慢性特发性荨麻疹患者嗜碱粒细胞转录激活蛋白-1的相关研究

目的 探讨转录激活蛋白1（AP-1）在慢性特发性荨麻疹（CIU）发病中的作用。方法 采用嗜碱粒细胞免疫磁珠分离技术,提取CIU患者和正常人对照者外周血嗜碱粒细胞,进一步分离嗜碱粒细胞核蛋白。分别通过TransAM AP-1 Family试剂盒和Western印迹法,研究CIU患者和正常人对照者外周血嗜碱粒细胞AP-1家族因子DNA结合活性的改变及P-c-jun蛋白的表达情况。结果 CIU组与正常人对照组相比,嗜碱粒细胞AP-1家族因子DNA结合活性存在一定的差异。CIU组P-c-jun、c-fos、Fos-B、Jun-B、Jun-D因子DNA结合活性高于正常人对照组,其中P-c-jun、Jun-D差异有统计学意义（P ＜ 0.05）。Fra-1因子DNA结合活性检测中,CIU组低于正常人对照组,但差异无统计学意义（P ＞ 0.05）。Western印迹法发现, CIU组P-c-jun（Ser73）蛋白表达较之正常人对照组升高（P ＜ 0.05）,而P-c-jun（Ser63）蛋白表达两组之间差异无统计学意义。结论 CIU患者嗜碱粒细胞AP-1家族部分因子DNA结合活性的改变及P-c-jun（Ser73）蛋白表达升高可能为CIU发病环节之一。     

慢性自发性荨麻疹患者外周血嗜碱粒细胞CD63和CD203c的表达

目的：检测慢性自发性荨麻疹患者中外周血嗜碱粒细胞的活化状态。方法：采用流式细胞技术分别检测慢性自发性荨麻疹患者风团不同持续时间下（A组<2 h,15例;B组12~24 h,15例）、治疗后患者（C组,15例）及健康对照组（D组,15例）外周血嗜碱粒细胞CD63+和CD203c+的表达情况。结果：A、B、C三组外周血嗜碱粒细胞CD63+和CD203c+活化百分率（0.097±0.019,0.072±0.015,0.051±0.012）均高于对照D组（0.007±0.002,P<0.05）。A、B、C三组之间两两比较无显著差异（P>0.05）。结论：活化的嗜碱粒细胞可能参与了慢性自发性荨麻疹的发病过程,但与风团的持续时间无相关性。     

慢性荨麻疹患者的嗜酸性粒细胞阳离子蛋白和类胰蛋白酶测定

为研究嗜酸性粒细胞阳离子蛋白(ECP)、类胰蛋白酶(tryptase)在慢性荨麻疹中的变化,采用PHARMACIAUNICAP-100系统酶免疫荧光检测仪,分别对18例慢性荨麻疹患者和29名正常人作ECP和tryptase检测。结果,慢性荨麻疹患者组ECP测定值为7.74±9.35ng/L,阳性率为27.8%。正常对照组ECP测定值为2.33ng/L,阳性率为0。两组对比有明显差异(P<0.01)。慢性荨麻疹患者组tryptase测定值为7.34±5.02ng/L,阳性率为72.2%。正常对照组tryptase测定值为4.15±1.52ng/L,阳性率为10.34%。两组相比也有明显差异(P<0.01)。慢性荨麻疹患者中存在嗜酸粒细胞和肥大细胞的激活,其释放的ECP和tryptase可分别作为嗜酸性粒细胞和肥大细胞激活的标志物,并可能提示与I型变态反应的延缓相有关。     

