白芍总苷联合环磷酰胺治疗系统性红斑狼疮及对外周血CD4^+CD25^+T细胞表达水平的影响

目的探讨白芍总苷联合环磷酰胺治疗系统性红斑狼疮(SLE)及对外周血CD4^+CD25^+T细胞表达水平的影响。方法研究对象为我院确诊的系统性红斑狼疮患者74例,按随机数字表法分为对照组和研究组,对照组37例予以环磷酰胺联合糖皮质激素治疗,研究组37例在对照组基础上予以白芍总苷治疗,测定所有患者治疗前后血清学指标,同时进行随访,记录不良反应及复发率状况。结果相对于治疗前,2组治疗后IgA、IgG、IgM,CD40^+,血清人可溶性血管细胞黏附因子(sVCAM)-1、白细胞介素(IL)-18,血管内皮生长因子(VEGF),基质金属蛋白酶(MMP)-3含量均降低,C3、C4,CD4^+CD25^+,MMP-9含量均升高,差异有统计学意义(P<0.05);相对于对照组,研究组治疗后IgA、IgG、IgM,CD40^+,sVCAM-1、IL-18,VEGF,MMP-3含量较低,C3、C4,CD4^+CD25^+,MMP-9含量较高,差异有统计学意义(P<0.05);研究组复发率18.92%(7/37)低于对照组复发率40.54%(15/37),2组间复发率对比,差异有统计学意义(P<0.05);与对照组比较,观察组总有效率为显著高于对照组,差异有统计学意义(P<0.05)。结论白芍总苷联合环磷酰胺治疗系统性红斑狼疮疗效确切,CD4^+CD25^+T细胞表达率提高,值得推广。     

微创手术治疗卵巢良性肿瘤对围手术期相关指标、生殖激素水平、体液及细胞免疫水平的影响

目的探讨腹腔镜手术治疗卵巢良性肿瘤的临床效果及对患者生殖激素、体液及细胞免疫功能的影响。方法选取2017年2月至2018年2月重庆市大足区人民医院诊治的118例良性卵巢肿瘤患者作为研究对象。采用随机数字表法分为微创组和传统组,每组各59例。微创组采用腹腔镜手术治疗,传统组采用传统开腹手术治疗,比较两组患者的围手术期相关指标、手术前后的血清雌激素(E2)、黄体生成素(LH)、促卵泡激素(FSH)、血清免疫球蛋白及外周血T淋巴细胞亚群。结果微创组患者的手术时间、术中出血量、术后肛门排气时间、住院时间均低于传统组,差异具有统计学意义(P0.05);术前,两组患者的血清E_2、LH、FSH水平差异无统计学意义(P0.05);术后,微创组患者的血清E_2高于传统组,差异具有统计学意义(P0.05),LH、FSH水平低于传统组,差异具有统计学意义(P0.05);术前,两组患者的CD3~+T细胞、CD4~+ T细胞、CD8~+ T细胞、CD4~+/CD8~+水平差异无统计学意义(P0.05);术后,微创组患者的CD3~+ T细胞、CD4~+ T细胞、CD4~+/CD8~+水平高于传统组,差异具有统计学意义(P0.05),CD8~+ T细胞水平低于传统组,差异具有统计学意义(P0.05);术前,两组患者的IgG、IgM、IgA水平差异无统计学意义(P0.05);术后,微创组患者的IgG水平高于传统组(P0.05),差异具有统计学意义,IgM、IgA水平与传统组差异无统计学意义(P0.05)。结论腹腔镜手术治疗卵巢良性肿瘤具有创伤小、恢复快,对患者的生殖激素水平、免疫功能影响更小的特征。     

