Baadsgaard O, Gupta A K, Taylor R S, Ellis C N, Voorhees J J, Cooper K D
Department of Dermatology, University of Michigan Medical Center, Ann Arbor.
J Invest Dermatol. 1989 Feb;92(2):190-5. doi: 10.1111/1523-1747.ep12276718.
The recent findings that the immunosuppressant cyclosporine A (CsA) improves psoriasis raises the possibility that cellular immune processes play a major role in the pathogenesis of psoriasis. We therefore investigated the phenotype and function of cells within psoriatic epidermis that can play a role in cellular immunologic reactivity. Double fluorescence microscopic studies with monoclonal antibodies of epidermal cells in suspension (EC) and of histologic sections demonstrated that involved psoriatic skin contained a significantly increased number of non-Langerhans cell T6-DR+ EC (4.9 + 2.1%) relative to uninvolved (0.3 +/- 0.1%), p less than 0.01. This non-Langerhans cell population was comprised of DR+ monocytes, DR+ activated T lymphocytes, a few DR+RFD1+ antigen-presenting cells (APC), and DR+ keratinocytes. Langerhans cell (LC) levels in EC suspension were not different between involved and uninvolved psoriatic epidermis. Functional studies demonstrated that involved psoriatic epidermal cells had an increased capacity to induce T-cell activation and proliferation relative to uninvolved EC (p less than 0.04). This increased APC activity was due to the non-LC T6-DR+HLe1+ APC population and not to DR+ keratinocytes. These results demonstrate that involved psoriatic epidermal cells contain both an increased number and function of antigen-presenting cells. The pathogenetic mechanisms in psoriasis may be related to ongoing cellular immune responses in the skin, and the effect of CsA may be mediated through a suppressive effect on the enhanced antigen-presenting cell activity.
近期发现免疫抑制剂环孢素A（CsA）可改善银屑病，这增加了细胞免疫过程在银屑病发病机制中起主要作用的可能性。因此，我们研究了银屑病表皮内可能在细胞免疫反应中起作用的细胞的表型和功能。对悬浮表皮细胞（EC）和组织切片进行单克隆抗体双荧光显微镜研究表明，与未受累皮肤（0.3±0.1%）相比，受累银屑病皮肤中T6-DR+非朗格汉斯细胞EC数量显著增加（4.9+2.1%），p<0.01。这个非朗格汉斯细胞群体由DR+单核细胞、DR+活化T淋巴细胞、少数DR+RFD1+抗原呈递细胞（APC）和DR+角质形成细胞组成。受累和未受累银屑病表皮的EC悬液中朗格汉斯细胞（LC）水平无差异。功能研究表明，与未受累EC相比，受累银屑病表皮细胞诱导T细胞活化和增殖的能力增强（p<0.04）。这种APC活性增加是由于非LC的T6-DR+HLe1+APC群体，而非DR+角质形成细胞。这些结果表明，受累银屑病表皮细胞中抗原呈递细胞的数量和功能均增加。银屑病的发病机制可能与皮肤中持续的细胞免疫反应有关，CsA的作用可能是通过对增强的抗原呈递细胞活性的抑制作用来介导的。
