Rosner K, Ross C, Karlsmark T, Petersen A A, Gottrup F, Vejlsgaard G L
Department of Dermatology, Rigshospitalet, University Hospital of Copenhagen, Denmark.
APMIS. 1995 Apr;103(4):293-9. doi: 10.1111/j.1699-0463.1995.tb01109.x.
Current understanding of the immunological mechanisms involved in the pathogenesis of venous leg ulcers is insufficient. In this study the cellular composition of skin biopsies taken from the center, the edge, and 2 cm distant from the edge of venous leg ulcers was characterized quantitatively by immunohistochemical staining. In the epidermis the mean numbers of Langerhans cells (CD1a+) were four times lower at the edge of the ulcer compared to clinically intact epidermis 2 cm distant from the edge. In the dermis a statistically significant increase in the mean numbers of macrophages (CD68+) and neutrophils (NP57+) from the distant area towards the center of the ulcer was observed. No significant differences were observed in the distribution of T cells nor in the ratio of CD4+/CD8+ T-cell subsets between the different regions of the ulcer. About 30% of T lymphocytes were CD8+ in all microenvironments. The center and the edge of the ulcer were dominated by macrophages comprising 63% and 53% of the cells respectively, while T lymphocytes dominated the distant area. The area 2 cm distant from the edge was also heavily infiltrated by macrophages and neutrophils. B cells (CD22+) and NK cells (CD56+) were relatively rare in all areas, comprising less than 3% of the dermal infiltrate. In conclusion, local microenvironments each with a different cellular composition can be defined within venous leg ulcers.
目前对静脉性腿部溃疡发病机制中免疫机制的理解尚不充分。在本研究中，通过免疫组织化学染色对取自静脉性腿部溃疡中心、边缘以及距边缘2厘米处的皮肤活检组织的细胞组成进行了定量分析。在表皮中，溃疡边缘的朗格汉斯细胞（CD1a+）平均数量比距边缘2厘米处临床完整的表皮低四倍。在真皮中，观察到从远处区域到溃疡中心巨噬细胞（CD68+）和中性粒细胞（NP57+）的平均数量有统计学意义的增加。在溃疡的不同区域之间，T细胞分布以及CD4+/CD8+ T细胞亚群比例均未观察到显著差异。在所有微环境中，约30%的T淋巴细胞为CD8+。溃疡的中心和边缘以巨噬细胞为主，分别占细胞的63%和53%，而远处区域以T淋巴细胞为主。距边缘2厘米处的区域也有大量巨噬细胞和中性粒细胞浸润。B细胞（CD22+）和NK细胞（CD56+）在所有区域相对较少，占真皮浸润细胞的比例不到3%。总之，在静脉性腿部溃疡内可以定义具有不同细胞组成的局部微环境。
