Oogarah P K, Rowland P L, Mitchell D M, Smith A, Chalmers R J, Rowan B, Haboubi N Y
Department of Histopathology, University Hospital of South Manchester, UK.
Br J Dermatol. 1995 Oct;133(4):512-8. doi: 10.1111/j.1365-2133.1995.tb02697.x.
In a previous study, it was shown that the serum levels of type III procollagen aminoterminal peptide (P3NP) were significantly greater in patients receiving methotrexate (MTX) treatment for psoriasis than in untreated control patients with psoriasis. Although levels were highest in patients with hepatic fibrosis and cirrhosis, serum P3NP concentrations in those patients with normal liver histology on light microscopy were also shown to be significantly higher than in controls. In the present study, liver biopsies from 22 such 'normal' patients were examined by electron microscopy, in order to determine whether P3NP levels correlated with ultrastructurally demonstrable fibrosis. Fibrosis in the perisinusoidal space of Disse was present in as many as 82% of biopsies. Although the prevalence of such fibrosis in psoriasis patients who have not received MTX is unknown, the high prevalence of Disse space fibrosis and of raised P3NP in MTX-treated patients suggests that MTX causes subtle liver damage in a majority of treated patients. However, we were unable to show a statistical correlation between P3NP and the degree of Disse space fibrosis.
在之前的一项研究中，结果显示，接受甲氨蝶呤（MTX）治疗的银屑病患者血清III型前胶原氨基端肽（P3NP）水平显著高于未经治疗的银屑病对照患者。虽然肝纤维化和肝硬化患者的水平最高，但光镜下肝组织学正常的患者血清P3NP浓度也显著高于对照组。在本研究中，对22例此类“正常”患者的肝活检组织进行了电镜检查，以确定P3NP水平是否与超微结构可显示的纤维化相关。多达82%的活检组织在狄氏间隙存在纤维化。虽然未接受MTX治疗的银屑病患者中这种纤维化的患病率尚不清楚，但MTX治疗患者狄氏间隙纤维化的高患病率和P3NP升高表明，MTX在大多数接受治疗的患者中会导致轻微肝损伤。然而，我们未能显示P3NP与狄氏间隙纤维化程度之间存在统计学相关性。
