Paller A S, Nelson A, Steffen L, Gottschalk L, Kaizer H
Department of Dermatology, Rush University of Rush-Presbytgerian-St Luke's Medical Center, Chicago, IL.
Arch Dermatol. 1988 Dec;124(12):1795-801.
Cutaneous biopsy specimens obtained from bone marrow transplant (BMT) patients, most with graft-vs-host disease (GVHD), were analyzed for infiltration by helper, cytotoxic, and suppressor T lymphocytes and natural killer cells. Lesional skin from patients with early mild GVHD and drug reactions showed a CD4/CD8 ratio of 5.0 or more, but later biopsy specimens from patients with acute GVHD and the majority of sections from those with chronic GVHD showed a CD4/CD8 ratio of 0.8 to 3.0 due to increased numbers of presumably cytotoxic cells. Significant numbers of suppressor (CD11 +/- CD16b-) cells were found in only one patient with severe chronic GVHD. Natural killer cells were not found. Preliminary examination of lesional skin from seven autologous BMT patients showed a similar trend of decreased CD4/CD8 ratios in the three patients with a syndrome that resembled GVHD. Analysis of CD4/CD8 ratios in serial biopsy specimens from patients with GVHD may allow more accurate monitoring of the progression of cutaneous GVHD and may help to elucidate the mechanism of development of the GVHD-like reaction in autologous BMT patients.
对取自骨髓移植（BMT）患者（大多数患有移植物抗宿主病，即GVHD）的皮肤活检标本进行分析，以检测辅助性T淋巴细胞、细胞毒性T淋巴细胞、抑制性T淋巴细胞和自然杀伤细胞的浸润情况。早期轻度GVHD患者和药物反应患者的病变皮肤显示CD4/CD8比值为5.0或更高，但急性GVHD患者的后期活检标本以及大多数慢性GVHD患者的切片显示，由于可能具有细胞毒性的细胞数量增加，CD4/CD8比值为0.8至3.0。仅在一名患有严重慢性GVHD的患者中发现了大量抑制性（CD11 +/- CD16b-）细胞。未发现自然杀伤细胞。对7名自体BMT患者的病变皮肤进行的初步检查显示，在3名患有类似GVHD综合征的患者中，CD4/CD8比值也有类似的下降趋势。对GVHD患者的系列活检标本进行CD4/CD8比值分析，可能有助于更准确地监测皮肤GVHD的进展，并有助于阐明自体BMT患者中GVHD样反应的发生机制。
