Yamamoto Toshiyuki, Nishioka Kiyoshi
Department of Dermatology, Tokyo Medical and Dental University, School of Medicine, Tokyo, Japan.
Exp Dermatol. 2005 Feb;14(2):81-95. doi: 10.1111/j.0906-6705.2005.00280.x.
Scleroderma is a fibrotic condition characterized by immunologic abnormalities, vascular injury and increased accumulation of matrix proteins in the skin. Although the aetiology of scleroderma is not fully elucidated, a growing body of evidence suggests that extracellular matrix overproduction by activated fibroblasts results from complex interactions among endothelial cells, lymphocytes, macrophages and fibroblasts, via a number of mediators. Cytokines, chemokines and growth factors secreted by inflammatory cells and mesenchymal cells (fibroblasts and myofibroblasts) play an important role in the fibrotic process of scleroderma. Recently, we established a murine model of scleroderma by repeated local injections of bleomycin. Dermal sclerosis was induced in various mouse strains, although the intensity of dermal sclerosis varied among various strains. Histopathological and biochemical analysis demonstrated that this experimental murine scleroderma reflected a number of aspects of human scleroderma. Further investigation of the cellular and molecular mechanisms of inflammatory reaction, fibroblast activation and extracellular matrix deposition following dermal injury by bleomycin treatment will lead to the better understanding of the pathophysiology and the exploration of effective treatment against scleroderma. This review summarizes recent progress of the cellular and molecular events in the pathogenesis of bleomycin-induced scleroderma; moreover, further perspective by using this mouse model has been discussed.
硬皮病是一种纤维化疾病,其特征为免疫异常、血管损伤以及皮肤中基质蛋白的积累增加。尽管硬皮病的病因尚未完全阐明,但越来越多的证据表明,活化的成纤维细胞过度产生细胞外基质是由内皮细胞、淋巴细胞、巨噬细胞和成纤维细胞之间通过多种介质进行的复杂相互作用所致。炎症细胞和间充质细胞(成纤维细胞和肌成纤维细胞)分泌的细胞因子、趋化因子和生长因子在硬皮病的纤维化过程中起重要作用。最近,我们通过反复局部注射博来霉素建立了硬皮病小鼠模型。在各种小鼠品系中均诱导出了皮肤硬化,尽管不同品系的皮肤硬化强度有所不同。组织病理学和生化分析表明,这种实验性小鼠硬皮病反映了人类硬皮病的多个方面。进一步研究博来霉素处理引起皮肤损伤后炎症反应、成纤维细胞活化和细胞外基质沉积的细胞和分子机制,将有助于更好地理解其病理生理学,并探索针对硬皮病的有效治疗方法。本综述总结了博来霉素诱导的硬皮病发病机制中细胞和分子事件的最新进展;此外,还讨论了使用该小鼠模型的进一步前景。