副肿瘤性天疱疮患者的脱发机制

目的探讨副肿瘤性天疱疮(PNP)患者血清中抗桥粒芯蛋白(DSG)抗体与头皮脱发之间的关系.方法收集我科收治的2例PNP,2例大疱性类天疱疮患者和5例正常人血清,及2例正常人头皮组织.采用酶联免疫吸附(ELISA)方法检测PNP患者血清中DSG 1和3抗体水平,间接免疫荧光法检测PNP患者血清与正常人头皮毛囊结合情况,同时采用正常人血清和大疱性类天疱疮患者血清作对照.结果2例PNP患者中,有1例抗DSG 3抗体强阳性,抗DSG1抗体弱阳性;另1例患者两种抗体均为阴性.2例患者血清均可与正常人头皮毛囊结合,表皮细胞间和毛囊的外毛跟鞘均可见荧光信号.大疱性类天疱疮患者血清只能与表皮基底膜带结合,正常人血清在基底膜带、表皮细胞间和毛囊均无任何荧光信号.结论PNP患者出现脱发可能与患者血清中抗DSG3抗体水平有关.

Mechanism of alopecia in patients with paraneoplastic pemphigus

Objective To investigate the relationship between the levels of antidesmoglein(DSG)1, 3 antibodies in the sera of patients with paraneoplastic pemphigus(PNP)and alopecia. Methods Sera from PNP patients, bullous pemphigoid patients, and normal healthy subjects were collected and 2 tissue samples from 2 healthy scalps were resected. Anti-DSG 1, 3 antibodies in the sera of PNP patients were detected by enzyme-linked immunosorbent assay(ELISA). Indirect immunofluorescent assay was used to detect whether the antibodies in the sera of PNP patients binds with the follicular epithelium of normal healthy scalp. Results Anti-DSG3 autoantibody was strongly positive and anti-DSG1 weakly positive in one patient, while both two antibodies were negative in the other patient. Their sera could bind to keratinocytes and follicular epithelium in human scalp. Immunofluorescent signals were found on the intercellular epidermal cell surface and outer root sheath of the follicular epithelium. However, the immunofluorescent signals in the section incubating with serum of bullous pemphigoid were only found on basal membrane zone. No signals were found in the section incubating with normal healthy serum. Conclusion Alopecia in PNP patients are correlated with the anti-DSG3.