Teymoortash Afshin, Tiemann Markus, Schrader Carsten, Werner Jochen A
Department of Otolaryngology, Head and Neck Surgery, Philipps University, Marburg, Germany.
J Oral Pathol Med. 2004 May;33(5):300-4. doi: 10.1111/j.0904-2512.2004.00093.x.
Chronic obstructive sialadenitis is characterized by acinar atrophy, lymphocytic infiltrates and progressive fibrosis. The immunological mechanisms involved in the pathogenesis of this disease are, for the most part, unknown. The aim of the present study was to characterize the lymphocytic infiltrates in chronic obstructive sialadenitis associated with sialolithiasis.
Paraffin-embedded tissue samples from 23 affected submandibular glands were immunostained for T-cells (CD3, CD4, CD8), cytotoxic T-cells (granzyme B), B-cells (CD20), plasma cells (CD38) and macrophages (Ki-M1P).
CD4-positive subsets were the predominant cells, and they were located mainly periductally. Isolated intraepithelial CD8-positive cytotoxic T-cells associated with ductal epithelial cell destruction were observed in all cases. B lymphocytes were restricted to lymphoid follicles located periductally and around intralobular ducts. In early stages of the disease, a large number of CD38-positive plasma cells were distributed diffusely in the periacinar area. With progression of the disease, conspicuous clusters of plasma cells were located especially between atrophic acini adjacent to fibrotic tissue. An intimate relation between the lymphocytic infiltrates and the ductal epithelium, the target of the inflammatory process, was observed.
The composition and distribution of inflammatory cells suggest that intraepithelial infectious agents may be the cause of the inflammatory reaction and the progressive fibrosis in this disease.
慢性阻塞性涎腺炎的特征为腺泡萎缩、淋巴细胞浸润和进行性纤维化。该疾病发病机制中涉及的免疫机制在很大程度上尚不清楚。本研究的目的是对与涎石症相关的慢性阻塞性涎腺炎中的淋巴细胞浸润进行特征描述。
对来自23个受累下颌下腺的石蜡包埋组织样本进行免疫染色，检测T细胞（CD3、CD4、CD8）、细胞毒性T细胞（颗粒酶B）、B细胞（CD20）、浆细胞（CD38）和巨噬细胞（Ki-M1P）。
CD4阳性亚群是主要细胞，主要位于导管周围。在所有病例中均观察到与导管上皮细胞破坏相关的孤立的上皮内CD8阳性细胞毒性T细胞。B淋巴细胞局限于导管周围和小叶内导管周围的淋巴滤泡。在疾病早期，大量CD38阳性浆细胞弥漫分布于腺泡周围区域。随着疾病进展，明显的浆细胞簇尤其位于与纤维化组织相邻的萎缩腺泡之间。观察到淋巴细胞浸润与作为炎症过程靶点的导管上皮之间存在密切关系。
炎症细胞的组成和分布表明，上皮内感染因子可能是该疾病炎症反应和进行性纤维化的原因。
