Velvart M, Felder M, Fehr K, Sommermeyer G, Cancer M, Wagenhäuser F J, Böni A
Z Rheumatol. 1983 Nov-Dec;42(6):320-7.
Immunohistochemical studies were performed on the temporal artery of 34 patients with clinically established polymyalgia rheumatica (PR) or temporal arteritis, 6 patients with vasculitis, and 25 patients with various diseases. The combined immunofluorescence and peroxidase-anti-Peroxidase Methode zeigte Immunoglobulin- und C3-Ablagerunin histologically affected and to some degree also in unaffected arteries of patients with PR and in all patients with temporal arteritis. The deposits were found both inter- and intracellularly, and contained IgA and to a lesser extend IgG, IgM, and C3. Linear deposits of leukocyte elastase were found along the fragmented internal lamina, and decaying polymorphonuclear (PMN) leukocytes surrounded by elastase-containing inclusions were found in the neighborhood of zones rich in elastic material. These findings suggest that immune complex deposition is a prominent feature of temporal arteritis and that the PMN elastase is probably involved in the destruction of elastic fibers. The combined immunohistochemical investigation appears to increase the diagnostic value of temporal artery biopsy.
对34例临床确诊为风湿性多肌痛（PR）或颞动脉炎的患者、6例血管炎患者以及25例患有各种疾病的患者的颞动脉进行了免疫组织化学研究。免疫荧光和过氧化物酶 - 抗过氧化物酶联合方法显示，在组织学上受影响的血管以及PR患者未受影响的动脉和所有颞动脉炎患者的动脉中，均有免疫球蛋白和C3沉积。沉积物在细胞内和细胞间均有发现，包含IgA，以及少量的IgG、IgM和C3。沿破碎的内弹力层发现白细胞弹性蛋白酶的线性沉积，并且在富含弹性物质的区域附近发现了被含弹性蛋白酶的内含物包围的正在解体的多形核（PMN）白细胞。这些发现表明免疫复合物沉积是颞动脉炎的一个突出特征，并且PMN弹性蛋白酶可能参与了弹性纤维的破坏。联合免疫组织化学研究似乎提高了颞动脉活检的诊断价值。
