Rodrigues Denise Bertulucci Rocha, Pereira Sanivia Aparecida Lima, dos Reis Marlene Antônia, Adad Sheila Jorge, Caixeta João Eduardo, Chiba Angélica Maeda, Sousa Richard Atila, Rodrigues Virmondes
Laboratory of Immunology, Universidade Federal do Triangulo Mineiro, 38025-180 Uberaba, Minas Gerais, Brazil.
Arch Pathol Lab Med. 2009 Jan;133(1):97-100. doi: 10.5858/133.1.97.
Endemic pemphigus foliaceus, or fogo selvagem, is a chronic autoimmune disease characterized by the formation of intraepidermal blisters that reduce adhesion between keratinocytes. Endemic pemphigus foliaceus is associated with the presence of autoantibodies and high levels of cytokines involved in the inflammatory response.
To evaluate the expression of the proinflammatory cytokines interleukin 1, interferon gamma, and tumor necrosis factor alpha; the proapoptotic inducers Fas and inducible nitric oxide synthase; and the apoptosis inhibitor Bcl-2; and to evaluate the presence of apoptosis.
Skin biopsies from 13 patients with endemic pemphigus foliaceus and controls were evaluated by immunohistochemistry and apoptosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay.
Proinflammatory cytokines were only detected in cells of the inflammatory exudate. Inducible nitric oxide synthase, Fas, and Bcl-2 were expressed by both epithelial and inflammatory cells. Epithelial apoptosis was observed in 12 cases (92.3%), and subepithelial apoptosis in 11 cases (85%).
This study suggests that apoptosis as well as the local production of proinflammatory cytokines are associated with endemic pemphigus foliaceus lesions. These results may contribute to the development of new therapeutic approaches to endemic pemphigus foliaceus.
地方性落叶型天疱疮，即丛林大疱疮，是一种慢性自身免疫性疾病，其特征为表皮内水疱形成，这会降低角质形成细胞之间的黏附力。地方性落叶型天疱疮与自身抗体的存在以及参与炎症反应的高水平细胞因子有关。
评估促炎细胞因子白细胞介素1、干扰素γ和肿瘤坏死因子α的表达；促凋亡诱导因子Fas和诱导型一氧化氮合酶；以及凋亡抑制因子Bcl-2；并评估凋亡的存在情况。
对13例地方性落叶型天疱疮患者和对照组的皮肤活检标本进行免疫组织化学评估，并通过末端脱氧核苷酸转移酶介导的dUTP缺口末端标记法测定凋亡情况。
促炎细胞因子仅在炎性渗出液的细胞中检测到。诱导型一氧化氮合酶、Fas和Bcl-2在上皮细胞和炎性细胞中均有表达。12例（92.3%）观察到上皮细胞凋亡，11例（85%）观察到上皮下凋亡。
本研究表明，凋亡以及促炎细胞因子的局部产生与地方性落叶型天疱疮皮损有关。这些结果可能有助于开发针对地方性落叶型天疱疮的新治疗方法。
