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。

Study on ultrastructural manifestation and immunopathology in skin lesions of atopic dermatitis

Objective:To investigate the pathogenesis of atopic dermatitis(AD)by observing the ultrastructure and immunopathol-ogy in the skin lesions.Methods:The serum levels of immunoglobulins(IgA,Ig G,Ig M,Ig E)were detected by enzyme-linked immunosorbent assay(ELISA)methods in21patients with AD.Meanwhile the skin biopsies were taken for histopathology,im-munopathology and electron microscope studies.Results:The serum levels of IgE were above150IU/L in16patients,but were under150IU/L in the other5patients.All patients had significantly higher serum IgG,IgM and lower serum IgA.Electron microscope showed that activated lymphocytes and some neutrophils infiltrated in both epidermis and dermis with inter-collagen edema in the early stage and collagen fibrosis in the later stage.Immuno-fluorescence indicated that the IgG type I(IgG1)precipitated in dermal papilla.Conclusion:The investigation indicates that pathogenetic aspect of AD includes immune re-sponses.Mast cell is the target for treatment.However,IgG1precipitation in the lesion dermal papilla may be related to chronic infection.