Xu Meng-Nan, Wang Qian, Wang Min, Xu Yuan, Yuan Si-Ming
Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, People's Republic of China.
Department of Plastic Surgery, Jinling Hospital, Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, 210002, People's Republic of China.
Clin Cosmet Investig Dermatol. 2022 Apr 13;15:643-651. doi: 10.2147/CCID.S358612. eCollection 2022.
Port wine stain (PWS) is a congenital skin lesion involving capillary malformations. Most PWS lesions will gradually become hypertrophic and appear nodular in contour. Current research shows that rapamycin, an mTOR inhibitor, is probably a promising adjunctive therapy for PWS, which suggests that the mTOR signaling pathway may play an important role in its pathological process.
From January 2013 to January 2019, 13 samples were obtained during the surgical excision. Each sample was divided into 3 parts according to the type of lesion, namely, the flat, hypertrophic and nodular lesions. Pathologic structures of each type were observed under the microscope after HE staining. The expression of mTORC1, p70S6, p-p70S6, eIF4EBP1 and p-eIF4EBP1 was examined by immunohistochemical staining and western blotting. The location of the expression of mTORC1, p-p70S6 and p-elF4EBP1 was further detected by immunofluorescence staining.
Large amounts of dilated and malformed vessels were observed in all types of PWS lesions. Abundant hyperplastic hair follicles/glands were shown in the hypertrophic or nodular lesions. Phosphorylation level of p70S6 and elF4EBP1 in PWS was significantly higher than those in normal skin and increased accordingly in the progression of PWS. Activated molecules in mTOR signaling pathway were mostly located in the endothelium of malformed vessels. They were also located in the hyperplastic hair follicles/glands of hypertrophic and nodular lesions.
The mTOR signaling pathway was increasingly activated during the progression of PWS. Enhanced activation of mTOR signaling pathway may contribute to the hypertrophy and nodularity of PWS. The results provide preliminary evidence for treating PWS and related syndromes by inhibiting mTOR signaling pathway.
葡萄酒色斑(PWS)是一种涉及毛细血管畸形的先天性皮肤病变。大多数PWS病变会逐渐肥厚,轮廓呈结节状。目前的研究表明,mTOR抑制剂雷帕霉素可能是一种有前景的PWS辅助治疗药物,这表明mTOR信号通路可能在其病理过程中起重要作用。
2013年1月至2019年1月,手术切除过程中获取13个样本。每个样本根据病变类型分为3部分,即扁平、肥厚和结节性病变。HE染色后在显微镜下观察各类型的病理结构。通过免疫组织化学染色和蛋白质印迹法检测mTORC1、p70S6、p-p70S6、eIF4EBP1和p-eIF4EBP1的表达。通过免疫荧光染色进一步检测mTORC1、p-p70S6和p-elF4EBP1表达的定位。
在所有类型的PWS病变中均观察到大量扩张和畸形的血管。肥厚性或结节性病变中可见丰富的增生性毛囊/腺体。PWS中p70S6和eIF4EBP1的磷酸化水平显著高于正常皮肤,并随PWS进展而相应增加。mTOR信号通路中的活化分子大多位于畸形血管的内皮细胞中。它们也位于肥厚性和结节性病变的增生性毛囊/腺体中。
PWS进展过程中mTOR信号通路被越来越多地激活。mTOR信号通路的增强激活可能导致PWS的肥厚和结节形成。这些结果为通过抑制mTOR信号通路治疗PWS及相关综合征提供了初步证据。