Baker B S, Griffiths C E, Lambert S, Powles A V, Leonard J N, Valdimarsson H, Fry L
Br J Dermatol. 1987 Apr;116(4):503-10. doi: 10.1111/j.1365-2133.1987.tb05869.x.
Sequential skin biopsies from six patients with severe psoriasis were studied during treatment with cyclosporin. Four of the patients cleared completely and the remaining two showed a marked improvement. A subset of dendritic cells, HLA-DR+ but lacking the T6 antigen characteristically expressed by Langerhans cells (DR+ 6-), was observed in lesional epidermis. They disappeared during treatment, before clinical improvement was apparent and at a rate which correlated with clearance of psoriasis. These cells were not found in normal or uninvolved psoriatic epidermis and their number in lesional skin appeared to be related to the clinical severity of the disease. Total numbers of CD4 and CD8, and HLA-DR+ CD8 T cells were substantially reduced in both epidermis and dermis prior to clinical improvement. In contrast, there was generally no decrease in the number of HLA-DR+ CD4 T cells in the epidermis during resolution, whereas these cells were reduced by an average of 68% in the dermis. The beneficial effects of cyclosporin in psoriasis further support the hypothesis that T cells play a central role in the pathogenesis of psoriasis. The cellular changes observed in the skin during cyclosporin treatment may help to elucidate the effects of this drug on immunoregulatory mechanisms in man.
对6例重度银屑病患者在接受环孢素治疗期间进行序贯皮肤活检。其中4例患者完全清除，其余2例有显著改善。在皮损表皮中观察到一种树突状细胞亚群，其HLA - DR阳性但缺乏朗格汉斯细胞典型表达的T6抗原（DR + 6 -）。它们在治疗期间消失，在临床改善明显之前，且消失速度与银屑病的清除相关。这些细胞在正常或未受累的银屑病表皮中未发现，其在皮损皮肤中的数量似乎与疾病的临床严重程度有关。在临床改善之前，表皮和真皮中的CD4和CD8总数以及HLA - DR + CD8 T细胞数量均大幅减少。相比之下，在病情缓解期间，表皮中HLA - DR + CD4 T细胞数量通常没有减少，而真皮中的这些细胞平均减少了68%。环孢素对银屑病的有益作用进一步支持了T细胞在银屑病发病机制中起核心作用的假说。环孢素治疗期间皮肤中观察到的细胞变化可能有助于阐明该药物对人体免疫调节机制的影响。
