Bos J D, Krieg S R
Acta Derm Venereol. 1985;65(5):390-7.
The effects of PUVA or corticosteroid treatment on the distribution pattern of immunocompetent cells in psoriasis symptomatic skin were investigated. A total of 29 biopsies, taken before and a regular intervals during treatment, were studied in a two-stage immunoperoxidase technique using monoclonal antibodies directed against T cells, their major subsets, interdigitating cells, and Langerhans' cells. T cell exocytosis was not affected by PUVA or corticosteroid treatment. Instead, both treatment regimens led to an initial increase in interbasally localized T8+ suppressor/cytotoxic T cells. Increased T4/T8 ratios within the subepidermal infiltrates were restored to normal except in one case, who did not respond to PUVA-treatment. Epidermal and dermal T6+ Langerhans' cells decreased to almost absent. RFD1+ interdigitating cells had the same tendency, except in the PUVA-non-responding patient. Treatment of psoriasis with PUVA or corticosteroids thus results in a normalization of an initial immune imbalance in infiltrating immunocompetent cells. A working hypothesis on psoriasis immunopathogenesis and its restoration by treatment is presented.
研究了补骨脂素紫外线A光化学疗法（PUVA）或皮质类固醇治疗对银屑病症状性皮肤中免疫活性细胞分布模式的影响。在治疗前及治疗期间定期进行活检，共获取29份活检样本，采用针对T细胞、其主要亚群、交错突细胞和朗格汉斯细胞的单克隆抗体，通过两阶段免疫过氧化物酶技术进行研究。PUVA或皮质类固醇治疗未影响T细胞胞吐作用。相反，两种治疗方案均导致基底间局部T8 +抑制/细胞毒性T细胞最初增加。除1例对PUVA治疗无反应的患者外，表皮下浸润内升高的T4/T8比值恢复正常。表皮和真皮T6 +朗格汉斯细胞减少至几乎消失。RFD1 +交错突细胞也有相同趋势，但对PUVA无反应的患者除外。因此，用PUVA或皮质类固醇治疗银屑病可使浸润的免疫活性细胞中最初的免疫失衡恢复正常。本文提出了一个关于银屑病免疫发病机制及其通过治疗恢复的工作假说。
