Sarsfield P, Jones D B, Wright D H
University Department of Pathology, Southampton General Hospital, UK.
Histopathology. 1996 Mar;28(3):213-9. doi: 10.1046/j.1365-2559.1996.d01-416.x.
We present a study which describes the immunophenotype and distribution of accessory cells in 13 resections of terminal ileum from patients with Crohn's disease. A panel of antibodies working in paraffin-embedded tissue was employed and these included PGM1 (CD68), S-100 protein, WR18 (HLA class II), factor XIIIa and acid cysteine proteinase inhibitor. This study revealed a heterogeneity of accessory cell populations which was profoundly influenced by local inflammatory and repair mechanisms. Both acid cysteine proteinase activity and S-100 protein positive cells are identified in more actively inflamed areas. The acid cysteine proteinase activity positive dendritic cell population was particularly numerous in ulcer bases. S-100 protein positive dendritic cells had a more limited distribution in close proximity to the epithelium in inflamed but otherwise intact mucosa adjacent to the areas of ulceration. PGM1 revealed normal distribution of macrophages within histologically uninvolved areas and, in addition, also stained granulomas and large numbers of dendritic cells in the inflamed, ulcerated and scarred areas. Factor XIIIa positive dendritic cells were especially numerous in areas of active scarring where they co-localized with PGM1 positive cells. They were largely absent from the more superficial ulcerated areas. HLA class II was strongly expressed on mononuclear inflammatory and dendritic cells. The strength of epithelial staining for HLA class II reflected the intensity of adjacent inflammation, except on ulcer-associated epithelium which consistently showed up-regulation independent of the severity of the inflammatory process. This study shows that localized alterations in the accessory cell distribution in Crohn's disease correlate with different states in the evolution of the inflammatory and repair process of the disease. The more acute lesions are associated with recruitment of acid cysteine proteinase activity and S-100 protein positive dendritic cells while factor XIIIa stained dentritic cells are especially numerous in areas of scarring.
我们开展了一项研究，描述了对13例克罗恩病患者回肠末端切除标本中辅助细胞的免疫表型及分布情况。采用了一组针对石蜡包埋组织的抗体，包括PGM1（CD68）、S-100蛋白、WR18（II类组织相容性抗原）、凝血因子XIIIa和酸性半胱氨酸蛋白酶抑制剂。该研究揭示了辅助细胞群体的异质性，这受到局部炎症和修复机制的深刻影响。在炎症更活跃的区域可识别出酸性半胱氨酸蛋白酶活性及S-100蛋白阳性细胞。酸性半胱氨酸蛋白酶活性阳性的树突状细胞群体在溃疡底部尤为众多。S-100蛋白阳性树突状细胞在溃疡周围炎症但其他方面完整的黏膜中，紧邻上皮的区域分布更有限。PGM1显示巨噬细胞在组织学上未受累区域分布正常，此外，在炎症、溃疡和瘢痕形成区域也对肉芽肿和大量树突状细胞染色。凝血因子XIIIa阳性树突状细胞在活跃瘢痕形成区域特别多，且与PGM1阳性细胞共定位。在较浅表的溃疡区域基本没有。II类组织相容性抗原在单核炎症细胞和树突状细胞上强烈表达。II类组织相容性抗原的上皮染色强度反映了相邻炎症的强度，但溃疡相关上皮除外，其始终显示上调，与炎症过程的严重程度无关。这项研究表明，克罗恩病中辅助细胞分布的局部改变与疾病炎症和修复过程演变的不同状态相关。较急性的病变与酸性半胱氨酸蛋白酶活性和S-100蛋白阳性树突状细胞的募集有关，而凝血因子XIIIa染色的树突状细胞在瘢痕形成区域特别多。
