Olbricht S M, Flotte T J, Collins A B, Chapman C M, Harrist T J
Arch Dermatol. 1986 Apr;122(4):418-21. doi: 10.1001/archderm.122.4.418.
Dermatitis herpetiformis (DH) is a pruritic papulovesicular skin disorder of unknown cause, characterized by granular IgA deposits in the dermis along the dermoepidermal junction. It is associated with gluten-sensitive enteropathy and increased IgA production by gut lymphoid tissue. We report four cases of immunologically documented DH studied by immunofluorescence technique. Monoclonal antibodies against the IgA subclasses IgA1 and IgA2 were used. IgA1 without IgA2 was found in the cutaneous deposits in each case. The IgA1 had both kappa and lambda light chains in approximately equal quantities. Because normal gut-associated lymphoid tissue produces 70% IgA1 and 30% IgA2, while circulating IgA is primarily IgA1, it could be concluded that the IgA in the skin of DH patients is not produced in the gut. However, the subclass restriction of the IgA produced by pathologic gut-associated lymphoid tissue is unknown. Alternatively, both IgA1 and IgA2 may be produced by the gut, but only IgA1 is involved in the production of cutaneous lesions.
疱疹样皮炎（DH）是一种病因不明的瘙痒性丘疹水疱性皮肤病，其特征是真皮内沿真皮表皮交界处有颗粒状IgA沉积。它与麸质敏感性肠病以及肠道淋巴组织IgA产生增加有关。我们报告了4例通过免疫荧光技术进行免疫学记录的DH病例。使用了针对IgA亚类IgA1和IgA2的单克隆抗体。在每个病例的皮肤沉积物中均发现了不含IgA2的IgA1。IgA1的κ链和λ链数量大致相等。由于正常的肠道相关淋巴组织产生70%的IgA1和30%的IgA2，而循环中的IgA主要是IgA1，因此可以得出结论，DH患者皮肤中的IgA并非在肠道产生。然而，病理性肠道相关淋巴组织产生的IgA的亚类限制尚不清楚。或者，IgA1和IgA2都可能由肠道产生，但只有IgA1参与皮肤病变的产生。
