鼻窦炎症性疾病中体骨巨细胞样多核巨细胞：肉芽肿性多血管炎（韦格纳肉芽肿）。
Osteoclast-like multinucleated giant cells in sinonasal inflammation of granulomatosis with polyangiitis (Wegener's granulomatosis).
机构信息
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
出版信息
Clin Exp Rheumatol. 2013 Jan-Feb;31(1 Suppl 75):S28-31. Epub 2013 Mar 4.
OBJECTIVES
To determine whether generation of osteoclast-like multinucleated giant cells (MNG) is a general feature of granulomatosis with polyangiitis (GPA).
METHODS
MNG phenotype of GPA sinus was examined by immunohistochemistry using antibodies against CD68, and cathepsin K. Tartrate resistant acid phosphatase (TRAP) expression was assessed by enzymatic color reaction. Effects of bacterial wall components peptidoglycan (PGN) or lipoteichoic acid (LTA) on TRAP + MNG formation were determined.
RESULTS
Tissue infiltrating MNGs in sinus expressed CD68, TRAP, and cathepsin K. They were strikingly less frequent in sinus than in lung lesions (23.1% vs. 70%, p=0.04). PGN and LTA inhibited MNG formation in a dose-dependent manner.
CONCLUSIONS
While the generation of osteoclast-like MNGs is an intrinsic feature of GPA, MNGs are rare in sinonasal GPA lesions. Inhibition of MNG formation by bacterial cell wall components may occur preferentially in this sinonasal microenvironment, and contribute to these striking regional pathological differences.
目的
确定破骨细胞样多核巨细胞（MNG）的生成是否是肉芽肿性多血管炎（GPA）的普遍特征。
方法
通过免疫组织化学方法使用针对 CD68 和组织蛋白酶 K 的抗体检查 GPA 鼻窦中的 MNG 表型。通过酶促颜色反应评估抗酒石酸酸性磷酸酶（TRAP）的表达。确定细菌细胞壁成分肽聚糖（PGN）或脂磷壁酸（LTA）对 TRAP+MNG 形成的影响。
结果
窦组织浸润的 MNG 表达 CD68、TRAP 和组织蛋白酶 K。它们在窦中比在肺部病变中明显较少（23.1%比 70%，p=0.04）。PGN 和 LTA 以剂量依赖性方式抑制 MNG 的形成。
结论
虽然破骨细胞样 MNG 的产生是 GPA 的固有特征，但 MNG 在 GPA 鼻旁窦病变中很少见。细菌细胞壁成分对 MNG 形成的抑制可能优先发生在这种鼻旁窦微环境中，并导致这些明显的区域性病理差异。
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