多糖蛋白联合苄星青霉素对早期隐性梅毒患者的效果观察

目的探讨多糖蛋白联合苄星青霉素对早期隐性梅毒患者的效果。方法选取2016年1月至2018年4月湖北省孝感市中心医院诊治的96例早期隐性梅毒的患者作为研究对象。分为联合组(n=48,苄星青霉素治疗+多糖蛋白),对照组(n=48,苄星青霉素治疗)。比较治疗前后两组患者临床疗效,血液中T淋巴细胞CD3~+、CD4~+、CD8~+和免疫球蛋白IgA、IgG、IgM水平,血清中丙二醛(MDA)和超氧化物歧化酶(SOD)水平和不良反应发生率。结果治疗后,联合组患者与对照组患者临床疗效等级分布和总有效率比较,差异具有统计学意义(P0.05),且联合组患者总有效率更高,差异具有统计学意义(P0.05);联合组患者和对照组患者CD3~+、CD4~+、CD4~+/CD8~+水平升高,且联合组患者更高,差异均具有统计学意义(均P0.05),联合组患者和对照组患者CD8~+水平降低,且联合组患者更低,差异均具有统计学意义(均P0.05);联合组患者和对照组患者IgA、IgG、IgM水平降低,且联合组患者更低,差异均具有统计学意义(均P0.05);联合组患者和对照组患者MDA水平降低,且联合组患者更低,差异均具有统计学意义(均P0.05),联合组患者和对照组患者SOD水平显著升高(P0.05),且联合组患者更高(P0.05);两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论使用多糖蛋白联合苄星青霉素能够显著改善早期隐性梅毒患者临床疗效,纠正患者T淋巴细胞亚群失衡,改善免疫失调,减轻氧化应激且安全性良好。     

特应性皮炎患儿外周血T细胞亚群与总IgE水平的相关性研究

目的探讨儿童特应性皮炎的外周血T细胞亚群水平及其与总IgE水平的相关性。方法采用流式细胞分析技术及荧光酶联免疫法对18例特应性皮炎患儿和18例正常儿童外周血T细胞亚群及总IgE水平进行测定。结果特应性皮炎患儿外周血CD4+、CD4+/CD8+比值均高于正常对照组(p0.01,p0.05),CD8+低于正常对照组(p0.05)。IgE增高特应性皮炎组CD4+、CD4+/CD8+比值均高于IgE正常组(p0.01,p0.05)和正常对照组(p0.01,p0.05),CD8+低于正常对照组(p0.05);IgE正常组CD4+、CD8+、CD4+/CD8+比值与正常对照组比较均无显著性差异(p0.05)。结论儿童特应性皮炎存在免疫功能失衡,表现为CD4+T细胞增多,功能亢进,CD8+T细胞不足导致免疫功能紊乱。T细胞亚群变化与总IgE水平增高相关。     

香蓝驱毒颗粒对扁平疣患者IgG、IgA及IgM水平的影响

目的评价中药香蓝驱毒颗粒对扁平疣患者免疫球蛋白IgG、IgA及IgM水平的影响。方法对照组60例扁平疣患者外用α-2b干扰素凝胶,治疗组60例扁平疣患者在对照组治疗方案的基础上口服用香蓝驱毒颗粒,均用药6周。测定治疗组及对照组扁平疣患者治疗前后及正常人群组血清IgG、IgA及IgM水平。结果治疗组与对照组治疗前IgG、IgA与IgM水平差异无统计学意义(P0.05),但均低于正常人组(P0.01);治疗后治疗组患者血清IgG、IgA及IgM水平明显高于治疗前(P0.01),并明显高于对照组(P0.01)。对照组治疗前后IgG、IgA与IgM水平差异无统计学意义(P0.05)。结论中药香蓝驱毒颗粒治疗扁平疣,其发挥疗效的作用机制,与提高患者的免疫球蛋白水平相关,可以提高患者的体液免疫效应,增强机体的抗病毒能力。     

复方虎杖散颗粒联合阿昔洛韦对复发性生殖器疱疹患者免疫功能、炎症指标的影响

目的探讨复方虎杖散颗粒联合阿昔洛韦对复发性生殖器疱疹(RGH)患者免疫功能、炎症指标的影响。方法选取2017年4月至2018年5月湖南中医药大学第一附属医院诊治的120例阴虚内热型RGH患者作为研究对象。随机分为两组,对照组(n=60)口服阿昔洛韦片,研究组(n=60)在对照组基础上予以复方虎杖散颗粒治疗。治疗结束后,比较两组患者临床疗效、中医证候积分、血清中炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、白细胞介素4(IL-4)]水平及T细胞亚群(CD3~+、CD4~+、CD8~+)水平,不良反应。结果对照组总有效率(85.00%)低于研究组(96.67%),差异具有统计学意义(P0.05)。治疗前,两组患者中医证候积分、IL-6、TNF-α、IL-4水平及CD3~+、CD4~+、CD8~+水平比较差异无统计学意义(P0.05);治疗后,两组患者中医证候积分、复发次数及IL-6、TNF-α、IL-4、CD8~+水平较本组治疗前明显下降,CD3~+、CD4~+值较本组治疗前明显升高,差异具有统计学意义(P0.05);治疗后,研究组患者中医证候积分、平均复发次数及IL-6、TNF-α、IL-4、CD8~+水平明显低于对照组,CD3~+、CD4~+水平明显高于对照组,差异均具有统计学意义(均P0.05)。观察组和对照组总不良反应发生率比较,差异无统计学意义(P0.05)。结论复方虎杖散颗粒联合阿昔洛韦治疗RGH疗效显著,可通过降低炎症因子IL-6、TNF-α、IL-6水平,调节免疫指标CD3~+、CD4~+、CD8~+水平改善患者临床症状,值得推广。     

