Wakugawa M, Yamada N, Nakagawa H, Tamaki K
Department of Dermatology, Faculty of Medicine, University of Tokyo.
Arerugi. 1995 Oct;44(10):1199-206.
To elucidate the active process of eosinophil infiltration in atopic dermatitis (AD), we performed patch testing using crude mite allergens on normal-appearing skin in adult AD patients with high levels of mite-specific IgE antibodies and analyzed positive reaction sites chronologically by histological and immunohistological methods. Positive reactions were observed in 6 out of 9 AD patients (66.7%), whereas none of 7 non-AD control subjects showed positive reactions. Skin biopsies were obtained from positive reaction sites at 2,6,12,24 and 48 hours after allergen challenge. Eosinophils were seen within postcapillary venules at 2 hours, followed by increased perivascular eosinophil infiltration at 6 hours which peaked at 24 and 48 hours. Epidermal eosinophilic spongiosis was also observed at 48 hours. The majority of infiltrating eosinophils showed positive reactions for BMK-13 and 15-59% of them were EG2 positive activated eosinophils. BMK-13, EG2 and anti-EP positive reactions were scattered throughout connective tissue and their areas were time-dependently increased. These findings suggest that eosinophil transmigration and activation play an important role in initiating early AD lesions induced by transepidermal mite allergen permeation.
为阐明特应性皮炎（AD）中嗜酸性粒细胞浸润的活跃过程，我们对螨特异性IgE抗体水平高的成年AD患者外观正常的皮肤进行了粗制螨过敏原斑贴试验，并通过组织学和免疫组织学方法按时间顺序分析了阳性反应部位。9例AD患者中有6例（66.7%）观察到阳性反应，而7例非AD对照受试者均未出现阳性反应。在过敏原激发后2、6、12、24和48小时从阳性反应部位获取皮肤活检样本。2小时时在毛细血管后微静脉内可见嗜酸性粒细胞，随后在6小时时血管周围嗜酸性粒细胞浸润增加，并在24和48小时达到峰值。48小时时还观察到表皮嗜酸性海绵形成。大多数浸润的嗜酸性粒细胞对BMK-13呈阳性反应，其中15 - 59%为EG2阳性活化嗜酸性粒细胞。BMK-13、EG2和抗EP阳性反应分散在整个结缔组织中，其面积随时间增加。这些发现表明嗜酸性粒细胞迁移和活化在由经表皮螨过敏原渗透诱导的早期AD病变起始中起重要作用。
