血液恶性肿瘤嗜酸性粒细胞性皮炎患者皮肤中辅助性 T 细胞 2 型相关分子的过表达。

Overexpression of helper T cell type 2-related molecules in the skin of patients with eosinophilic dermatosis of hematologic malignancy.

机构信息

Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy.

Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy.

出版信息

J Am Acad Dermatol. 2022 Oct;87(4):761-770. doi: 10.1016/j.jaad.2021.07.007. Epub 2021 Jul 13.

DOI:10.1016/j.jaad.2021.07.007

PMID:34265409

Abstract

BACKGROUND

Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare dermatosis associated with blood tumors.

OBJECTIVE

To characterize the expression of T-cell and B-cell markers and pruritogenic mediators in EDHM skin.

METHODS

Immunohistochemical and immunofluorescence analysis were performed in 12 skin samples of EDHM, 11 samples of bullous pemphigoid (BP), and 5 samples from healthy controls (HC). Serum levels of interleukin (IL) 4 were analyzed in 11 patients with EDHM, 11 BP patients, and 5 HC by enzyme-linked immunosorbent assay.

RESULTS

T-cell markers, including clusters of differentiation (CD) 3, CD4, CD8, and CD5 were significantly overexpressed in EDHM and BP skin compared to HC. A predominance of CD4 over CD8 cells and GATA3 (helper T cell type 2 [Th2] marker) over T-bet (Th1 marker) cells were observed. FOXP3 expression was increased but the FOXP3/CD4 ratio was low. B-cell markers were under-represented, without significant differences between the 3 groups. IL-4 and IL-31 were significantly overexpressed in EDHM and BP compared to HC and colocalized with the Th2-associated marker GATA3. Eotaxin-1 was significantly overexpressed in EDHM compared to BP and HC. IL-4 serum concentration was significantly increased in EDHM and BP compared to HC.

LIMITATIONS

Small sample size; retrospective design.

CONCLUSIONS

Targeting Th2-related molecules, in particular IL-4, holds promise for EDHM management.

摘要

背景

嗜酸性粒细胞性皮肤病与血液肿瘤相关，是一种罕见的皮肤病。

目的

描述嗜酸性粒细胞性血液病相关性皮肤病（EDHM）皮肤中 T 细胞和 B 细胞标志物及瘙痒介质的表达情况。

方法

对 12 例 EDHM 皮肤样本、11 例大疱性类天疱疮（BP）皮肤样本和 5 例健康对照（HC）皮肤样本进行免疫组化和免疫荧光分析。采用酶联免疫吸附试验检测 11 例 EDHM 患者、11 例 BP 患者和 5 例 HC 的血清白细胞介素（IL）4 水平。

结果

与 HC 相比，EDHM 和 BP 皮肤中 T 细胞标志物，包括分化群（CD）3、CD4、CD8 和 CD5 的表达明显上调。观察到 CD4 细胞多于 CD8 细胞，GATA3（辅助性 T 细胞 2 型[Th2]标志物）多于 T-bet（Th1 标志物）细胞。FOXP3 表达增加，但 FOXP3/CD4 比值较低。B 细胞标志物表达不足，3 组间无显著差异。与 HC 相比，EDHM 和 BP 中 IL-4 和 IL-31 表达明显上调，且与 Th2 相关标志物 GATA3 共定位。与 BP 和 HC 相比，嗜酸性粒细胞趋化因子-1 在 EDHM 中表达明显上调。与 HC 相比，EDHM 和 BP 患者的血清 IL-4 浓度明显升高。