Fujimoto Norihiro, Yajima Mayumi, Ohnishi Yoshihiro, Tajima Shingo, Ishibashi Akira, Hata Yasuki, Enomoto Utayo, Konohana Izumi, Wachi Hiroshi, Seyama Yoshiyuki
Department of Dermatology, National Defense Medical College, Saitama, Japan.
J Invest Dermatol. 2002 Mar;118(3):479-84. doi: 10.1046/j.0022-202x.2001.01695.x.
Primary localized cutaneous nodular amyloidosis is a rare form of cutaneous amyloidosis. Amyloid fibrils in primary localized cutaneous nodular amyloidosis have been reported to be originated from immunoglobulin light chains. Immunohistochemical studies on the lesional skins of four patients with primary localized cutaneous nodular amyloidosis demonstrated that amyloid deposits of all cases showed a positive reaction with the antibodies for beta2-microglobulin and advanced glycation end products as well as immunoglobulin light chain (kappa or lambda). No beta2-microglobulin and advanced glycation end product immunoreactivity was found in the amyloid deposits of other primary localized cutaneous amyloidosis (lichen amyloidosis and macular amyloidosis). Double immunofluorescence study of the lesional skin of primary localized cutaneous nodular amyloidosis showed that anti-kappa light chain, anti-beta2-microglobulin and anti-advanced glycation end product antibodies mostly reacted with the same area of amyloid deposit. Amyloid proteins were sequentially extracted with distilled water from one case of primary localized cutaneous nodular amyloidosis and recovered in the five water-soluble fractions (fractions I-V). Immunoblot assay of amyloid fibril proteins demonstrated that immunoreactive polypeptides with anti-kappa light chain antibody (29 kDa) and with anti-beta2-microglobulin antibody (12 kDa) were detected in fractions I-V, whereas immunoreactive polypeptide with anti-advanced glycation end product antibody (12 kDa) was detected exclusively in fractions III-V but not in fractions I and II. Two-dimensional polyacrylamide gel electrophoresis revealed that 12 kDa polypeptide in fractions I and II was electrophoretically identical with authentic beta2-microglobulin and that beta2-microglobulin in fractions III-V was advanced glycation end product-modified beta2-microglobulin with more acidic pI value. These results indicate that beta2-microglobulin is another major component of amyloid fibrils in primary localized cutaneous nodular amyloidosis and that beta2-microglobulin in primary localized cutaneous nodular amyloidosis is partly subjected to the modification of advanced glycation end product.
原发性局限性皮肤结节性淀粉样变是皮肤淀粉样变的一种罕见形式。据报道,原发性局限性皮肤结节性淀粉样变中的淀粉样纤维源自免疫球蛋白轻链。对4例原发性局限性皮肤结节性淀粉样变患者的皮损进行免疫组织化学研究表明,所有病例的淀粉样沉积物对β2-微球蛋白、晚期糖基化终产物以及免疫球蛋白轻链(κ或λ)抗体均呈阳性反应。在其他原发性局限性皮肤淀粉样变(苔藓样淀粉样变和斑状淀粉样变)的淀粉样沉积物中未发现β2-微球蛋白和晚期糖基化终产物免疫反应性。对原发性局限性皮肤结节性淀粉样变皮损进行的双重免疫荧光研究表明,抗κ轻链、抗β2-微球蛋白和抗晚期糖基化终产物抗体大多与淀粉样沉积物的同一区域发生反应。从1例原发性局限性皮肤结节性淀粉样变病例中依次用蒸馏水提取淀粉样蛋白,并在5个水溶性级分(级分I-V)中回收。对淀粉样纤维蛋白进行免疫印迹分析表明,在级分I-V中检测到与抗κ轻链抗体反应的免疫反应性多肽(29 kDa)和与抗β2-微球蛋白抗体反应的免疫反应性多肽(12 kDa),而与抗晚期糖基化终产物抗体反应的免疫反应性多肽(12 kDa)仅在级分III-V中检测到,在级分I和II中未检测到。二维聚丙烯酰胺凝胶电泳显示,级分I和II中的12 kDa多肽在电泳上与 authentic β2-微球蛋白相同,级分III-V中的β2-微球蛋白是晚期糖基化终产物修饰的β2-微球蛋白,其pI值更酸性。这些结果表明,β2-微球蛋白是原发性局限性皮肤结节性淀粉样变中淀粉样纤维的另一个主要成分,并且原发性局限性皮肤结节性淀粉样变中的β2-微球蛋白部分受到晚期糖基化终产物的修饰。