Department of Dermato-allergology, University Hospital of Copenhagen Gentofte, Hellerup, Denmark.
Clin Exp Immunol. 2011 Sep;165(3):310-7. doi: 10.1111/j.1365-2249.2011.04428.x. Epub 2011 Jun 14.
An inverse relation between contact allergy and autoimmune diseases is suggested from epidemiological studies. The aim of this study was to investigate susceptibility and reactivity in patients with psoriasis, patients with diabetes and healthy controls in an experimental sensitization study. We sensitized 68 adult individuals (23 patients with psoriasis, 22 patients with diabetes and 23 healthy controls) with diphenylcyclopropenone (DPCP) and assessed challenge responses with visual scoring and ultrasound. Skin biopsies from challenged skin were investigated for differences in down-regulatory mechanisms with immunohistochemistry and gene-expression profiles using microarray technology. The sensitization ratios were 26%, 36% and 65% for the psoriatic, diabetic and healthy groups, respectively. Logistic regression analysis gave an odds ratio (OR) for a patient with psoriasis or diabetes type I of being sensitized to 0·18 [95% confidence interval (CI): 0·039-0·85], P = 0·031 and 0·74 (95% CI: 0·548-1·008), P = 0·056, respectively. A high degree of forkhead box P3-positive (FoxP3(+) ) cells were found in biopsies of positively challenged reactions, but only limited numbers in negatively challenged reactions, with no difference among the groups. No specific mRNA expression was found in the challenged skin of negative elicitation reactions, also indicating no sign of active down-regulation. The study contibutes strongly to the evidence of a decreased susceptibility to develop contact allergy in individuals with autoimmune diseases such as psoriasis.
从流行病学研究中可以看出接触过敏与自身免疫性疾病之间呈负相关。本研究旨在通过实验性致敏研究，调查银屑病患者、糖尿病患者和健康对照者的易感性和反应性。我们用二苯环丙烯酮（DPCP）对 68 名成年个体（23 名银屑病患者、22 名糖尿病患者和 23 名健康对照者）进行致敏，并通过视觉评分和超声评估挑战反应。用免疫组织化学和微阵列技术的基因表达谱研究了来自挑战皮肤的活检标本中下调机制的差异。银屑病、糖尿病和健康组的致敏率分别为 26%、36%和 65%。逻辑回归分析得出，银屑病或 1 型糖尿病患者的致敏比值分别为 0.18（95%CI：0.039-0.85），P = 0.031 和 0.74（95%CI：0.548-1.008），P = 0.056。在阳性反应的活检标本中发现了大量的叉头框 P3 阳性（FoxP3(+)）细胞，但在阴性反应的活检标本中只发现了有限数量的细胞，各组之间没有差异。在阴性激发反应的挑战皮肤中未发现特定的 mRNA 表达，这也表明没有主动下调的迹象。该研究有力地证明了在自身免疫性疾病（如银屑病）患者中，接触过敏的易感性降低。
