Leung D Y, Travers J B, Giorno R, Norris D A, Skinner R, Aelion J, Kazemi L V, Kim M H, Trumble A E, Kotb M
Department of Pediatrics, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado 80206, USA.
J Clin Invest. 1995 Nov;96(5):2106-12. doi: 10.1172/JCI118263.
Recent studies have suggested that T cells play a critical role in the pathogenesis of psoriasis. Guttate psoriasis is a well-defined form of psoriasis frequently associated with streptococcal throat infection. This study tested the hypothesis that T cells in acute guttate psoriasis skin lesions may be activated by streptococcal superantigens. Peripheral blood as well as lesional and perilesional skin biopsies were analyzed for T cell receptor V beta repertoire using monoclonal antibodies against 10 different V beta families. Skin biopsies from all patients with acute guttate psoriasis, but not skin biopsies from patients with acute atopic dermatitis or inflammatory skin lesions induced in normal subjects with sodium lauryl sulfate, demonstrated selective accumulation of V beta 2+ T cells (P < 0.05). The expansion of V beta 2+ T cells occurred in both the CD4+ and the CD8+ T cell subsets. Sequence analysis of T cell receptor beta chain genes of V beta 2-expressing T cells from skin biopsies of patients with guttate psoriasis showed extensive junctional region diversity that is more compatible with a superantigen rather than a conventional (nominal) antigen-driven T cell response. All streptococcal isolates from patients with guttate psoriasis secreted streptococcal pyrogenic exotoxin C, a superantigen known to stimulate marked V beta 2+ T cell expansion. These data support the concept that acute guttate psoriasis is associated with superantigenic stimulation of T cells triggered by streptococcal superantigen(s).
近期研究表明，T细胞在银屑病的发病机制中起关键作用。点滴状银屑病是一种明确的银屑病类型，常与链球菌性咽炎感染相关。本研究检验了以下假设：急性点滴状银屑病皮肤损害中的T细胞可能被链球菌超抗原激活。使用针对10个不同Vβ家族的单克隆抗体，分析外周血以及皮损和皮损周边皮肤活检组织中的T细胞受体Vβ库。所有急性点滴状银屑病患者的皮肤活检组织，而非急性特应性皮炎患者或在正常受试者中用十二烷基硫酸钠诱导的炎症性皮肤损害患者的皮肤活检组织，均显示Vβ2 + T细胞选择性积聚（P < 0.05）。Vβ2 + T细胞在CD4 +和CD8 + T细胞亚群中均有扩增。对点滴状银屑病患者皮肤活检组织中表达Vβ2的T细胞的T细胞受体β链基因进行序列分析，结果显示广泛的连接区多样性，这更符合超抗原而非传统（普通）抗原驱动的T细胞反应。从点滴状银屑病患者分离出的所有链球菌菌株均分泌链球菌致热外毒素C，这是一种已知能刺激显著的Vβ2 + T细胞扩增的超抗原。这些数据支持了急性点滴状银屑病与链球菌超抗原触发的T细胞超抗原刺激相关的概念。
