Griffiths C E, Barrison I G, Leonard J N, Caun K, Valdimarsson H, Fry L
Department of Dermatology, St Mary's Hospital, London.
Clin Exp Immunol. 1988 May;72(2):280-3.
The distribution and activation of T-lymphocyte subsets in the small intestinal mucosa of coeliac disease and dermatitis herpetiformis subjects on a normal diet has been studied and compared to normal controls. Double-labelling immunofluorescence techniques with monoclonal antibodies were used on cryostat tissue sections. Intestinal epithelial cells demonstrated staining for HLA-DR, the intensity being proportional to the degree of enteropathy. In both patients and controls nearly all (97%) intra-epithelial lymphocytes were of the CD8 subset and not activated as judged by HLA-DR expression. In the lamina propria there was an approximate 50-fold increase in T cells in the patients as compared with the controls. Whilst the ratio of total CD4 to total CD8 cells was unchanged, the CD4 subset was preferentially activated in the patients. Thus in the normal controls the median ratio of activated CD4 cells to activated CD8 cells was 1.67 whilst for dermatitis herpetiformis and coeliac disease it was 3.42 and 6.07 respectively. These findings suggest that the lamina propria is a site of vigorous T-cell activity in gluten-sensitive individuals and is consistent with the view that the enteropathy of dermatitis herpetiformis and coeliac disease is the result of a delayed-type hypersensitivity against gliadin.
对乳糜泻和疱疹样皮炎患者在正常饮食情况下小肠黏膜中T淋巴细胞亚群的分布及激活情况进行了研究，并与正常对照进行比较。采用单克隆抗体双标记免疫荧光技术对低温恒温器组织切片进行检测。肠上皮细胞显示出HLA - DR染色，其强度与肠病程度成正比。在患者和对照中，几乎所有（97%）上皮内淋巴细胞均为CD8亚群，且根据HLA - DR表达判断未被激活。与对照相比，患者固有层中的T细胞数量增加了约50倍。虽然总CD4细胞与总CD8细胞的比例未变，但患者中的CD4亚群被优先激活。因此，在正常对照中，活化CD4细胞与活化CD8细胞的中位数比例为1.67，而疱疹样皮炎和乳糜泻患者分别为3.42和6.07。这些发现表明，固有层是麸质敏感个体中T细胞活跃的部位，这与疱疹样皮炎和乳糜泻的肠病是对麦醇溶蛋白迟发型超敏反应的结果这一观点一致。