NB-UVB对特应性皮炎患者外周血CLA~+CD8~+T细胞的影响

目的观察窄谱中波紫外线(NB-UVB)治疗特应性皮炎(AD)患者的临床疗效,并分析其对外周血皮肤归巢的CD8~+T细胞数量及表达杀伤功能相关蛋白水平的影响,探讨NB-UVB治疗AD的作用机制。方法选取19例AD患者,予NB-UVB照射治疗8周,采用特应性皮炎积分指数(SCORAD)判断病情严重程度;并用流式细胞术检测外周血表达皮肤淋巴细胞相关抗原(cutaneous lymphocyte-associated antigen,CLA)的CD8~+T细胞(CLA~+CD8~+T细胞)的比例,分析其杀伤功能相关蛋白穿孔素、颗粒酶B的表达。另选15例健康体检者作为正常对照。结果 (1)SCORAD评分在AD治疗前组明显高于治疗后组,差异有统计学意义(P0.01);(2)CLA~+CD8~+T细胞的比例在AD治疗前组明显高于对照组,差异有统计学意义(P0.01),且AD治疗前组CLA~+CD8~+T细胞的比例与SCORAD评分正相关(Pearson相关,P0.01);穿孔素和颗粒酶B的表达在AD治疗前组均明显高于对照组,差异均有统计学意义(P均0.01);(3)NB-UVB治疗后,AD患者血清CLA~+CD8~+T细胞的比例较治疗前明显降低,差异有统计学意义(P0.05),且表达穿孔素和颗粒酶B水平也均较治疗前明显下降,差异均有统计学意义(P均0.05)。结论 NB-UVB照射可明显下调AD患者外周血CLA~+CD8~+T细胞的比例及杀伤功能相关蛋白的表达,这可能是NB-UVB治疗AD的机制之一。NB-UVB治疗AD安全有效。     

112例白癜风患者外周血T淋巴细胞亚群和免疫球蛋白及补体水平的检测分析

目的:了解白癜风患者的细胞免疫和体液免疫功能状态.方法:对112例白癜风患者外周血T淋巴细胞亚群采用流式细胞仪进行定量分析,并检测血清IgG、IgA、IgM、C3和C4水平.同时以60例健康体检者做对照.结果:寻常型进展期患者CD3 T细胞、CD4 T细胞水平低于正常对照组,CD8 T细胞则升高(P＜0.01);寻常型稳定期及节段型的结果与正常对照组差异无统计学意义.白癜风患者血清IgG、IgA、IgM、C3和C4水平与对照组差异无统计学意义.结论:白癜风患者的免疫功能存在一定程度的异常.     

重组人干扰素α-2b应用时机对宫颈上皮内瘤变治疗效果的影响

目的:探讨重组人干扰素α-2b应用时机对宫颈上皮内瘤变治疗效果的影响。方法:选取我院2014年1月至2015年2月收治的129例采用LEEP刀宫颈锥切术治疗的宫颈上皮内瘤变患者进行研究,按随机数字表法将其分为研究组和对照组,研究组在术前术后均给予重组人干扰素α-2b治疗,对照组在术后给予重组人干扰素α-2b,比较两组患者治疗效果及免疫功能水平。结果:研究组治疗总有效率为90.76%,对照组为75.00%,组间比较差异有统计学意义(χ~2=4.612,P0.05)。术后1年随访,研究组无复发病例,对照组5例(7.81%)复发,复发率比较差异无统计学意义(χ~2=3.391,P0.05)。研究组术中出血量[(4.46±1.65)m L vs(24.31±3.26)m L]和愈合时间[(4.25±1.51)周vs(5.63±1.74)周]较对照组低,阴道排液量月经量发生率低于对照组,差异有统计学意义(P0.05)。治疗后研究组CD8~+水平低于对照组,IgG、IgM、IgA、CD4~+、CD4~+/CD8~+均高于对照组,差异有统计学意义(P0.05)。结论:LEEP刀宫颈锥切术治疗宫颈上皮内瘤变手术前后均应给予重组人干扰素α-2b治疗,可有效提高治疗效果,改善患者免疫功能。     

