Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
J Dermatol. 2021 Sep;48(9):1357-1364. doi: 10.1111/1346-8138.15937. Epub 2021 May 18.
Papuloerythroderma (PEO) is a representative form of senile erythroderma with an unclear pathogenesis. This study aimed to characterize the T-cell phenotypes responsible for the pathogenesis of PEO. Cytokine profiles and cutaneous lymphocyte antigen (CLA) expression on circulating T lymphocytes in patients with PEO were simultaneously analyzed using flow cytometry. The patients with PEO showed significantly higher circulating interleukin (IL)-4-, IL-13-, IL-22-, and IL-31-producing CD4 and CD8 T-cell levels than healthy subjects. However, their levels significantly decreased after remission of PEO. No difference was observed in the proportions of circulating interferon (IFN)-γ- and IL-17-producing CD4 and CD8 T cells between the patients with PEO and healthy subjects. In particular, the proportion of circulating IL-4-, IL-13-, IL-22-, and IL-31-producing CD4 and CD8 T cells was much higher in the CLA subset than in the CLA subset. There was a positive correlation between IL-13-, IL-22-, and IL-31-producing CD4 T cells and the disease severity score of PEO. Moreover, a positive correlation was also observed between the proportion of IL-22- or IL-31-producing cells and circulating IL-13-producing cells in both CD4 and CD8 T cells, and approximately 50% of both IL-22- and IL-31-producing CD4 and CD8 T cells coproduced IL-13. IL-13/IL-22/IL-31 skewing within the skin-homing T-cell population may be involved in the pathogenesis of PEO.
斑片状红皮病(PEO)是一种以发病机制不明为特征的老年红皮病的代表性形式。本研究旨在描述导致 PEO 发病机制的 T 细胞表型。通过流式细胞术同时分析 PEO 患者循环 T 淋巴细胞的细胞因子谱和皮肤淋巴细胞抗原(CLA)表达。与健康受试者相比,PEO 患者的循环 CD4 和 CD8 T 细胞中产生白细胞介素(IL)-4、IL-13、IL-22 和 IL-31 的细胞水平显著升高。然而,在 PEO 缓解后,其水平显著降低。PEO 患者和健康受试者之间循环 IFN-γ和 IL-17 产生的 CD4 和 CD8 T 细胞比例没有差异。特别是,CLA 亚群中循环产生 IL-4、IL-13、IL-22 和 IL-31 的 CD4 和 CD8 T 细胞的比例明显高于非 CLA 亚群。循环产生 IL-13、IL-22 和 IL-31 的 CD4 T 细胞与 PEO 的疾病严重程度评分之间存在正相关。此外,在 CD4 和 CD8 T 细胞中,IL-22 或 IL-31 产生细胞的比例与循环 IL-13 产生细胞之间也存在正相关,并且大约 50%的 IL-22 和 IL-31 产生的 CD4 和 CD8 T 细胞共同产生 IL-13。皮肤归巢 T 细胞群中 IL-13/IL-22/IL-31 倾斜可能参与 PEO 的发病机制。