Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Dermatology and Venereology, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Immunol Rev. 2018 Mar;282(1):232-247. doi: 10.1111/imr.12632.
This review presents evidence that the skin mast cell, in particular the MC subtype, is the primary effector cell in urticaria. Mast cells are located in the upper dermis, the ideal situation for wheal formation and sensory nerve stimulation. Increased numbers of mast cells are found in both lesional and non-lesional skin in CSU and inducible urticaria. Mast cell degranulation in the area of wheals has been demonstrated repeatedly by light and electron microscopy. Histamine, PGD and tryptase are found in the venous blood draining wheal formation. The last 2 are specific for mast cells rather than basophils. Mast cell reactivity is increased in active urticaria by local inflammatory cytokines and neuropeptides. Mast cell cytokines and neuropeptides, particularly nerve growth factor, induce a Th2 type inflammation that is particularly obvious at the sites of whealing. In conclusion, autoimmunity, either of Type 1 viz. IgE antibodies to local autoallergens, or Type 2b, viz. IgG autoantibodies to IgE or its receptor, are considered to be the most frequent causes of CSU. In both cases, the mast cell is likely to be the axial cell in producing the wheals.
这篇综述提出证据表明，皮肤肥大细胞，特别是 MC 亚型，是荨麻疹的主要效应细胞。肥大细胞位于真皮上层，是风团形成和感觉神经刺激的理想位置。在慢性自发性荨麻疹和诱导性荨麻疹的皮损和非皮损皮肤中均可发现数量增加的肥大细胞。光镜和电镜反复证实肥大细胞在风团区域脱颗粒。在风团形成区域的静脉血液中可发现组胺、PGD 和类胰蛋白酶。后两者是肥大细胞而不是嗜碱性粒细胞的特异性标志物。在活动性荨麻疹中，局部炎症细胞因子和神经肽会增加肥大细胞的反应性。肥大细胞细胞因子和神经肽，特别是神经生长因子，会诱导 Th2 型炎症，在风团部位尤为明显。总之，自身免疫，无论是针对局部自身抗原的 1 型 IgE 抗体，还是针对 IgE 或其受体的 2b 型 IgG 自身抗体，都被认为是慢性自发性荨麻疹的最常见原因。在这两种情况下，肥大细胞很可能是产生风团的轴心细胞。