中重度特应性皮炎患者外周血IL-31水平及IgE表达与临床相关性

目的检测中重度特应性皮炎患者外周血白细胞介素(IL)-31及IgE的水平、CD4~+T细胞的活化。方法中重度特应性皮炎患者18例及健康对照者25例,抽取外周静脉血,流式细胞仪检测CD3~+CD4~+CD69~+T细胞百分比,ELISA检测血清中IL-31、IgE的水平。结果中重度特应性皮炎患者外周血CD3~+CD4~+CD69~+T细胞百分比明显升高(P0.01)。外周血IL-31及IgE的水平均明显升高(P0.01),与SCORAD评分均有显著性相关(P0.01)。结论特应性皮炎患者体内T细胞被信号分子激活活化,从而可能促进细胞因子的分泌而加重临床症状。     

电灼结合中药内服外洗治疗尖锐湿疣的疗效观察

目的观察电灼结合中药内服外洗治疗尖锐湿疣的临床疗效及对患者T淋巴细胞亚群的影响。方法选择从2013年7月至2017年11月山西医科大学附属大同市第三人民医院泌尿外科治疗尖锐湿疣的患者148例,随机分成对照组和观察组两组,每组74例。对照组患者单独采用电灼治疗;观察组患者在采用电灼基础上结合中药内服外洗共同治疗。结果观察组尖锐湿疣患者复发率为10.8%,低于对照组尖锐湿疣患者复发率28.4%,差异具有统计学意义。(P<0.01)。两组治疗后复发组CD3+细胞、CD4+细胞水平、CD4+/CD8+细胞比值较未复发组低,而CD8+细胞水平较未复发组高,差异具有统计学意义。(P<0.05)。治疗后,观察组尖锐湿疣患者CD3+水平、CD4+水平、CD4+/CD8+比值高于对照组尖锐湿疣患者,且观察组尖锐湿疣患者CD8+水平低于对照组尖锐湿疣患者CD8+水平,差异具有统计学意义(P<0.01)。结论电灼结合中药内服外洗能减少尖锐湿疣的复发率。在临床治疗中,监测尖锐湿疣患者外周血T淋巴细胞亚群,对尖锐湿疣患者治疗后的复发预估及相应增强免疫治疗具有重要的指导意义。     

过敏性紫癜病情与免疫球蛋白及T淋巴细胞亚群水平的相关性研究

目的探讨过敏性紫癜患儿病情与免疫球蛋白及T淋巴细胞亚群水平的相关性。方法收集2017年11月至2019年2月来我院进行治疗的90例过敏性紫癜(HSP)患儿的临床资料,作为观察组。选取同时期来我院进行健康体检的健康志愿儿童90例为对照组。观察免疫球蛋白水平、各组T淋巴细胞亚群及NK细胞阳性百分率、相关性。结果重度组IgA、IgG、IgM水平最高,中度组次之,轻度组最低,但都高于对照组,组间对比,差异显著(P <0.05);重度组CD3+T、CD4+T、CD4+T/CD8+T、NK细胞阳性百分率水平最低,CD8+T水平最高,组间对比,差异显著(P <0.05);血清IgA水平、CD8+T水平,和HSP症状表现为正相关,r=0.618、0.591,P <0.05;CD3+T、CD4+T、CD4+T/CD8+T、NK细胞阳性百分率水平,和HSP症状表现为负相关,r=-0.612、-0.588、-0.579、-0.599,P <0.05。结论过敏性紫癜患儿病情与免疫球蛋白及T淋巴细胞亚群水平有相关性,临床可根据这些指标的变化,辅助临床诊断。     

New insights into disease pathogenesis in crusted (Norwegian) scabies: the skin immune response in crusted scabies

