共刺激分子在Behcet病患者结节红斑组织中的表达

目的探讨Behcet病患者结节红斑中B7:CD28/CTLA-4的表达及意义。方法采用免疫组化方法对5例Behcet病活动期患者腿或臂部结节红斑中CD4、CD8、CD19、CD68、HLA-DR、B7-1、B7-2、CD28和CTLA-4分子表达的情况进行了检测,并用双重染色方法探讨了细胞来源。结果Behcet病结节红斑中表皮约90%的细胞表达B7-1和B7-2,但无CD28和CTLA-4表达。真皮和皮下表达CD4、CD8、CD19、CD68、HLA-DR、CD1a、CD28、CTLA-4、B7-1和B7-2的细胞均显著增多。双染结果显示,100%CD4+T细胞表达CD28分子,47.9%的CD4+T细胞表达CTLA-4分子。100%CD68+细胞表达B7-1和B7-2分子。分别有74.5%和60.8%的HLA-DR+细胞表达B7-1和B7-2分子。结论CD28和CTLA-4分子主要表达于CD4+T细胞,B7-1和B7-2分子主要表达于单核巨噬细胞、抗原提呈细胞和角朊细胞。B7:CD28/CTLA-4通路可诱导巨噬细胞和T淋巴细胞的功能和活性,对Behcet病患者结节红斑的发生、炎症的持续和扩大起重要作用。

Expression of Costimulatory Molecules in Erythema Nodusum of Patients with Behcet Disease

Objective To investigate the expression and the role of costimulatory molecules B7:CD28/CTLA-4 in erythema nodusum of patients with Behcet disease. Methods Erythema nodusum from 5 patients with progressing Behcet disease and normal skin from 2 healthy individuals were analyzed by immunohistochemical examination for expression of CD4, CD8, CD19, CD68, HLA-DR, B7-1, B7-2, CD28 and CTLA-4 molecules. Labelled cells were visualised using either single or double staining techniques. Results Approximately 90% of epithelial cells in erythema nodusum expressed B7-1 and B7-2 molecules, but no expression of CD28 and CTLA-4. CD4~+Tcells, CD8~+T cells, CD19~+cells, CD68~+cells, HLA-DR~+cells, B7-1~+cells, B7-2~+cells, CD28~+cells and CTLA-4~+cells were increased significantly in the dermis and subcutaneous tissue. Double staining showed that CD28 molecules were expressed on 100% of CD4~+T cells, CTLA-4 molecules were expressed on 47.9% of CD4~+T cells, respectively. All CD68~+ cells expressed B7-1 and B7-2 molecules. B7-1 and B7-2 molecules were expressed on 74.5% and 60.8% of HLA-DR~+cells, respectively. Conclusion CD28 and CTLA-4 molecules are mainly expressed on CD4~+T cells, B7-1 and B7-2 are mainly expressed on macrophages, antigen-presenting cells and keratinocytes. B7:CD28/CTLA-4 costimulatory pathway can induce the function and activation of macrophages and T lymphocytes, and play an important role for the incidence, diffusion and consistence of inflammation in erythema nodusum.