神经性皮炎皮损处神经纤维的数量及其与朗格汉斯细胞关系的研究

目的探讨神经性皮炎患者皮损处神经纤维的数量变化及其与朗格汉斯细胞接触的关系.方法用辣根过氧化物酶结合的链霉亲和素-生物素技术观察24例神经性皮炎患者皮损处神经纤维的表达及数量变化.用免疫荧光双标记及共聚焦激光扫描显微镜技术观察神经性皮炎患者皮损处神经纤维与朗格汉斯细胞接触数量关系.用实时定量PCR方法检测皮损处神经生长因子mRNA的表达情况.结果 神经性皮炎患者皮损处神经纤维长度显著增加,与皮损周边对照(t=6.90,P<0.001)及正常人对照(t=5.71,P<0.001)比较差异有统计学意义.皮损表皮内有神经纤维接触的朗格汉斯细胞占朗格汉斯细胞总数的百分数明显增多,与皮损周边对照(X²=43.91,P<0.001)及正常人对照(X²=46.11,P<0.001)比较差异有统计学意义.皮损处神经生长因子mRNA高表达,与皮损周边对照(t=3.25,P<0.01)及正常人对照(t=3.67,P<0.01)比较差异有统计学意义.结论 神经性皮炎患者皮损处存在高水平活性的NGF导致神经纤维增生.

Quantification of nerve fibers and their contact with Langerhans cells in the lesional skin of neurodermatitis

Objective To quantify the intraepidermal nerve fibers and to observe their contacts with Langerhans cells in the lesional skin of neurodermatitis.Methods Skin specimens were resected from 24 patients with neurodermatitis and 24 normal human controls.A labeled-streptavidin-biotin(LAB-SA)method was used to study the expression and counts of nerve fibers in the specimens.Double labeled immunofluorescency and confocal laser scanning microscopy were employed to observe the contact of nerve fibers with Langerhans cells.The mRNA expression of NGF was measured by real time PCR in the specimens.Results The nerve fibers were significantly longer in lesions of neurodermatitis than those in normal controls (337.33±91.94μm vs 206.60±64.21μm,t=5.71,P<0.001)and those in the skin around the lesions (337.33±91.94μm vs 210.74±70.69μm,t=6.90,P<0.001).The percentage of intraepidermal nerve fibers contacting with Langerhans cells was significantly higher in lesions of neurodermatitis than that in normal control(56.14±10.12)% vs(22.49±5.93)%,X²=46.11,P<0.001)and that in the skin around the lesions(56.14±10.12)% vs(23.93±5.97)%,X²=43.91,P<0.001).The mRNA expression of nerve growth factor significantly increased in the lesional skin than in the skin around the lesions and in normal controls(2761.5±178.5 vs 1859.5±157.9,t=3.25,P<0.01;2761.5±178.5 vs 1003.5±102.1,t= 3.67,P<0.01).Conclusion It is indicated that nerve fibers hyperplasy in the lesions of lichen simplex chronicu,which may be related to the high level of nerve growth factor in the area.