就CD4 CD25 Treg分化发育、表型、作用机制及其在性传播疾病中的作用作一综述.     

白癜风患者外周血CD4+CD25+调节性T细胞的检测

Objective To determine the level of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo at different stages and to study its relationship with the development of vitiligo. Methods Blood samples were collected from 34 outpatients with vitiligo, including 19 cases of progressive vitiligo and 15 cases of stable vitiligo, as well as from 20 normal human controls. Flow cytometry was used to detect the levels of peripheral CD4+ and CD4+CD25+ T lymphocytes in these samples. Results Compared with the controls, the percentage of CD4+CD25+ regulatory T lymphoeytes in peripheral lymphocytes was significantly lower in patients with progressive vitiligo than those in patients with stable vitiligo and normal human con-trois [(2.43±0.30)% vs (3.49±0.39)% and (3.34±0.24)%, both P <0.05], but no significant difference was found between patients with stable vitiligo and normal human controls (P＞0.05). A significantly nega-tive correlation was observed between the percentage of CD4+CD25+ regulatory T lymphocytes and lesion area in patients with progressive vitiligo (r = -0.48, P <0.05), but not in patients with stable vitiligo (P ＞0.05). There was no significant correlation between the course of disease and the percentage of peripheral CD4+CD25+ regulatory T lymphocytes in patients with progressive vitiligo or stable vitiligo (both P ＞ 0.05). Conclusion There is an abnormal proportion of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo, which may be related to the development of vitiligo.     

CD+4 CD+25调节性T细胞在自身免疫病中的意义

阐明CD4 CD2 5调节性T细胞作用机制及其自身免疫病的关系。     

白癜风患者外周血CD4+CD25+调节性T细胞的检测

Objective To determine the level of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo at different stages and to study its relationship with the development of vitiligo. Methods Blood samples were collected from 34 outpatients with vitiligo, including 19 cases of progressive vitiligo and 15 cases of stable vitiligo, as well as from 20 normal human controls. Flow cytometry was used to detect the levels of peripheral CD4+ and CD4+CD25+ T lymphocytes in these samples. Results Compared with the controls, the percentage of CD4+CD25+ regulatory T lymphoeytes in peripheral lymphocytes was significantly lower in patients with progressive vitiligo than those in patients with stable vitiligo and normal human con-trois [(2.43±0.30)% vs (3.49±0.39)% and (3.34±0.24)%, both P <0.05], but no significant difference was found between patients with stable vitiligo and normal human controls (P＞0.05). A significantly nega-tive correlation was observed between the percentage of CD4+CD25+ regulatory T lymphocytes and lesion area in patients with progressive vitiligo (r = -0.48, P <0.05), but not in patients with stable vitiligo (P ＞0.05). There was no significant correlation between the course of disease and the percentage of peripheral CD4+CD25+ regulatory T lymphocytes in patients with progressive vitiligo or stable vitiligo (both P ＞ 0.05). Conclusion There is an abnormal proportion of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo, which may be related to the development of vitiligo.     

白癜风患者外周血CD4+CD25+调节性T细胞的检测

Objective To determine the level of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo at different stages and to study its relationship with the development of vitiligo. Methods Blood samples were collected from 34 outpatients with vitiligo, including 19 cases of progressive vitiligo and 15 cases of stable vitiligo, as well as from 20 normal human controls. Flow cytometry was used to detect the levels of peripheral CD4+ and CD4+CD25+ T lymphocytes in these samples. Results Compared with the controls, the percentage of CD4+CD25+ regulatory T lymphoeytes in peripheral lymphocytes was significantly lower in patients with progressive vitiligo than those in patients with stable vitiligo and normal human con-trois [(2.43±0.30)% vs (3.49±0.39)% and (3.34±0.24)%, both P <0.05], but no significant difference was found between patients with stable vitiligo and normal human controls (P＞0.05). A significantly nega-tive correlation was observed between the percentage of CD4+CD25+ regulatory T lymphocytes and lesion area in patients with progressive vitiligo (r = -0.48, P <0.05), but not in patients with stable vitiligo (P ＞0.05). There was no significant correlation between the course of disease and the percentage of peripheral CD4+CD25+ regulatory T lymphocytes in patients with progressive vitiligo or stable vitiligo (both P ＞ 0.05). Conclusion There is an abnormal proportion of peripheral CD4+CD25+ regulatory T lymphocytes in patients with vitiligo, which may be related to the development of vitiligo.     

白癜风患者外周血CD4+CD25+调节性T细胞的检测

目的 检测不同病期白癜风患者外周血CD4+CD25+调节性T细胞水平,探讨其与白癜风发病的关系.方法 白癜风患者34例,进展期19例,稳定期15例.通过流式细胞仪对不同病期白癜风患者外周血CD4+、CD4+CD25+T细胞水平进行检测,并与20例正常人比较.结果 进展期患者外周血中CD4+CD25+调节性T细胞占外周血淋巴细胞的表达率低于正常对照组(P<0.05);稳定期患者与正常对照组比,差异无统计学意义(P＞0.05);进展期患者低于稳定期患者,差异有统计学意义(P<0.05).进展期患者CD4+CD25+调节性T细胞占外周血淋巴细胞表达率与皮损面积呈负相关(P<0.05),稳定期则无相关性(P＞0.05).进展期与稳定期患者CD4+CD25+调节性T细胞占外周血淋巴细胞水平与病程均无明显相关性(P＞0.05).结论 白癜风患者外周血中存在异常比例的cD4+CD25+调节性T细胞,可能与白癜风的发病有关.