中间丝蛋白与特应性皮炎皮肤屏障功能

特应性皮炎的病因复杂,发病机制尚未明确,可能是遗传、环境、皮肤屏障功能缺陷及免疫相互作用的结果.中间丝蛋白基因是表皮分化复合物基因簇的成员之一,与细胞膜形成及表皮终末分化密切相关.中间丝蛋白基因突变是特应性皮炎发病的重要易患因素之一,中间丝蛋白的减少和缺失,可能是引起特应性皮炎等十燥性皮肤病的主要原因.     

Association between P478S polymorphism of the filaggrin gene and risk of psoriasis in a Chinese population in Taiwan

Abnormal keratinocyte terminal differentiation is one of the important characteristics of psoriatic lesions. Filaggrin (FLG) is a key protein that facilitates the terminal differentiation of the epidermis. Thus, FLG genetic variants may modify the risk of psoriasis. In total, 314 patients with psoriasis and 611 control subjects were analyzed for the presence of FLG R501X, 2282del4 mutations, and P478S (rs11584340, C/T base change) polymorphism by polymerase chain reaction (PCR). The analysis revealed that both the R501X and 2282del4 mutations were not present in a subset of 200 patients (64%) with psoriasis. In contrast, a marginally significant difference (P = 0.020) was found in the distribution of rs11584340 genotype frequencies between psoriatic patients and controls. The frequency of the TT genotype in psoriasis patients was significantly higher than in controls (37.9% vs. 29.1%, respectively, P = 0.007). The T allele frequency of patients (60.5%) was also significantly higher than that of controls (53.9%) (P = 0.007). After adjusting for age and gender, carriers of the TT genotype were 1.46 (95% CI, 1.08–1.96) times more likely than non-carriers to have psoriasis (P = 0.013). In conclusion, our results suggest that FLG P478S polymorphism may confer susceptibility to the development of psoriasis among Taiwanese Chinese.     

特应性皮炎的临床表型和内表型

特应性皮炎患者的临床表型及内表型多样,明确不同临床表型及内表型的特征,对协助诊断并实施针对性治疗有重要意义。本文从特应性皮炎不同发病年龄、种族背景及疾病严重程度等方面综述其临床表型差异,概述内表型及相关生物标志物的临床意义。     

结合珠蛋白遗传多态性与特应性皮炎的关系

目的:检测特应性皮炎(AD)患者血中结合珠蛋白(Hp)表型和Hp基因频率的分布,并分析与病情严重程度之间的关系.方法:采用聚丙烯酰胺凝胶垂直平板电泳技术检测131例AD患者和134例正常对照者血中Hp表型的分布.结果:(1)不同病情严重程度患者之间的Hp表型及Hp基因频率分布无明显差别(P>0.05).(2)患者组与对照组相比,Hp1-1和Hp2-1明显增高(P<0.05),Hp1基因频率明显增高(P<0.05).(3)混合性AD组与单纯性AD组相比,Hp1-1和Hp2-1明显增高(P<0.05),Hp1基因频率明显增高(P<0.05).结论:带有血清Hp2-1和Hp1-1的人群可能对AD有遗传易感性.Hp1基因在AD患者中有聚集现象,与其遗传易感性增高有某种内在联系,可能在AD发病中起一定作用.     

Head and neck atopic dermatitis and malassezia-furfur-specific IgE antibodies

BACKGROUND: Atopic dermatitis of the head and neck (HNAD) has been recognized as a separate entity. Malassezia furfur, a lipophilic yeast, is considered to be a pathogenic allergen in this form of atopic dermatitis. OBJECTIVE: The purpose of this study was to determine the level of IgE anti-M.-furfur antibodies and their relation to the severity of the disease. METHODS: IgE anti-M.-furfur antibodies were assayed in 106 patients with HNAD. Controls included 25 patients with non-HNAD, 20 with nonatopic dermatitis and 16 with seborrheic dermatitis (including 4 with AIDS). RESULTS: There was a highly significant correlation between the level of anti-M.-furfur IgE and clinical severity. Furthermore, there was a significant but smaller correlation between total IgE and clinical severity. In patients with HNAD, total IgE was higher amongst men. CONCLUSION: IgE anti-M.-furfur antibodies are a good and specific marker for HNAD. IgE M. furfur levels are strongly correlated with the severity of the disease.     

特应性皮炎患者血清转谷氨酰胺酶2特异性IgE水平与病情相关性研究

目的 检测特应性皮炎(AD)患者血清中转谷氨酰胺酶2(TG2)特异性IgE(sIgE)的表达水平,并分析与患者病情的相关性.方法 共入组77例AD患者,其中,44例≥12岁,33例＜12岁,内源性AD(特异性sIgE阴性,且总IgE＜150 kU/L)20例,外源性AD(一种以上的外源性过敏源sIgE++以上,或总IgE≥150 kU/L)49例.采用免疫捕获及生物素标记的酶联免疫分析法检测77例AD患者、40例成人寻常性银屑病患者和30例成人健康对照血清中TG2 sIgE水平.记录AD患者年龄、病程、SCORAD评分、嗜酸性粒细胞计数和总IgE及TG2的sIgE水平.结果 ≥12岁AD组、＜12岁AD组、银屑病组和对照组外周血TG2 sIgE水平(A450)分别为1.02±0.2、1.04±0.044、0.93±0.25、0.71±0.13.≥12岁AD、寻常性银屑病和健康对照组外周血中TG2 sIgE表达水平差异有统计学意义(x2=37.407,P＜0.001);两两组间比较发现,≥12岁AD组、银屑病组TG2 sIgE水平均显著高于对照组(t值分别为7.38、4.83,均P＜0.001).内源性AD组TG2 sIgE水平(1.16±0.03)高于外源性AD组(1.02±0.20)(t=2.27,P=0.02).AD患者组TG2 sIgE水平与年龄、病程、SCORAD评分、嗜酸性粒细胞计数、血清总IgE水平均无显著相关性(r值分别为0.03、0.14、-0.04、-0.08和0.06,均P＞0.05).结论 AD患者血清中TG2 sIgE水平明显升高,TG2可能是AD患者的一种自身抗原,但TG2 sIgE与患者的病情严重程度无明显相关性.     

