Yu H S, Kao C H, Yu C L
Department of Dermatology, Kaohsiung Medical College, Taiwan, Republic of China.
J Invest Dermatol. 1993 Jun;100(6):823-8. doi: 10.1111/1523-1747.ep12476728.
To test for autoantibodies in patients with vitiligo, skin biopsies from 16 patients with active vitiligo and 12 patients with stable vitiligo were examined by direct immunofluorescence. In periodate-lysine-paraformaldehyde-fixed biopsy specimens, the presence of IgG deposits in keratinocytes and the number of keratinocytes with focal IgG in active vitiligo were significantly greater than in stable vitiligo. To test whether the antibodies to normal human keratinocytes or melanocytes are present in vitiligo, we used an indirect immunofluorescent test and enzyme-linked immunosorbent assay to test the serum of 43 patients. With unfixed viable melanocytes, we found a granular pattern of IgG staining on the plasma membrane of melanocytes incubated with patients' sera but not in cells incubated with the control sera. With methanol-fixed melanocytes, however, we found a homogeneous pattern of IgG staining in the cytoplasm of melanocytes. With unfixed viable keratinocytes as targets, there was no deposit of IgG on the cells. A homogeneous pattern of IgG binding in the cytoplasm of methanol-fixed keratinocytes suggested the presence of antikeratinocyte autoantibodies to cytoplasmic keratinocyte components. The fluorescence staining for IgG binding was more prominent in active or extensive vitiligo. Vitiligo sera were cytotoxic for melanocytes but not for keratinocytes in vitro. Antimelanocytic antibodies may play a role in melanocytotoxicity, whereas antikeratinocyte antibodies may occur secondary to cellular damage.
为检测白癜风患者体内的自身抗体，对16例活动期白癜风患者和12例稳定期白癜风患者的皮肤活检组织进行了直接免疫荧光检查。在经高碘酸盐-赖氨酸-多聚甲醛固定的活检标本中，活动期白癜风患者角质形成细胞中IgG沉积物的存在以及出现局灶性IgG的角质形成细胞数量均显著多于稳定期白癜风患者。为检测白癜风患者体内是否存在针对正常人角质形成细胞或黑素细胞的抗体，我们采用间接免疫荧光试验和酶联免疫吸附测定法检测了43例患者的血清。对于未固定的活黑素细胞，我们发现与患者血清孵育的黑素细胞质膜上有IgG染色的颗粒状模式，而与对照血清孵育的细胞中则没有。然而，对于经甲醇固定的黑素细胞，我们发现黑素细胞的细胞质中有IgG染色的均匀模式。以未固定的活角质形成细胞为靶点时，细胞上没有IgG沉积。甲醇固定的角质形成细胞质中IgG结合的均匀模式提示存在针对细胞质角质形成细胞成分的抗角质形成细胞自身抗体。IgG结合的荧光染色在活动期或泛发性白癜风中更为明显。白癜风患者的血清在体外对黑素细胞具有细胞毒性，但对角质形成细胞无细胞毒性。抗黑素细胞抗体可能在黑素细胞毒性中起作用，而抗角质形成细胞抗体可能继发于细胞损伤。