Background Crusted scabies is a rare and severely debilitating disease characterized by infestation of the skin with up to millions of Sarcoptes scabiei mites, high total IgG levels, extremely high total IgE levels, and the development of hyperkeratotic skin crusts that may be loose, scaly and flaky or thick and adherent. Objectives To describe crusted scabies skin pathogenesis and identify markers associated with an inappropriate immune response leading to disease progression. Patients/methods Serial sections from skin biopsies obtained from two patients with severe crusted scabies were examined by immunohistochemistry for cell surface markers and inflammatory and regulatory cytokines. Concurrent levels of total B‐ and T‐cell subsets and IgE, IgA, IgM, IgG and IgG subclasses were analysed in the blood. In addition antibody levels were recorded in a further 33 patients with crusted scabies and 14 patients with ordinary scabies. Results A predomination of infiltrating CD8+ T lymphocytes in the dermis was observed compared with minimal helper T lymphocytes (CD4+) and the absence of any B cells. The proportion of T and B lymphocytes and T‐cell subsets in the blood of these patients were within normal ranges, indicating a selective movement of CD8+ T cells into the dermis. Furthermore, strong staining for the inflammatory cytokine interleukin‐1β and anti‐inflammatory cytokine transforming growth factor‐β1 was observed. Elevated levels of IgE, IgG, IgG1, IgG3 and IgG4 were recorded. Conclusions Skin‐homing cytotoxic T cells contribute to an imbalanced inflammatory response in the dermis of crusted scabies lesional skin. This, in combination with the lack of B cells, is contributing to the failure of the skin immune system to mount an effective response resulting in uncontrolled growth of the parasite.     

Immunoglobulins and Their Receptors on Epidermal Langerhans Cells in Atopic Dermatitis

To elucidate the etiological role of immunoglobulin molecules on Langerhans cells (LCs) in atopic dermatitis, we conducted immunohistochemical studies on the localization of immunoglobulin G1 (IgG1), IgG2, IgG3, IgG4, IgA and IgM on epidermal LCs from 30 patients with atopic dermatitis (AD) and five non-atopic healthy volunteers. We also investigated the types of receptors for the immunoglobulins (FcεRI, FcεRII, FcγRI, FcγRII, and FcγRIII) on epidermal LCs in the patients. IgE positive epidermal LCs were observed in 28 of 30 AD patients, and 46.7% of the epidermal LCs were positive for IgE. Both IgG1- and IgG2-positive epidermal LCs were obserbed in 70% of AD patients, and 21.8% and 28.7% of the total epidermal LCs were positive for IgG1 and IgG2, respectively. IgG3- or IgG4-positive LCs were present in only small proportions of AD patients. IgA-positive LCs were observed in 8 AD patients; our study suggested that the IgA bound on LCs was secretory IgA (S-IgA). These surface immunoglobulins were observed significantly more frequently on epidermal LCs in the involved skin of AD than in clinically uninvolved skin. No IgM-positive epidermal LCs were observed in the AD patients or healthy volunteers. In non-atopic healthy controls, no immunoglobulin-binding LCs were observed. In receptors for immunoglobulins, FcεRI and FcγRII were exclusively expressed on nearly all epidermal LCs from all AD patients and all non-atopic controls. These results suggested that not only IgE but also IgG and IgA may play some etiological role in the pathogenesis of AD.     

乌司他丁结合低分子肝素钙治疗急诊重症脓毒症的临床观察

目的分析乌司他丁结合低分子肝素钙的临床应用价值及对细菌感染率和血清超氧化物歧化酶(Superoxide Dismutase,SOD)、丙二醛(Malondialdehyde,MDA)水平的影响。方法将2016年8月-2018年10月间西安市第一医院收治的100例急诊重症脓毒症患者随机分为观察组及对照组;对照组采用乌司他丁治疗,观察组在对照组基础上使用乌司他丁结合低分子肝素钙治疗;记录两组重症加强护理病房(intensive Care Unit,ICU)住院时间、28 d病死率、不良反应发生率以及新发感染发生情况;治疗前后检测患者血中降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interieukin-6,IL-6)水平评估患者体内炎症因子水平,血衆凝血酶原时间(prothrombin time,PT)、激活的部分凝血活酶时间(actived partial thromboplastin time,APTT)、奸维蛋白原(fibrinogen,FIB)以及静脉血血小板记数(blood platelet,PLT)水平评估体内凝血功能,SOD、MDA、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白A(inununoglobulin A,IgA)及免疫球蛋白M(Immunoglobulin M,IgM,)水平评估免疫指标功能;采用急性生理与慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation D,APACHEⅡ)及急诊科脓毒症相关死亡率评分(mortality in emergency department score,MEDS)量表对患者临床指标进行评估。结果两组28 d死亡率及不良反应发生率无明显差异(P>0.05);观察组新发感染发生率均低于对照组,且差异具有统计学意义(PC0.05);治疗后观察组CRP、PCT、IL-6、PT、APTT、MDA水平明显低于对照组,PLT、FIB、SOD、IgG、IgA及IgM水平明显高于对照组,差异其有统计学意义(P<0.05);治疗后边察组APACHEⅡ及MEDS量表评分均明显低于对照组,差异具有统计学意义(P<0.05)。结论乌司他丁结合低分子肝素钙治疗可有效提高急诊重症脓毒症的治疗疗效,显著降低细菌感染率,并改善患者血清SOD、MDA水平。     

