Mahoney S E, Duvic M, Nickoloff B J, Minshall M, Smith L C, Griffiths C E, Paddock S W, Lewis D E
Department of Dermatology, University of Texas Medical School, Houston 77030.
J Clin Invest. 1991 Jul;88(1):174-85. doi: 10.1172/JCI115275.
Persons with HIV infection sometimes develop aggressive psoriasis or Kaposi's sarcoma (KS) not usually seen in other immunosuppressed patients. However, a specific and direct pathophysiological role for HIV-1 in these AIDS-associated disorders remains unclear since HIV has not been easily detected in these skin lesions. By combining in situ hybridization with the sensitive detection technique of confocal laser scanning microscopy, we have demonstrated HIV RNA transcripts in 5 of 15 lesional skin biopsies from HIV-infected psoriasis patients, and in 3 of 8 Kaposi's sarcoma biopsies from HIV-infected patients. HIV transcripts were not detected in normal appearing skin from HIV-infected patients or in psoriatic and normal skin biopsies from uninfected individuals (P = 0.006). Although previous attempts to demonstrate viral sequences in psoriasis and KS lesions have been unsuccessful, in situ hybridization with confocal microscopy has shown the presence of HIV RNA transcripts predominantly within CD4+, Factor XIIIa positive dermal dendrocytes. HIV or cytokines produced by infected cells in skin lesions may therefore play a direct role in the pathogenesis of HIV-associated psoriasis and KS.
感染HIV的人有时会患上侵袭性银屑病或卡波西肉瘤（KS），而这些疾病在其他免疫抑制患者中并不常见。然而，HIV-1在这些与艾滋病相关的疾病中具体而直接的病理生理作用仍不清楚，因为在这些皮肤病变中不容易检测到HIV。通过将原位杂交与共聚焦激光扫描显微镜的灵敏检测技术相结合，我们在15例来自感染HIV的银屑病患者的皮损活检组织中有5例检测到HIV RNA转录本，在8例来自感染HIV的患者的卡波西肉瘤活检组织中有3例检测到。在感染HIV患者外观正常的皮肤中或未感染个体的银屑病及正常皮肤活检组织中未检测到HIV转录本（P = 0.006）。尽管之前在银屑病和KS病变中检测病毒序列的尝试均未成功，但共聚焦显微镜原位杂交显示HIV RNA转录本主要存在于CD4 +、因子ⅩⅢa阳性的真皮树突状细胞内。因此，皮肤病变中被感染细胞产生的HIV或细胞因子可能在HIV相关银屑病和KS的发病机制中起直接作用。