荨麻疹患者外周血嗜碱性粒细胞表面CD63表达的研究

目的观察荨麻疹患者外周血中活化的嗜碱性粒细胞表面表达CD63的数量,探讨嗜碱性粒细胞的活化程度,为临床检测提供新方法。方法用屋尘螨浸液作划破试验,筛选敏感的荨麻疹患者。用CD63-FITC等抗体标记嗜碱性粒细胞,流式细胞技术检测CD63的表达情况。结果急、慢性患者活化嗜碱性粒细胞百分率分别为33.77～15.75%、11.66～5.25%,与正常人比较均有显著差异(P<0.05);经变应原刺激后,急、慢性患者活化嗜碱性粒细胞百分率分别为60.25～18.88%、22.22～7.89%,急、慢性患者活化前、活化后也均存在明显差异(P<0.05),而且急性患者活化程度更高(P<0.05)。结论通过测定嗜碱性粒细胞表达CD63可能有助于过敏的诊断。     

嗜碱性粒细胞在慢性自发性荨麻疹发病及治疗预测中的作用

嗜碱性粒细胞在慢性自发性荨麻疹(CSU)等变态反应性炎症中发挥着不可替代的作用.过敏反应期间,嗜碱性粒细胞以IgE依赖或非IgE依赖的方式被激活,细胞内外信号转导调节发生异常,释放组胺、IL-4、IL-13、血小板活化因子(PAF)等效应分子,组织中的趋化因子促进嗜碱性粒细胞向外周组织募集,使得外周血嗜碱性粒细胞减少....     

桂龙消玉汤治疗慢性荨麻疹的临床研究及对嗜酸粒细胞阳离子蛋白等的影响

目的研究桂龙消玉汤治疗风寒型慢性荨麻疹的疗效及机制，寻求新的检测方法。方法51例患者随机分为治疗组和对照组，治疗组给予桂龙消玉汤，对照组给予氯雷他定片加法莫替丁片口服。结果两组疗效比较P〈0．05，两组白介素-4、IgE比较均为P〈0．05，两组嗜酸粒细胞阳离子蛋白（ECP）及两组症状积分与ECP的关系均为P〈0．01或P〈0．05。结论桂龙消玉汤是通过调控Ⅰ型变态反应的多个环节达到治疗目的的．ECP检测是慢性荨麻疹灵敏简便的检测方法。     

慢性荨麻疹患者甲状腺自身抗体检出情况及其临床特征研究

目的 探讨伴有甲状腺自身抗体阳性的慢性荨麻疹患者临床与血清学特点.方法 2016年1-12月,杭州市第三人民医院皮肤科70例慢性荨麻疹住院患者,依据是否伴有甲状腺自身抗体进行分组.对比两组患者的荨麻疹临床表现、自身皮肤血清试验结果、住院天数、出院转归、血常规、抗体、血清总IgE和IgG.结果 70例慢性荨麻疹患者中有26例(37.1％)伴有甲状腺自身抗体阳性,44例(62.9％)甲状腺自身抗体阴性.甲状腺自身抗体阳性的慢性荨麻疹患者较甲状腺自身抗体阴性组风团更大,瘙痒更剧烈(z=4.399,P＜0.001)、持续时间更长(z=4.43,P＜0.001)、发作频率更高(z=7.362,P＜0.001)、更易伴发系统症状(x2=7.068,P＜0.05)、自身皮肤血清试验阳性率更高(x2=6.559,P＜0.05)、住院时间更长(t=3.184,P＜0.05)、出院时痊愈率更低(x2=5.524,P＜0.05)、嗜碱性粒细胞数量更低(t=3.19,P＜0.05).结论 伴有甲状腺自身抗体阳性的慢性荨麻疹患者多表现为病情较重的荨麻疹,多伴有自身皮肤血清试验阳性和嗜碱性粒细胞水平降低.     