Antigens from Leishmania amastigotes inducing clinical remission of psoriatic arthritis

A first generation vaccine (AS100-1) was manufactured with protein from four cultured Leishmania species, which proved to be effective in the treatment of psoriasis. A single blind trial on 3,132 psoriasis patients revealed 508 (16.2%) subjects with psoriatic arthritis (PsA) that received AS100-1 antigens. The study group was distributed according to percent psoriasis area and severity index (PASI) reduction from PASI 10 to PASI 100. All groups decreased in arthritis score (AS), tender joints counts and nail changes after treatment; the highest decreased in the PASI 100 group. Relapses of psoriasis and PsA had PASI and AS lower than initial values before treatment. Clinical remissions were at lower doses and less time, after the second course of treatment. Peripheral blood mononuclear cells (PBMC) lymphocyte subsets (LS) varied with PASI range (1–10, 11–20 and 21–72). Pre-treatment, absolute values of gated LS: CD4+, CD8+HLA−, CD8+HLA+, CD8+CD3−, CD8+CD3+ decreased in PBMC as PASI increased, suggesting migration from the blood to the skin. In contrary to the previous finding, the following LS: CD8+CD4−, CD3+CD8−, HLA+CD8−, CD19, CD8+CD4+ and membrane surface immunoglobulin IgA+, IgD+, IgM+, IgE+, and IgG+ increased in PBMC as PASI increased suggesting activation and proliferation by unknown antigens creating a homeostatic cycle between skin/joints and peripheral blood. After nine doses of AS100-1, the following LS: CD8+CD3+, CD8+HLA+, CD3+CD8−, CD4+CD8−, CD8+HLA−, HLA+CD8−, CD8+CD3−, CD19+, CD8+CD4−, CD8+CD4+, IgA+, IgD+, IgM+, IgE+, and IgG+ decreased significantly as compared with values before treatment. The LS decreased stops the vicious cycle between skin/joints and blood explaining clinical remission of lesions.     

特应性皮炎患者皮损超微结构及免疫病理研究

目的:研究特应性皮炎(AD)患者皮损超微病理及免疫病理的表现,探讨AD的发病机制。方法:取21例患者外周血,测定血清IgE、IgA、IgG、IgM,并取典型皮损分别做超微组织病理和免疫病理检查。结果:16例AD患者血清IgE值>150IU/L,5例≤150IU/L,血清IgG、IgM值明显升高,而IgA值明显降低。电镜检查表皮可见激活的淋巴细胞,少数中性粒细胞侵入表皮,早期真皮可见胶原间质水肿,后期间质纤维呈波浪性增生,无论在表皮或真皮均可见到活化型的免疫应答细胞。结论:AD发病与免疫有关。治疗AD的靶细胞是肥大细胞。IgG1蛋白沉积可能与AD慢性感染有关。     

Mononuclear cell-bound CD23 is elevated in both atopic dermatitis and psoriasis.

As patients with atopic dermatitis (AD) frequently have elevated serum IgE levels, the relation of this disease to CD23/Fc epsilon RII, a low affinity Fc receptor for IgE, and its soluble forms, sCD23, was studied. We examined the expression of CD23 on peripheral blood mononuclear cells (PBMC) as well as the serum IgE and sCD23 levels in 33 patients with AD and in 9 patients with psoriasis in comparison with 10 healthy donors. In AD patients, the numbers of CD23+ unfractionated PBMC and CD23+ small adherent cells were significantly elevated (P less than 0.05, resp. P less than 0.005). In psoriatic patients however, CD23 was also significantly elevated on PBMC (P less than 0.05) and on small adherent cells (P less than 0.05). There was no significant difference in the frequencies of CD23+ cells between AD and psoriasis patients. In all donors, CD23 could be detected only on B cells, but not on monocytes/macrophages. In AD patients who were examined twice, an increase or decrease of the clinical AD score was always accompanied by an increase or decrease, resp., of cell-bound CD23. The serum sCD23 level was not significantly increased in either group of patients. Our results suggest that CD23 should be considered as a nonspecific marker for B cell activation in the context of inflammation and not as a specific marker for AD.