斑块状银屑病与特应性皮炎和扁平苔藓的比较：病变部位T细胞亚群、表皮增殖和分化情况

Plaque psoriasis vs. atopic dermatitis and lichen planus: a comparison for lesional T-cell subsets, epidermal proliferation and differentiation.

作者信息

Bovenschen H J, Seyger M M B, Van de Kerkhof P C M

机构信息

Department of Dermatology, University Medical Center St Radboud, Nijmegen, René Descartes dreef 1, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.

出版信息

Br J Dermatol. 2005 Jul;153(1):72-8. doi: 10.1111/j.1365-2133.2005.06538.x.

DOI:10.1111/j.1365-2133.2005.06538.x

PMID:16029329

Abstract

BACKGROUND

T-cell infiltration in plaque psoriasis has recently been an important subject of investigation. Interestingly, comparative analyses of the disease-specific composition of the lesional T-cell infiltrate in plaque psoriasis and other inflammatory dermatoses have only sparsely been performed.

OBJECTIVES

To compare plaque psoriasis vs. atopic dermatitis and lichen ruber planus with respect to T-cell subsets, epidermal proliferation and keratinization.

PATIENTS AND METHODS

Biopsies were taken from untreated lesional skin of patients, six with psoriasis, six with atopic dermatitis and six with lichen planus. T-cell subsets (CD4+, CD8+, CD45RO+, CD45RA+, CD2+, CD25+), an epidermal proliferation (Ki-67) and a keratinization marker (K10) were stained immunohistochemically and quantified using image analysis.

RESULTS

The high number of CD8+ T cells (52 +/- 13 cells mm(-1)) found in the psoriatic epidermis was not found in the epidermis of atopic dermatitis (9 +/- 4), nor in the epidermis of lichen planus (34 +/- 10). The other T-cell subsets in the epidermis and dermis showed no statistically significant differences between psoriasis and atopic dermatitis. In contrast to the limited presence of CD4+, CD8+ and CD2+ in the psoriatic dermis (110 +/- 19, 27 +/- 9, 127 +/- 41, cells mm(-1), respectively), more impressive numbers of these cells were observed in the dermis of lichen planus (300 +/- 53, 144 +/- 38, 272 +/- 48, respectively). CD45RO+ memory effector T-cell counts were significantly higher in the epidermis of lichen planus (39 +/- 10) than in psoriasis (19 +/- 5). Psoriatic epidermis proved to have major keratinocyte hyperproliferation (247 +/- 26 cells mm(-1) lamina basalis), as compared with atopic dermatitis (134 +/- 15) and lichen planus (128 +/- 20). Furthermore, a marked decreased expression of keratin 10 was observed in psoriasis (41% of epidermal area) contrary to atopic dermatitis (70%).

CONCLUSIONS

Psoriatic epidermis exhibits a pronounced CD8+ epidermotropism with accompanying epidermal hyperproliferation and abnormal keratinization, which changes are only minimally expressed in atopic dermatitis and lichen planus. In plaque psoriasis, substantially fewer activated CD4+ and CD8+ T cells in the dermis and less CD45RO+ T cells in the epidermis are present in comparison with lichen ruber planus.

摘要

背景

斑块状银屑病中的T细胞浸润近来一直是重要的研究课题。有趣的是，针对斑块状银屑病与其他炎症性皮肤病中皮损T细胞浸润的疾病特异性组成的比较分析却鲜有开展。

目的

比较斑块状银屑病与特应性皮炎和扁平苔藓在T细胞亚群、表皮增殖及角质化方面的差异。

患者与方法

取自患者未经治疗的皮损活检组织，其中银屑病患者6例、特应性皮炎患者6例、扁平苔藓患者6例。采用免疫组织化学方法对T细胞亚群（CD4⁺、CD8⁺、CD45RO⁺、CD45RA⁺、CD2⁺、CD25⁺）、表皮增殖标志物（Ki-67）和角质化标志物（K10）进行染色，并通过图像分析进行定量。

结果

在银屑病表皮中发现的大量CD8⁺ T细胞（52±13个/mm⁻¹）在特应性皮炎表皮（9±4个/mm⁻¹）和扁平苔藓表皮（34±10个/mm⁻¹）中均未发现。表皮和真皮中的其他T细胞亚群在银屑病和特应性皮炎之间未显示出统计学上的显著差异。与银屑病真皮中CD4⁺、CD8⁺和CD2⁺数量有限（分别为110±19、27±9、127±41个/mm⁻¹）相比，扁平苔藓真皮中这些细胞的数量更多（分别为300±53、144±38、272±48个/mm⁻¹）。扁平苔藓表皮中的CD45RO⁺记忆效应T细胞计数显著高于银屑病（39±10个/mm⁻¹ vs 19±5个/mm⁻¹）。与特应性皮炎（134±15个/mm⁻¹）和扁平苔藓（128±20个/mm⁻¹）相比，银屑病表皮显示出明显的角质形成细胞过度增殖（基底层247±26个/mm⁻¹）。此外，与特应性皮炎（70%）相反，银屑病中角蛋白10的表达明显降低（占表皮面积的41%）。