特发性高嗜酸性粒细胞综合征

患者男,46岁。全身泛发丘疹、结节伴瘙痒3年。皮肤科检查：双侧腋窝及腹股沟多发淋巴结肿大,全身皮肤弥漫性褐色斑,躯干及四肢见多发黄豆大丘疹及结节,头发及眉毛脱落,皮损受累面积超过90%。实验室检查：外周血中嗜酸性粒细胞7.71×10⁹/L,血小板源性生长因子受体α(PDGFRA)、血小板源性生长因子受体β(PDGFRB)基因阴性。皮损组织病理示真皮乳头层及真皮浅层血管和皮肤附属器周围淋巴浆细胞及嗜酸性粒细胞浸润。骨髓涂片及组织病理示嗜酸性粒细胞计数及比例增高,诊断：特发性高嗜酸性粒细胞综合征。予甲泼尼龙及沙利度胺等治疗,嗜酸性粒细胞数降至正常,皮损及症状均改善。     

Comparison of chronic autoimmune urticaria with chronic idiopathic urticaria

BACKGROUND: Chronic urticaria has been described in patients with Helicobacter pylori infection. Despite numerous studies, the correlation between H. pylori infection and chronic urticaria is doubtful. Our study was performed to determine the prevalence of H. pylori infection in autoimmune urticaria and in patients suffering from autoimmune urticaria and autoimmune thyroiditis. METHODS: The authors widely investigated 48 patients. The examinations were extended principally to autologous serum skin test, antithyroid antibodies, and the presence of H. pylori infection as well as detection of antibodies against H. pylori. RESULTS: Out of the 48 patients, 26 were regarded as having autoimmune origin. The prevalence of antithyroid antibodies was different in the two groups of patients with urticaria. There were 11 patients (42.3%) in the autoimmune group compared with three patients (13.6%) in the nonautoimmune group with antithyroid peroxidase antibody (P = 0.03). The difference in the prevalence of H. pylori infection was significant between autoimmune urticaria with and without thyroid autoimmunity (90.9% vs. 46.7%; P = 0.02). Autoimmune thyroiditis was connected with CagA +H. pylori strains, as the H. pylori- specific IgG antibodies revealed significant differences in a prevalence of 120 kDa (P < 0.05). CONCLUSIONS: The authors observed a relationship between autoimmune urticaria and autoimmune thyroiditis. The results strengthen the possibility of cross-reactivity being triggered between CagA plus H. pylori strains and some other organ-specific autoimmune diseases such as autoimmune urticaria and autoimmune thyroiditis. This indicates a possible role of H. pylori in triggering autoimmune urticaria in at least a select group of patients.     

慢性特发性荨麻疹免疫机制研究进展

慢性特发性荨麻疹的病因目前尚不明确。研究表明,慢性特发性荨麻疹发病大多有自身免疫机制参与,现已发现了数种与慢性特发性荨麻疹有关的自身抗体,其中抗FcεRI抗体、抗IgE抗体在慢性特发性荨麻疹发病中的地位尤为重要。B淋巴细胞刺激因子可能参与慢性特发性荨麻疹自身抗体的形成。另外,部分慢性特发性荨麻疹患者HLA-Ⅱ类抗原的等位基因DRB1 04频率增加,提示该病发病具有自身免疫遗传基础。     

慢性特发性荨麻疹与瘦素水平的相关性研究

目的 探讨慢性特发性荨麻疹(CIU)与瘦素水平的相关性。方法 对45例CIU患者做了自体血清皮肤试验（ASST）,根据结果分为ASST阳性组及ASST阴性组,对CIU各组与32例正常对照组之间,采用放射免疫技术检测其血清瘦素水平,并进行比较。结果 （1）45例CIU患者中ASST阳性率为37.78%。（2）CIU患者血清瘦素水平（12.51士4.29ng/ml）较正常对照（15.57士4.38ng/ml）显著降低（P<0.01）。（3）与正常对照（15.57士4.38ng/ml）比较,ASST阳性组（11.30士4.41ng/ml）及ASST阴性组（13.23士4.13ng/ml）血清瘦素水平分别显著降低(P值分别为0.002,0.039);而ASST阳性组与ASST阴性组间瘦素水平无显著性差异（P>0.05）。结论 CIU患者瘦素水平下降,瘦素可能在CIU的发生发展中起作用。     

