Malhotra R, Stenn K S, Fernandez L A, Braverman I M
Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.
Lab Invest. 1989 Aug;61(2):162-5.
Psoriasis is a chronic inflammatory and proliferative epidermal skin disease associated with prominent new vessels in the dermis. Heretofore, unresolved was the question which skin element causes stimulation of vessel formation in this lesion: the epidermis, the dermis, vessels themselves, inflammatory cells, and so forth. It has been argued that the dermis by means of its vessels is responsible for the rapid and prominent epidermal growth and that psoriasis is simply a dermal-induced epidermal disease. Recognizing that vascular proliferations do not occur in the absence of an angiogenic stimulus we asked where in psoriatic skin is that angiogenic element found. By using the rabbit cornea angiogenic assay, the vessel-stimulating properties of epidermis and dermis (separated after cold trypsinization overnight), collected from psoriatic-plaque skin and normal skin both nonpsoriatic and psoriatic patients, were measured. The corneas were examined on days 2, 4, 8, 10, and 12 and graded from 1 to 5+ for vessel growth. Psoriatic plaque epidermis revealed a 4 to 5+ stimulus (8 of 12 corneas). Epidermis from normal subjects or from nonlesional psoriatic patient skin also revealed a 4 to 5+ stimulus (3 of 5 and 5 of 8, respectively). In no case was the dermal implant from normal (7 implants) or psoriatic patients (3 implants of lesional skin) angiogenic. The angiogenic activity of epidermis is stable to freezing and boiling. This study indicates that the vessel-stimulating properties of psoriatic and nonpsoriatic skin are associated with the epidermis and that the developing psoriatic lesion may involve complex epidermal to dermal as well as dermal to epidermal signals.
银屑病是一种慢性炎症性增殖性皮肤病，与真皮中明显的新血管有关。迄今为止，尚未解决的问题是，在这种病变中是哪种皮肤成分导致血管形成受到刺激：表皮、真皮、血管本身、炎症细胞等等。有人认为，真皮通过其血管对表皮的快速和显著生长负责，银屑病仅仅是一种由真皮诱导的表皮疾病。认识到在没有血管生成刺激的情况下不会发生血管增殖，我们不禁要问，在银屑病皮肤中，这种血管生成成分在哪里被发现。通过使用兔角膜血管生成试验，测量了从银屑病斑块皮肤以及非银屑病和银屑病患者的正常皮肤中收集的表皮和真皮（经过冷胰蛋白酶消化过夜后分离）的血管刺激特性。在第2、4、8、10和12天检查角膜，并根据血管生长情况从1到5+进行分级。银屑病斑块表皮显示出4到5+的刺激（12只角膜中有8只）。正常受试者或非病变银屑病患者皮肤的表皮也显示出4到5+的刺激（分别为5只中的3只和8只中的5只）。在任何情况下，来自正常受试者（7个植入物）或银屑病患者（3个病变皮肤植入物）的真皮植入物都没有血管生成活性。表皮的血管生成活性对冷冻和煮沸都很稳定。这项研究表明，银屑病和非银屑病皮肤的血管刺激特性与表皮有关，并且正在发展的银屑病病变可能涉及复杂的表皮到真皮以及真皮到表皮的信号。
