Rambukkana A, Das P K, Krieg S, Faber W R
Department of Dermatology, University of Amsterdam, The Netherlands.
Scand J Immunol. 1992 Jul;36(1):35-48. doi: 10.1111/j.1365-3083.1992.tb02938.x.
The granulomatous skin lesions of human leprosy are known to be due to the cutaneous immune reaction to various mycobacterial antigens. In the present study, by immunohistochemical analysis using a previously characterized monoclonal antibody (MoAb) 3A8 we have demonstrated a selective expression of the 3A8 epitope of mycobacterial 30-kDa proteins, the major secreted proteins of mycobacteria, in various forms of leprosy lesions across the clinical spectrum. The localization of MoAb 3A8 staining is confined to the areas of cellular infiltrates of the lesions. In tuberculoid lesions the intense 3A8 staining was seen mostly in association with the membrane of the dermal cellular infiltrates whereas in highly bacilliferous lepromatous lesions the staining seems to be diffused with granular appearance but not in the form of bacteria. In patients with reversal reaction the staining was specifically extended to cells infiltrating the epidermis. MoAb 3A8 did not show any reactivity with inflammatory skin lesions of patients other than those with leprosy. Since the 3A8 epitope of 30-kDa proteins has been shown to be present in all cellular compartments of the mycobacteria and in the actively secreted BCG 85 antigen complex, MoAb 3A8 reactive protein(s) in leprosy lesions may be derived either from degraded somatic mycobacterial products or from antigens actively secreted by live bacilli. The latter could be true in the cases of untreated lepromatous lesions with high bacterial load since live M. leprae has also been considered to secrete corresponding 30-kDa proteins similar to other closely related mycobacteria. By double immunoenzyme staining we clearly demonstrate the expression of 3A8 epitope on CD68+ macrophages in the granulomas of tuberculoid leprosy, whereas in highly bacilliferous lepromatous lesions most of the double staining was seen in a diffuse pattern within the interstitial space of the cellular infiltrate as well as in the cytoplasm of CD68+ macrophages. In lesions from reversal reaction the 3A8 epitope is more strongly expressed on CDla+ dendritic Langerhans cells (LC) both in the epidermis and in the dermis as compared with other types of leprosy. This provides evidence for the involvement of LC in handling of mycobacterial antigenic epitopes in leprosy lesions. Further, immunoenzyme double staining revealed that the expression of this mycobacterial 3A8 epitope on antigen presenting cells such as CD68+ macrophages and CDla+ LC is present in juxtaposition with CD3+ T cells including the alpha beta and gamma delta receptor-bearing T cells in the granuloma.(ABSTRACT TRUNCATED AT 400 WORDS)
已知人类麻风病的肉芽肿性皮肤病变是由于对各种分枝杆菌抗原的皮肤免疫反应所致。在本研究中,我们使用先前鉴定的单克隆抗体(MoAb)3A8进行免疫组织化学分析,结果显示,在整个临床谱的各种形式麻风病病变中,分枝杆菌30 kDa蛋白(分枝杆菌的主要分泌蛋白)的3A8表位有选择性表达。MoAb 3A8染色的定位局限于病变的细胞浸润区域。在结核样病变中,强烈的3A8染色主要见于真皮细胞浸润的膜,而在高菌量的瘤型麻风病病变中,染色似乎呈弥漫性且有颗粒状外观,但并非呈细菌形式。在发生逆转反应的患者中,染色特异性地扩展到浸润表皮的细胞。MoAb 3A8除了与麻风病患者的炎症性皮肤病变有反应外,与其他患者的炎症性皮肤病变无任何反应。由于已证明30 kDa蛋白的3A8表位存在于分枝杆菌的所有细胞区室以及活性分泌的卡介苗85抗原复合物中,因此麻风病病变中MoAb 3A8反应性蛋白可能来源于分枝杆菌体细胞降解产物或活菌主动分泌的抗原。在细菌载量高的未经治疗的瘤型麻风病病变中可能就是后一种情况,因为麻风杆菌也被认为会分泌与其他密切相关分枝杆菌类似的相应30 kDa蛋白。通过双重免疫酶染色,我们清楚地证明在结核样麻风病肉芽肿中,3A8表位在CD68 +巨噬细胞上表达,而在高菌量的瘤型麻风病病变中,大多数双重染色见于细胞浸润间隙内以及CD68 +巨噬细胞胞质中的弥漫模式。在逆转反应的病变中,与其他类型的麻风病相比,3A8表位在表皮和真皮中的CD1a +树突状朗格汉斯细胞(LC)上表达更强。这为LC参与处理麻风病病变中的分枝杆菌抗原表位提供了证据。此外,免疫酶双重染色显示,在肉芽肿中,这种分枝杆菌3A8表位在抗原呈递细胞如CD68 +巨噬细胞和CD1a + LC上的表达与包括αβ和γδ受体阳性T细胞在内的CD3 + T细胞并列存在。(摘要截于400字)