Helicobacter pylori and idiopathic chronic urticaria

BACKGROUND: Different studies have shown a high prevalence of Helicobacter pylori (HP) infection in patients with chronic urticaria (CU), and occasional remission of the skin lesions after eradication therapy. Recent investigations, however, have failed to find a significant relationship between the two conditions. We designed a case-control study to assess the prevalence of HP infection and the effect of bacterium eradication on the outcome of the skin disease in patients affected by CU. The literature is reviewed. METHODS: Twenty-five patients diagnosed with CU were included. Information about their medical history and a complete laboratory investigation ruled out other diseases or situations suspected to cause CU. Twenty-five healthy volunteers from a census-based, randomized sample were used as controls. HP infection was assessed by the (13)C-urea breath test (UBT). Eradication therapy included oral amoxicillin, omeprazole, and clarithromycin for 1 week. RESULTS: The high prevalence of HP infection (68%) and mean titer of UBT (24.13) in our patients with idiopathic CU do not differ from the general population. Marked differences were observed in the mean age of the CU patients with positive UBT (45.52years) vs. those without HP infection (35.25 years). After eradication therapy, only one patient showed a complete remission of urticaria and two showed a partial remission. CONCLUSIONS: Our results support a lack of relationship between HP infection and the course of idiopathic CU.     

Microarray analysis of phosphatase gene expression in human melanoma

BACKGROUND: Tyrosine phosphate is abnormally elevated in malignant melanoma, and this has been interpreted to reflect the activity of oncogenic protein tyrosine kinases. However, elevation may also arise due to decreased protein tyrosine phosphatase (PTP) expression. OBJECTIVES: To survey phosphatase gene expression in melanoma cell lines, a benign naevus and normal melanocytes: we searched for downregulation of phosphatase gene expression in malignant cells that may indicate a role as melanoma suppressor genes. METHODS: Microarray analysis was used to compare gene expression for 133 phosphatase genes, comprising 39 PTPs, 16 dual-specificity phosphatases (DSPs), 47 serine/threonine phosphatases and 31 acid/alkaline and lipid-based phosphatases. Northern blotting analysis was used to study gene expression in human melanoma biopsies. RESULTS: There was decreased expression of four DSP genes (including PTEN); eight receptor PTP genes were downregulated in melanoma, among which were PTP-KAPPA and PTP-PI (consistent with our previous data). In addition, PTP-RF/LAR was downregulated in 13 of 22 metastatic melanomas. CONCLUSIONS: The expression of multiple PTP receptors is decreased in melanoma; this may be a mechanism which stimulates autonomous growth in advanced melanoma.     

Clinical characteristics of pruritus in chronic idiopathic urticaria

BACKGROUND: Although pruritus is a predominant symptom of chronic idiopathic urticaria (CIU) its clinical characteristics have not been explored. OBJECTIVES: To characterize the clinical pattern and sensory and affective dimensions of the itch experience, utilizing a comprehensive itch questionnaire. METHODS: A structured questionnaire based on the McGill pain questionnaire was used in 100 patients suffering from CIU randomly recruited from a tertiary referral centre. RESULTS: All 100 patients recruited with CIU completed the questionnaire. In 68 patients pruritus appeared on a daily basis. Most patients experienced their pruritus at night and in the evening (n = 83), and 62 reported difficulty in falling asleep. Pruritus involved all body areas, but mostly the arms (n = 86), back (n = 78) and legs (n = 75). Accompanying symptoms were a sensation of heat in 45 patients and sweating in 15. Most patients (n = 98) were prescribed antihistamines (mainly sedating), of whom 34 experienced long-term relief. The sensation of itch was reported to be stinging (n = 27), tickling (n = 25) and burning (n = 23). Seventy-six patients found their pruritus bothersome, 66 annoying and 14 complained of depression. The itch intensity at its peak was more than double that felt after a mosquito bite. The worst itch scores of those who felt depressed were significantly higher than of those who did not (P = 0.018). There was a positive correlation between the sensory and affective scores during worst itch (P < 0.001). CONCLUSIONS: This study describes the itch experienced in CIU, highlighting sensory and affective dimensions. The itch questionnaire was found to be a valuable tool for evaluating pruritus in CIU and its unique features.