Giannelli G, Brassard J, Foti C, Stetler-Stevenson W G, Falk-Marzillier J, Zambonin-Zallone A, Schiraldi O, Quaranta V
Institute of Clinica Medica II, Universita degli Studi, Bari, Italy.
Lab Invest. 1996 Jun;74(6):1091-104.
Lichenoid lesions of the skin are characterized by a band-like dermal inflammatory infiltrate and structural alterations of the basement membrane (BM). The etiopathogenesis of these lesions, of which lichen planus (LP) is perhaps the prototypic example, is unknown. Acute cases of LP are accompanied by the destruction of epidermal BM, degeneration of basal keratinocytes with loss of tonofilaments and hemidesmosomes, vesicular alterations, and even blister formation. Chronic LP is characterized by hyperkeratosis and acanthosis in the epidermis, fibrosis, and dense infiltrate in dermis. We found that acute LP lesions are characterized by uneven or absent immunostaining for laminin-5, laminin-1, and collagen type IV. Distribution and activity of gelatinases matrix metalloproteinase (MMP)-9 and MMP-2, and a specific inhibitor of MMP-2, tissue inhibitor of metalloprotein-2, were analyzed. The expression and activity of MMP-2 were increased, whereas tissue inhibitor of metalloprotein-2 expression was weak in the involved areas during the acute phase of LP. Moreover, we demonstrated in vitro that MMP-2 is directly capable of digesting laminin-5 gamma 2 chains to yield a 80-kd fragment. We also observed a weak or absent staining of all examined integrin receptors in the acute LP lesions. In chronic lesions, the staining of BM components was similar to normal controls. In these sections, normal expression of gelatinases and inhibitor was observed. There was, however, up-regulation and altered polarity of integrin receptors. These results indicate a link between overexpression of gelatinases, BM disruption, and altered integrin expression. In LP, the digestion of BM by MMP-2 may contribute to the pathogenesis by inducing altered integrin expression in basal keratinocytes and ultimately blister formation.
皮肤苔藓样病变的特征是带状真皮炎症浸润和基底膜(BM)的结构改变。这些病变的病因发病机制尚不清楚,其中扁平苔藓(LP)可能是典型例子。急性LP病例伴有表皮BM破坏、基底角质形成细胞变性,张力丝和半桥粒丧失,水泡样改变,甚至水疱形成。慢性LP的特征是表皮角化过度和棘层肥厚、纤维化以及真皮致密浸润。我们发现急性LP病变的特征是层粘连蛋白-5、层粘连蛋白-1和IV型胶原免疫染色不均匀或缺失。分析了明胶酶基质金属蛋白酶(MMP)-9和MMP-2的分布和活性,以及MMP-2的特异性抑制剂金属蛋白酶组织抑制剂-2。在LP急性期,受累区域MMP-2的表达和活性增加,而金属蛋白酶组织抑制剂-2的表达较弱。此外,我们在体外证明MMP-2能够直接消化层粘连蛋白-5γ2链,产生一个80-kd片段。我们还观察到急性LP病变中所有检测的整合素受体染色较弱或缺失。在慢性病变中,BM成分的染色与正常对照相似。在这些切片中,观察到明胶酶和抑制剂的正常表达。然而,整合素受体有上调和极性改变。这些结果表明明胶酶过表达、BM破坏和整合素表达改变之间存在联系。在LP中,MMP-2对BM的消化可能通过诱导基底角质形成细胞中整合素表达改变并最终导致水疱形成而促进发病机制。