LITEC, Pôle Biologie Santé, Poitiers University, Poitiers, France.
Am J Pathol. 2013 Mar;182(3):806-18. doi: 10.1016/j.ajpath.2012.11.030. Epub 2013 Jan 11.
Hypertensive leg ulcer (HLU) is an inflammatory disease characterized by intense pain, alteration of vascularization, and skin necrosis. The optimal treatment relies on surgical removal of necrotic tissues covered by a split-skin graft. We studied the histomorphology of the lesions and investigated the involvement of inflammatory cells and cytokines to further define the physiopathology of HLU. We report epidermis acanthosis and a preferential occlusion of the precapillary arterioles with infiltration of neutrophils, macrophages, and T lymphocytes in the dermis. OSM, IL-1β, and IL-6 were overexpressed in the ulcer, whereas the Th17-derived cytokines were not. In vitro, the addition of IL-1β and OSM promoted acanthosis and destructuring of reconstructed epidermis. Exogenous IL-1β and OSM synergistically induced epidermal acanthosis in mice. These data show that OSM and IL-1β are not only a biological characteristic signature of HLU, but these cytokines reflect a specific inflammatory state, directly involved in the pathogenesis. We suggest that anti-cytokine biotherapies could be an alternative strategy to surgery to treat HLU.
高血压性腿部溃疡(HLU)是一种炎症性疾病,其特征为剧烈疼痛、血管化改变和皮肤坏死。最佳治疗方法依赖于手术切除覆盖在皮肤移植片上的坏死组织。我们研究了病变的组织形态学,并研究了炎症细胞和细胞因子的参与,以进一步阐明 HLU 的病理生理学。我们报告表皮棘皮病和小动脉前毛细血管优先闭塞,伴有真皮中中性粒细胞、巨噬细胞和 T 淋巴细胞浸润。OSM、IL-1β 和 IL-6 在溃疡中过度表达,而 Th17 衍生的细胞因子则没有。在体外,添加 IL-1β 和 OSM 促进了重建表皮的棘皮病和结构破坏。外源性 IL-1β 和 OSM 协同诱导小鼠表皮棘皮病。这些数据表明,OSM 和 IL-1β 不仅是 HLU 的生物学特征标志,而且这些细胞因子反映了一种特定的炎症状态,直接参与发病机制。我们建议抗细胞因子生物疗法可能是治疗 HLU 的替代手术策略。