Total and specific IgE levels in patients with atopic dermatitis

Ten young adults with chronic atopic dermatitis have been followed for up to 18 months through periods of clinical exacerbation and remission. Sequential estimation of total levels of circulating IgE and specific IgE by the radioallergosorbent technique (RAST) showed no significant correlation between IgE levels and severity of skin involvement. However, a clear correlation between clinical history, prick tests and RAST tests was obtained in several cases. Serum IgE levels in seven patients with ‘pure’ atopic dermatitis were elevated to levels similar to those found in three patients with additional respiratory symptoms.     

Langerhans cell hyperplasia and IgE expression in canine atopic dermatitis

Langerhans cells appear to be critical for IgE-mediated allergen capture and presentation in human atopic dermatitis. The present study sought to determine whether epidermal (i.e Langerhans cells) and dermal dendritic cells in the skin of dogs with atopic dermatitis are hyperplastic and expressed surface IgE. Frozen sections of lesional or nonlesional atopic and normal control canine skin were immunostained with CD1a-, CD1c-, and IgE-specific monoclonal antibodies. The enumeration of cells was performed by morphometry in both the epidermis and the dermis. Cell counts were compared with each individual’s total serum IgE levels. Higher numbers of epidermal and dermal dendritic cells were present in atopic dogs than in normal control animals. Epidermal Langerhans cell counts were significantly higher in lesional than in nonlesional atopic specimens. IgE⁺ dendritic cells were observed in lesional atopic epidermis and dermis, and nonlesional atopic dermis, but not in normal control skin specimens. The percentages of IgE⁺ dendritic cells were correlated with each patient’s total serum IgE levels. These results demonstrate dendritic cell hyperplasia and IgE expression in canine atopic dermatitis. Increased epidermal Langerhans cell counts in lesional specimens suggest an epidermal allergen contact in canine atopic dermatitis.     

Fc epsilon R+ lymphocytes and IgE in atopic dermatitis

Lymphocytes bearing Fc receptors for IgE (Fc epsilon R) and serum IgE were determined on eighty-one patients with atopic dermatitis by immunofluorescence assay using H107 monoclonal antibody and radioimmunosorbent test, respectively. The patients were divided into three groups with mild, moderate, and severe involvement, based on the extent of skin lesions. Both exploratory data analysis and statistical analysis by nonparametric methods showed significant correlations of the percentage of Fc epsilon R+ lymphocytes and serum IgE level with the extent of skin involvement. The nature of skin lesions of the moderate and severe patients also correlated significantly with the percentage of Fc epsilon R+ lymphocytes. There was no correlation between such the nature of skin lesions and serum IgE level.     

IgE and IgG4 levels in children with atopic dermatitis

Serum IgE and IgG4 concentrations were determined in 102 children with atopic dermatitis (AD) of varying severity and activity. Total as well as specific IgE levels, determined by the radioallergosorbent test (RAST), were correlated with disease severity and the coexistence of atopic respiratory diseases. The IgG 4 levels of children with only AD, even in severe cases, were within the normal ranges of healthy children. In contrast, the IgG4 levels of children with both cutaneous and respiratory atopic manifestations were elevated, suggesting that IgG4 are probably associated with respiratory diseases but do not play any role in the pathogenesis of the skin disorder.     

IgE and peripheral blood T-lymphocyte levels in patients with atopic dermatitis

The percentages of suppressor T lymphocytes were compared in 111 patients with atopic dermatitis and 100 healthy volunteers. In the former group there was a statistically significant reduction of suppressor T cells, which was not related to IgE level. Similar decrease in T cells has been found in patients with normal IgE as well as in patients having 10-fold increase in serum IgE. Our results were compared to previously published data of other investigators.     

Behavior of eosinophilic granulocytes, total IgE and allergen-specific IgE antibodies in atopic neurodermatitis during hospital treatment in the North Sea climate

Absolute number of eosinophilic leucocytes, total IgE level, and specific IgE antibodies against the environmental antigens cock's foot, house-dust, and house-dust mite (dermatophagoides pteronyssinus) were obtained from 25 patients suffering from atopic dermatitis at the beginning as well as towards the end of hospital treatment in the maritime climate of the North Sea. Initially the absolute eosinophilic leucocytes were increased. According to the improvement of the atopic skin lesions, there was a significant decrease up to normal rates in several cases at the end of hospital treatment. The increased number of eosinophilic leucocytes observed at the beginning of therapy was correlated to the total IgE level. On an average, pathologic initial rates of total IgE going along with acute lesions decreased during hospital treatment; but this observation may be statistically accidental, the cutaneous lesions, however, completely disappeared. Elevated initial rate of antigen-specific IgE antibodies, as well, showed obvious reduction, but they did not reach normal values in any case. According to update knowledge, the IgE level in serum seems to be predominantly controlled by a multifactorial genetic system.