寻常型银屑病皮肤中皮肤归巢T细胞免疫组化研究

目的 探讨皮肤归巢T细胞在寻常型银屑病(PV)发病中的作用。方法 采用间接免疫荧光双标法研究正常人皮肤和PV患者皮肤中浸润的皮肤归巢T细胞分类及其变化。结果 ①正常人皮肤及PV皮损中浸润的T细胞绝大多数表达皮肤淋巴细胞相关抗原(CLA),CLA⁺细胞高度表达CD45RO,只有个别为CD45RO阴性。②进行期皮损CD4⁺CLA⁺及CD8⁺CLA⁺T细胞数高于静止期皮损(P<0.05),静止期皮损CD4⁺CLA⁺细胞数高于消退期皮损(P<0.05),消退期皮损CD8+CLA+细胞数高于PV外观正常皮肤(P<0.05),进行期皮损周边外观正常皮肤CD4⁺CLA⁺及CD8⁺CLA⁺细胞数高于静止期皮损周边外观正常皮肤(P<0.05).③部分病例皮损的表皮中见大量CLA⁺树突状细胞,正常人皮肤未见此细胞。结论 正常人皮肤及PV皮损中T细胞绝大多数为皮肤归巢T细胞;进行期及静止期PV皮损中浸润的细胞主要为CD3⁺、CD4⁺、CD45RO⁺、CLA⁺T细胞,CD3⁺、CD4⁺、CD45RO⁺、CLA⁺T细胞可能在PV发病中起重要作用。

Immunohistochemical Study of Skin- homing T Lymphocytes in Psoriasis Vulgaris

Objective To investigate the role of skin homing T lymphocytes in the development of psoriasis vulgaris(PV). Methods Indirect immunofluorescent double staining technique was employed to study the expression of infiltrating skin homing T lymphocytes in normal, uninvolved perilesional and lesional psoriatic skin in different stages (progressing, stable or regressing) and in normal human skin. Results ①Expression of cutaneous lymphocyte associated antigen (CLA) was found in the majority of CD3⁺T lymphocytes in normal human skin and in lesions of PV, and CD45RO phenotype was expressed in almost all CLA⁺T lymphocytes. ②In psoriatic lesions, the number of CD4⁺CLA⁺ and CD8⁺CLA⁺ cells was higher in progressive stage than that in stable stage(P<0.05); the number of CD4⁺CLA⁺ cells was higher in stable stage than that in regressive stage(P<0.05). The number of CD8⁺CLA⁺ cells was higher in regressive stage of psoriatic lesions than that in normal appearing skin of psoriasis(P<0.05). The number of CD4⁺CLA⁺ and CD8⁺CLA⁺ cells of uninvolved perilesional psoriatic appearing skin was higher in progressive stage than that in stable stage(P<0.05). ③A great number of CLA⁺ dendritic cells was found in the lesional epidermis of some psoriatic patients, but not found in normal human skin. Conclusions In both normal human skin and psoriatic skin, the majority of T lymphocytes are skin homing (CLA⁺) T lymphocytes. Intraepidermal and dermal infiltrating T cells in lesions of PV belong predominantly to CD3⁺, CD4⁺, CD45RO⁺, CLA⁺ subsets, and these cells may play an important role in the pathogenesis of PV.